CARIBBEAN GROUP FOR COOPERATION IN ECONOMIC DEVELOPMENT YOUTH DEVELOPMENT IN THE CARIBBEAN DISCUSSION DRAFT Caribbean Country Management Unit Latin America and the Caribbean Region The World Bank This paper was prepared under the auspices of the Caribbean Group of Cooperation in Econornic 'Development .(CGCED). Established' in 1977, ,the CGCED has evolved .into a forum for policy dialogue and aid coordination among the Caribbean countries, international financial institutions, bilateral donors, non-governmental. orgatiizations, and private sector enterprises. A meeting. of the COCED has been held every two years in Washington, DC and. chaired by the World Bank. In addition to country strategy papers, the following studies have. been prepared for the 2002 meeting:' Caribbean Economic Overview 2002: Macr.oeconomic Volatility, Household Vulnerability,, and Institutional and Policy Responses (World Bank) Implementation of the Caribbean Single Market and Economy (Messrs. Brewster, Dolan, and Stewart) Development Assistance and Economic Development in the (Caribbean. Region: Is There a Correlation? (World Bank) Natural Hazard Risk Management in the Caribbean. Revisiting the Challenge Natural Hazard Risk Management in the Caribbean. Good Practices and Country Case Studies (Technical Annex) (World Bank) Youth Development in the Caribbean (World Bank) YOUTH DEVELOPMENT IN THE CARIBBEAN Report No. 24163-LAC June 2002 Caribbean Country Management Unit Latin America and the Caribbean Region The World Bank YOUTH DEVELOPMENT IN THE CARIBBEAN TABLE OF CONTENTS PAGE No. Table of Contents .............. iii Preface ....... ,v Acronyms .............. vi Executive Summary .............. vii 1 Introduction .1 Backqgmvund andjusufication .1 Objectives, Appmach and Data Sources .2 Caribbean Context.4 Report Or,ganiation ................................7........7 2. Framework for Analyzing Caribbean Youth. 8 Definitions.8 Conceptual Framework .10 3. Negative Outcomes Observed Among Caribbean Youth .16 Early Sexual Initiation and Pregnang. .16 HI V/AIDS.17 Physical and SexualAbuse .19 School Leavin~g.20 Unemtplo)'ment.20 Cnime and Violence.22 Substance Abuse and Drug Dealing.24 Social Exclusion.26 4. Sources of Positive and Negative Youth Outcomes.29 Individual.29 Micro-Environment.32 Macro-Envwironment.39 Interconnectedness offactors.45 Final Thoughts.47 5. The Costs of Risky Adolescent Behavior.48 School Leaving.48 Adolescent Pregnan~y.51 Crime.53 HI V/AIDS.55 Unemployment.57 Final Thou,ghts.58 Sc oo L av n ....................................................................................2 6. Youth Development Policies and Programs ..................................... 59 Poliy Context ..................................... 59 Youth Serzices and Programs ..................................... 62 Existing Re,gionalPrograms ..................................... 68 Final Thomghts ..................................... 69 7. Conclusions and Policy Directions ..................................... 71 Caribbean Youth Development - Entgy PointsforAction ..................................... 74 Movin,g Forward - Next Steps ..................................... 81 Bibliography .82 Annex 1. Methodological Description for Chapter 4 Annex 2. Lifetime Earnings Figures Annex 3. Methodology For Cost Calculations, Chapter 5 Annex 4. Caribbean Youth Policies And Programs iv PREFACE This report examines youth development in the Caribbean today. Organized into seven chapters, the report provides an overview of the risks Caribbean youth are facing, evidence of the protective and risk factors underlying the problems youth are facing, an estimation of costs of risky youth behaviors and an overview of the policy framework and the types of programs in place that target youth. The report responds directly to a request by the Caribbean Group for Cooperation and Economic Development at its 2000 consultative meeting for the Bank to analyze the situation of Caribbean youth. It also provides an important input into the Bank's strategic social agenda for the Caribbean. The report also follows on other World Bank economic and sector work prepared in the Caribbean including: A Review of Gender Issues in the Dominican Republic, Haiti and Jamaica Report (21866-LAC May 2002), the Domninican Republic Poverty Assessment (21306-DR, January 16, 2001), the Trinidad and Tobago Youth and Social Development (20088-TR, June 2000), the HIV/AIDS in the Caribbean: Issues and Options report (20491-LAC, June 2000) and the Violence and Urban Poverty in Jamaica: Breaking the Cycle report (15895-JM,January 1997). Wendy Cunningham and Maria Correia wrote this report based on background papers written by Robert Blum, Lincoln Williams, David Luther, Julia Hasbun, and Arlette St. Ville (consultants) and Wendy Cunningham and Enrique Hennings (LCSPG); expert advice from Patrice Lafleur and Armstrong Alexis (Commonwealth Youth Programme); and invaluable peer review from Gary Barker (consultant). The Country Director is Orsalia Kalantzopoulos, the Lead Economist is Ali Khadr, the Sector Director is Ernesto May, the Chief Economist is Guillermo Perry and the Vice-President is David de Ferranti. v ACRONYMS AIDS Acquired Immune Deficiency Syndrome CGCED Caribbean Group for Cooperation and Economic Development CARICOM Catibbean Community CEE Common Entrance Exam CXC Caribbean Examinations Council CYP Commonwealth Youth Programme HIV Human Immunodeficiency Syndrome ILO International Labour Organa-tion LAC Latin America and the Caribbean MLG Ministry of Local Government Jamaica) NGO Non-Governmental Organization NYC National Youth Council OECS Organization of Eastem Caribbean States PAHO Pan American Health Organization PIOJ Planning Institute of Jamaica STI Sexually Transmitted Infection UN United Nations US United States of America UNDCP United Nations International Drug Control Programme WHO World Health Organization vi EXECUTIVE SUMMARY Introduction This report responds to the growing concern over issues facing Caribbean youth today, and specifically, to a request made by the Caribbean Group for Cooperation and Economic Development (CGCED) to report on the subject of youth at the Sixteenth CGCED being held in June 2002. Much has been written about the problems plaguing Caribbean youth, but much less is known about their underlying causes, and what should be done about them. This report attempts to contribute to the debate and discussion on these questions. Caribbean youth are generally happy and healthy. They attend school, participate in social and cultural events, enjoy the loving support of a family and peers, and plan for the future. However, factors are present in the Caribbean that have the potential to de-rail the process of positive youth development. This report focuses on those who are at-risk of or have deviated from healthy behaviors. The objectives of this report are threefold. It aims to: (1) identify the risk and protective factors and determinants of youth behaviors and development; (2) demonstrate that the negative behaviors of youth are costly not only to the youth themselves but to society as a whole; and (3) identify key intervention points for youth development, taking into account identified risk and protective factors for the Caribbean. The report is based mainly on the following data sources: a Pan-American Health Organization data set (1997- 1999) on the behaviors of school-going adolescents from nine Caribbean Community (CARICOM) countries; focus groups and in-depth interviews carried out in the Dominican Republic and Saint Lucia in 2002; household or labor force surveys (1995-1999) for Saint Lucia, Guyana, Dominican Republic and Jamaica; and consultations on study findings with stakeholders from the Dominican Republic and Jamaica. This report relies on data sources and studies from as many Caribbean countries as possible, but focuses on the Bank's client countries, these being the OECS countries, Belize, Dominican Republic, Guyana, Haiti, Jamaica, Suriname, and Trinidad and Tobago. It places less focus on Haiti, however, due to socioeconomic disparities between Haiti and its neighboring Caribbean countries. Conceptual Framework For the purposes of this study, youth is defined as spanning the adolescent period between 10 to 24 years of age. Youth or adolescent development thus refers to the physical, social, and emotional processes of maturation that occur during the 10 to 24 year age period. The adolescent period represents the transition from childhood to adulthood, with biological processes driving the initiation of adolescence and societal factors largely determining the initiation of adulthood. This study uses an 'ecological' framework to demonstrate the linkages between: (1) the underlying risk and protective factors of youth behaviors; (2) youth outcomes; and (3) vii subsequent adult outcomes. It is termed 'ecological' because the framework shows the relationship between the individual adolescent and his/her environment. Risk factors are those factors that increase the likelihood of experiencing negative outcomes. Protective factors, assets, resources and resilience counterbalance the risk factors. Risk and protective factors exist at three levels: at the level of the individual; the micro-environment (comprising family; social networks, peers and role models; community and neighborhood); and the macro-environment (including mass media, economy, public institutions, cultural and historical background, and social norms on gender). A simplistic version of the model shows that risk and protective factors affect youth outcomes, which in turn, shape the kind of adults the youth will become. Negative risk outcomes can become nsk factors. Risk and Protective Factors * Micro-environment YAut Outcomes * Individual .: Key Findings While the Caribbean is Culturally Diverse, Many Negative Youth Outcomes are Common Across Countries -And Particular to the Caribbean Region Despite historical, political, cultural, and linguistic diversity, the negative outcomes observed among Caribbean youth are quite similar. These include: early sexual initiation, HIV/AIDS, sexual and physical abuse, school leaving (drop-out and exit), unemployment, crime and violence, substance abuse and drug dealing, and social exclusion. Negative outcomes that are particular to Caribbean countries are briefly described below. * Sexual andphysical abuse is high in the Caribbean - and socially accepted in many Caribbean countries. Corporal punishment continues to be widespread in Caribbean schools and homes - particularly among boys. And according to the nine-country CARICOM study, one in ten school-going adolescents have been sexually abused. The high incidence of sexual abuse among Caribbean boys stands out vis-a-vis other countries. Even more noteworthy is the "disturbing pattern of cultural 'normalcy' in child and physical and sexual abuse" in the Caribbean (Barrow 2001). * The onset of sexual initiation in the Caribbean is the earliest in the world (with the exception of Africa where early sexual experiences take place within marriage). Early sexual debut is known to predispose young people to early pregnancy, HIV/AIDS and other STIs. viii * The region has the highest incidence of HI V/AIDS outside ofAfrica - and youth are an at-risk group. Among other things, HIV/AIDS is linked to cultural values about sexuality, which are particular to the Caribbean. * The incidence ofrage amongyoungpeople is extremely Aighr 40 percent of school-going CARICOM students reported feelings of rage. High rates of sexual abuse and physical abuse among children likely play out in rage among young people, which can affect their school performance and lead to violence. * Youth unemployment is especially elevated in some Caribbean countries. International comparisons indicate that Barbados, the Dominican Republic, Trinidad and Tobago, and Jamaica have high rates. Indeed Jamaica - at 33 percent - has the highest rate of unemployment in the Americas. * In contrast to the U.S., which has high levels of youth violence, the proportion of Caribbean adolescent males who carry firearms is extremely high Fully one- fifth of students had carried a weapon to school in the 30 days previous to the survey and nearly as many had been in a fight using weapons. Gang violence is also high in the Caribbean, with 20 percent of male students and 12 percent of female students at one point having belonged to a gang. * While data on drug use are scanty, anecdotal evidence suggests a widespread social acceptance of alcohol and marijuana in some Caribbean countries, both among in-school and out-of-school youth (Barker 1995). Out-of-school youth ages 13-19 years are most at-risk of substance abuse as well as drug dealing (ibid.). Further complicating the situation, the Caribbean is a major trans-shipment point for drugs entering the U.S. and Europe. Costs to Risky Adolescent Behavior are High Problems plaguing Caribbean youth are costly. Although it is impossible to put a value on a human life or on the range of positive and negative externalities generated by youth, rough estimates show that losses to society from risky youth behaviors such as teen pregnancy, school leaving, crime, and HIV/AIDS - both in terms of direct expenditures and foregone productivity - reach into the billions of dollars. Some rough calculations are as follows: * The total net costs over the lifetime that are attributed to each cohort of adolescent mothers is estimated be US$63 million in Jamaica. * School leavers cost Guyana into the billions of dollars if one considers all school leavers and the cost of foregone earnings over their lifetime. * Data for Trinidad and Tobago show that the most basic direct and indirect costs of crime amount to about US$11,813 per capita over six months per offender, which includes the cost of arrest, court appearances, the six months of incarceration and foregone productivity. ix * The indirect costs of AIDS, representing the foregone production of individuals who dies prematurely, ranges from 0.01 to 0.37 percent of GDP in just the year 2000. * If youth unemployment were eliminated, the increase in GDP would range from 1.36 percent in Barbados to 7.54 percent in Jamaica. Youth are Not the Problem Youth are not the problem but a product of their micro- and macro- environments. For the most part, they rationally react to the situation in which they find themselves. Drug dealing, for example, would be rational for a young person, if no other forms of employment existed, the family needed money, and the drug lord provided protection and a sense of belonging. Evidence from this study suggests that in the Caribbean, the following factors are the most important in determining the outcomes of youth: * Family. The family is the strongest protective and risk factor for youth behavior and outcomes. It is protective in that family connectedness, appropriate levels of parental discipline, moral guidance, protection from dangers in the adult world, and economic support, allow young people to acquire personal and social skills while young. Conversely, parental displays of negative behaviors (substance abuse, violence), physical, sexual, and emotional abuse by family members, and the absence of parental guidance and support are risk factors. * Schools. Connectedness to schools is highly protective against all risky behaviors including using drugs and alcohol and engaging in violent or sexual activitv. For example, among school-going adolescents, the probability of sexual behavior falls by 30 percentage points for boys and 60 percentage points for girls if they are connected to schools. Conversely, the school system can have devastating effects on those youth with low academic achievement by not granting them a place in school and, as a corollary, making them feel socially excluded and "worthless". * Poverty. Young people in disadvantaged situations are often forced to find work and have few options except informal sector work, drug trade, or prostitution. Parents - particularly single parents - are more likely to be absent from the household, and frequently leave youth and children unattended and unsupervised. Young girls in some countries - often at the encouragement of their mothers - will engage in opportunistic sex to relieve poverty and contribute to household income And childbearing is still used a strategy for gaining economic support in countries like Jamaica. Lastly, income inequality - which is demonstrated by the presence of drug dons, foreign tourists, and the media - encourages the engagement of youth in 'easy money' activities, including drugs and commercial sex work. * Gender. Gender is a central risk factor in Caribbean societies. Almost all children in Jamaica and Saint Lucia, for example, are born out of wedlock, which means that many fathers are absent from the lives of their children. The exclusionary nature of fathering dates back to slavery when men were not permitted to play the role of x spouse and father. At the same time, social norms promote sexual prowvess and multi-fathering among men. These norms have important intergenerational effects. Children of absent fathers are more likely to fare poorly in school. And men's inability to provide economic support means that women often raise children on their own, leading to greater levels of poverty and vulnerability among these women and their children. A key message that arises out of research findings is the interconnectedness of factors that predispose risky behavior and outcomes. Empirical analysis of risk and protective factors carried out using the nine-country CARICOM data demonstrates the complex inter-relations between family, school, and community factors in the microenvironment. Study results also show that changing any one of the risk factors will improve outcomes. These findings are consistent with the international evidence. Many Youth Programs Exist but Littde is Known about Their Effectiveness Much is being done in the area of youth development, with government and the NGO sector both active in different ways. Innovative private sector and private-public sector initiatives for youth also look promising. And at the regional level, the Commonwealth Youth Programme has made significant progress in assisting Caribbean countries to develop youth policies and in building a cadre of youth and professional staff qualified to work on youth issues. But limited information on the situation of youth themselves - particularly out-of-school youth who are 'unattached' to formal institutions - and on the nature and effectiveness of the multitude of programs that exist makes evaluation and informed planning difficult. The crosscutting nature of youth - which implies a need for effective coordination across institutional lines - presents an additional challenge. Entry Points for Action and Strategy Forward While the transitional period from childhood to adulthood is unquestionably a challenge for many, the majority of Caribbean youth make the transition unencumbered. Yet the report demonstrates that there are serious social and economic consequences associated with not addressing the minority group of youth who are at-risk of negative behaviors or are suffering the impact of their negative circumstances - not only for the youth themselves and their families, but for society-at-large. This situation thus calls for decisive action of the part of Caribbean policy makers and governments in the area of youth development. Governments and policy makers should focus on the following key areas: sexual abuse, physical abuse, early sexual debut and early'pregnancy, AIDS/HIV prevention, access to education and school retention, crime and violence; and substance abuse. Some actions should target youth broadly while others should be directed at specific at-risk groups (primary risk, secondary risk, or tertiary risk). The report suggests the following areas of intervention: 1. Reform the Education System and Maximize the Protective Effects of Schools by improving access and retention, improving the quality of education, xi eliminating corporal punishment, using educational activities and campaigns to reduce violence and promote conflict resolution, and institutionalizing permanent school-based information and education campaigns on sexual abuse and exploitation. 2. Upgrade the Public Health Care System by establishing new protocols, tools, and techniques for reaching youth and their families (including developing mental health approaches), upgrading the skills of existing medical health professionals, training graduates on new protocols, and ensuring that protocols include confidentiality and gender-differentiated services. Ensure that the nursing and medical professions play a role in condemning sexual and physical abuse of children and adolescents and putting the issue on the public health agenda. 3. Institutionalize National Level Mentoring Systems for At-Risk Youth by identifying existing effective programs and creating incentives for NGOs and the private sector to expand these programs to the national level. 4. Reform and Strengthen Legal, Judicial and Policing Systems by improving juvenile justice (review and harmonization of laws, strengthening of family courts, training of legal practitioners, modernizing of the courts, and use of alternative custodial sentences); increasing the control of weapons; and reforming the police. 5. Use the Media and Social Marketing to change norms and values related to the following key risk areas for youth: sexual abuse and exploitation; early sexual initiation; corporal punishment and physical abuse; alcohol consumption and drug use. Use social marketing techniques - which draw on commercial marketing principles - to increase the effectiveness of communication and education techniques. 6. Make Families and Fathers a Top Public Policy Issue: put in place incentives to make parents accountable for their children Oegal, tax breaks) and use the education system, the public health system and the media to teach at-risk parents fundamental parenting skills; put in place incentives to increase fathers' rights and responsibilities to their children. 7. Strengthen Community and Neighborhood Supports to Adolescents and Their Families by establishing youth funds to finance innovative NGO and community-based initiatives for youth; and by experimenting with the integrated services model for youth and families. The latter involves a collaborative arrangement between the public, NGO and private sectors in the provision of integrated cohesive services for youth and children. Moving Forward - Next Steps To ensure a coordinated, concerted and sustained effort, this report recommends a region-wide approach to youth development in the Caribbean. Clearly, policy-making and programming on youth need to take place at a national level. But because youth is a crosscutting issue and, for the most part, youth lack an organized and vocal constituency, the xii implementation of youth-centered policies and programs is difficult. A regional effort that provides oversight would thus ensure that the topic remains on the regional agenda. A regional thrust is also justified based on the commonalities of youth issues across countries and the economies of scale that could be achieved in aligning efforts - in terms of improved efficiency and increased cross-country learning. As for next steps the report recommends a high level regional conference to discuss details and implementation of actions, and define interventions based on each Caribbean nation's country context. The regional conference would convene top-level decision makers across government to devise an integrated strategy for the cross-sectoral issue of youth development. This would put youth at the center of a collaborative governmnent policy rather than relegating youth and their challenges to marginalized sub-ministries with little power and resources. xiii 1. INTRODUCTION BACKGROUND AND JUSTIFICATION 1. There is a growing concern among the public and policy makers alike over the situation of Caribbean youth today. Although the majority of youth are doing well, there is increasing recognition of those who are not able to overcome the challenges presented to them by their environment. Temas such as "in crisis", "plight", "in peril" are commonly used in reference to Caribbean youth (Danns et al 1997, Williams 2002). The concerns that have been raised over and over again in the discourses and literature on youth in the Caribbean include the spread of Acquired Immune Deficiency Syndrome (AIDS) among young people, the threat to well being by early initiation into sexual activity and teenage pregnancy, the pervasive youth unemployment, the inequality of education, the involvement of youth in drug trade and crime and violence as an altemative to unemployment and poverty, and the social exclusion of youth. The Commonwealth Youth Programme's publication "Tomorrow's Adults: A Situational Analysis of Youth in the Commonwealth Caribbean" notes that while youth would legally be adults from the age of 18 in most countries, many young people in the Caribbean are denied passage into adulthood due to labor market constraints, lack of participation in decision-making processes, constraints to ownership of property and goods, and lack of status and role in society (Danns et al. 1997). 2. Caribbean youth issues have emerged during volatile macroeconomic conditions. Over the last two decades, many Caribbean nations experienced economic decline and stagnation resulting from a loss of their preferential treatment in agriculture products, depressed market for minerals, losses due to lack of market diversification, stagnation of the manufacturing sector in the face of increased competition, and the increasing vulnerability of the tourism sector. Several countries thus have implemented structural adjustment and stabilization programs, with corollary cutbacks in health, education, housing, and social welfare programs. Global economic recession, debt service obligations and declines in development assistance have prevented many Caribbean nations from economic recovery and growth. 3. But is it true that many youth in the Caribbean are at-risk? And is the situation of Caribbean youth significantly different from that of other countries in the face of economic downturn and stagnation? While a broad term, at-risk generally refers to youth who face "environmental, social and family conditions that hinder their personal development and their successful integration into society as productive citizens". For most youth worldwide, the critical transition period from childhood to young adulthood is delicate and challenging, and hinges on the adequate support and guidance from family, schools, and society at large (Feldmen and Elliott 1997). The literature on youth in the Caribbean and the findings of this report suggests that negative youth outcomes are a result of failures on the part of families, government, and society as a whole to provide the appropriate and adequate supports for young people to grow into responsible and productive adults. 4. While there has been much debate and discussion on the challenges Caribbean youth face, relatively little has been done to gain an understanding of the nature of their problems, the underlying causes of youth risks and behaviors and the corollary policies and programs required to address the issues. Youth development and youth at-risk have been on the agendas of most Caribbean governments for some time. According to Huggins (1998), most Caribbean countries have identified youth as a target for social development and welfare planning, having set up youth desks and departments in government, assigned public resources for youth, and funded programs specifically for youth (cited in Alexis 2000). However, while attention has been dedicated to youth, limited empirical analysis and evaluation have been carried out to underpin these programs (ibid.). The focus of youth programs has been on leisure and service to the community rather than developing a good understanding of the needs of and challenges faced by youth and how meeting these needs and addressing these challenges can lead -to the overall economic and social development of societies as a whole in the Caribbean. 5. Recognizing the importance of youth issues and the need for an improved empirical basis for youth programs, governments in the Caribbean have requested the Bank's assistance to better understand the nature of youth issues and what needs to be done to improve the conditions for youth, to examine the costs of not investing in youth given competing demands for resources, and to identify the role of the state and other actors in providing services to youth. Specifically, in 2000, the Caribbean Group for Cooperation and Economic Development (CGCED) selected "youth" as one of the featured topics at its 2002 June meeting. This report serves as the World Bank's main contribution to youth development for the June meeting. OBJECTrvES, APPROACH AND DATA SOURCES Objectives 6. This document has three specific research objectives: (a) to identify the risk and protective factors that affect youth development in the Caribbean; (b) to demonstrate that the issues facing Caribbean youth are costly not only to themselves but to society as a whole; and (c) to identify key intervention points for youth development, taking into account identified risk and protective factors Data and Methodology 7. A youth development model, based on the public health literature and adapted to the Caribbean, serves as the organizing framework to the report. This model organizes the influences of youth development by identifying risk and protective factors within the macro- environment; the micro-environment (peers, family and community) and the individual him/herself. 2 8. For the analysis, the report draws on both original data collection and analysis and a review of existing literature. The primary data sources were: * Pan-American Health Organization (PAHO) health data (1997-1999). A cross-sectional data set from nine Caribbean Community (CARICOM) countries - Antigua, Bahamas, Barbados, British Virgin Islands, Dominica, Grenada, Guyana, Jamaica, and Saint Lucia.' - which includes information on youth behaviors and their causes. The data were collected in schools, by statisticians at the ministries of health in each country. Sample size was representative of school-going teenagers within each country, which does not represent all youth since many leave school prior to graduation. * Focus groups and in-depth interviews from the Dominican Republic and Saint Lucia (2002). Qualitative data were collected from 26 focus group discussions with young men and women and 27 in-depth semi-structured interviews with youth experts in the Dominican Republic and Saint Lucia. Sixteen focus groups were comprised of 6-10 youth age 14-24 years who were considered at risk of engaging in unhealthy behaviors or who currently do engage in such behaviors. The samples were drawn from juvenile detentions centers, church groups, community groups, schools, and a whole range of youth in both rural and urban areas of the countries. The remaining focus groups were youth not at risk (control groups) and adult parents or peers of youth. Discussions with all the focus groups emphasized pre-conditions that lead to unhealthy youth behavior and the motivation for participation in such behavior. In Saint Lucia, focus groups were also held with the parents/adult peers of the at-risk youth. The structured interviews with youth experts served for triangulation and to better understand the breach between the understanding of those who work with youth and the youth themselves. * Household/Labor Force surveys (1995-1999). Household or labor force surveys for Saint Lucia (1995), Guyana (1999), Dominican Republic (1998), and Jamaica (1998) were used to cost-out the youth behaviors. Country selection was based solely on the availability of data. 9. Data sets are used for different purposes throughout the report. The analysis of risk and protective factors was based on the qualitative data and econometric analysis of the PAHO data. The analysis of the cost of risky youth behavior relied on household and labor force surveys as well as databases of international organizations including PAHO, the International Labour Organization (ILO), and the United Nations (UN). The review of programs and the existing network for youth support in the Caribbean relied on the semi- structured interviews. All sections were heavily supported with existing literature. I The survey was a collaborative effort between the ministries of health in the nine countries, PAHO, and the World Health Organization (WHO) Collaborating Center in Adolescent Health at the University of iMinnesota, tinneapolis. 3 Approach 10. A multi-disciplinary international team - including Caribbean experts - was responsible for carrying out this study. Report preparation was based on a multi-stage process, which involved: (a) carrying out consultations with government and civil society representatives in Barbados and Saint Lucia in March 2002; (b) carrying out focus groups and semi-structured interviews with key experts in Saint Lucia and the Dominican Republic in February to March 2002; (c) conducting an author's meeting in the Dominican Republic in April 2002 to identify key lessons and policy recommendations; (d) carrying out consultations on key findings and main messages with Government and civil society stakeholders in the Dominican Republic and Jamaica (including youth groups in both countries) in April and May 2002 respectively. 11. Future stages include: presenting the report at the June 2002 CGCED meeting in Washington D.C., holding a Caribbean regional meeting to fine tune recommendations in September 2002 (proposed), and publishing and disseminating the report. CARIBBEAN CONTEXT Teitorial Scope 12. Definitions of the territorial scope of the Caribbean vary. According to World Bank (2000a), the "wider" Caribbean region includes: * The sovereign-state members of CARICOM, including both island-nations (Antigua and Barbuda, the Bahamas, Barbados, Dominica, Grenada, Haiti, Jamaica, Montserrat, St. Kitts and Nevis, Saint Lucia, St. Vincent and the Grenadines, and Trinidad and Tobago) and the mainland countries of Belize im Central America and Guyana and Suriname in South America. * Spanish-speaking Cuba and the Dominican Republic. * The semiautonomous states of the Kingdom of the Netherlands (Aruba and the Netherlands Antilles island of Bonaire, Cura,ao, Saint Marten, Statia and Saba). * The British Overseas Territories, that is, Anguilla, Bermuda, British Virgin Islands, Cayman Islands, and the Turks and Caicos Islands. * The U.S. commonwealth of Puerto Rico and territory of the U.S. Virgin Islands. 4 * The territories of the Republic of France consisting of French Guyana, St. Marten, Guadeloupe, and Martinique. 13. The Caribbean is a multiethnic region with many cultural differences. There are English-speaking countries (e.g. Trinidad and Tobago), Spanish-speaking countries (e.g. the Dominican Republic), French-speaking countries (e.g. Haiti), and Dutch-speaking countries (e.g. Suriname). The majority of the population is of African descent although there are also people of European, Hispanic, and Asian ancestry (e.g. East Indians in Trinidad and Tobago and Guyana). 14. The mainland states of Belize, Guyana, and Suriname, which by virtue of language and heritage form part of the Caribbean region, are much larger in land mass than the island states of the Caribbean: Belize (29,963 km2 population 215,000), Guyana (219,470 kin2, population 813,000), and Suriname (163,820 kM2, population 437,000). The island states of the Caribbean vary in size and population from Anguilla (91 km2 and 8,000 inhabitants) to Jamaica, 11,424 km2 and a population of 2,447,000. 15. Historically, the Caribbean region has been strongly influenced by Europe and the United States. Many of the English-speaking Caribbean countries have modeled their educational, legal system and political systems on the United Kingdom. The countries of the English-speaking Caribbean have a combined population of around 6.7 million scattered over the Caribbean Sea, whose farthest points span about 3,500 kilometers between the coast of Belize and Guyana. The Bahamas and the Dominican Republic are economically reliant on the United States. France and Holland also have strong links with some of the non-English speaking countries, for example Martinique and Cura,ao. Therefore, there has been much migration from these countries to the Caribbean. The Caribbean is a major tourist destination, attracting visitors from many parts of the world. Similarly, over the past 40 years, for economic reasons, many Caribbean citizens have migrated, primarily to the United States, Canada, and the United Kingdom. There is also much business travel within and outside the Caribbean. 16. For the purposes of this report, the Caribbean area of focus includes the Bank's client countries, these being the Organization of Eastern Caribbean States (Anguilla, Antigua and Barbuda, British Virgin Islands, Domrinica, Grenada, Montserrat, St. Kitts & Nevis, Saint Lucia, St. Vincent and the Grenadines) as well as Belize, the Dominican Republic, Guyana, Haiti, Jamaica, Suriname, and Trinidad and Tobago. However, given the disparity in socioeconomic conditions between Haiti and its Caribbean neighbors, limited focus is placed on that country. Demographics of Caribbean Youth 17. Caribbean youth make up about 30 percent of the population (see Table 1.1) with data for available countries indicating that Saint Lucia has the highest proportion of youth age 10-24 years (34 percent) and St. Kitts and Nevis having the lowest proportion (24 percent). 5 Table 1.1: Total Population by Age Group for Some Caribbean Countries St. Vincent and Dontinican the Grenadines St. Kitts and Nevis Grenada Republic Jamaica Guyana Saint Lucia Barbados Year=2000 Year=2000 Year=2000 Year= 1998 Year=1997 Year=1999 Year=1995 Year=1995 Population l'opulation Population Population Plopulation Plopulation l'opulation lPopulation Age % of Total by % of Iotal by % of Total by % of ''otal by % of Total by % of Total by % of ''otal by % of 'Iotal by group Population Age Group Poptilation Age Group Population Agc Group Population Agc Group Population Age Group Populatioi Age Group Population Agc Group Population Age Group 0-4 11.7 13,455 7.8 3,198 10.0 9,800 11.7 968,218 11.5 293,199 12.1 103,909 9.1 13,235 7.5 19,899 5-9 13.9 15,985 9.9 4,049 11.9 11,662 13.0 1,073,871 11.7 298,052 12.3 105,193 12.4 18,035 8.2 21,742 10-14 12.4 14,260 9.3 3,823 13.4 13,132 11.6 953,360 11.5 293,965 11.2 96,120 12.7 18,471 8.3 22,022 I5-19 41:2 4.2,88 8.2 $152 1.2 10,976 iO' 6' 87,59.6 9.6 243,907 i O'.0 85,849 12f2 17,44 9.1 24,20 20-24 l8.8 10;120 6.6 2,686, 7.6 - 7648 8.9 O 735,449 '8.4 214,2814 8.6 73,609 J9.i ,i30235 8.6 22,726 25-29 ,6;9 7,35 7.4 3,045 6:5 6,370 7.8',44,653 8.6 219,389 8.6 73951 8.4 12,217 9.3 24,5390 30-34 .7.4 8,510 7 3i6 6.4 6,272 7:4 609,985 7.3 i85,420 ' 76 2 9,017 8.8 23,3508 35-39 5.9 6,785 8.9 3,659 7.4 7,252 5.9 488,649 6.2 157,837 7.4 63,252 7.1 10,326 7.4 19,524 40-44 5.0 5,750 5.8 2,358 5.1 4,998 5.0 409,408 4.5 115,952 6.3 53,666 3.9 5,672 5.9 15,553 45-49 1.7 1,955 6.4 2,624 3.5 3,430 4.1 340,073 3.8 980,74 4.6 38,944 3.7 5,381 4.2 11,078 50-54 3.4 3,910 3.3 1,343 2.9 2,842 3.5 290,548 3.1 79,429 3.3 28,588 3.3 4,800 3.8 10,152 55-59 2.5 2,875 2.8 1,138 2.8 2,744 2.6 215,435 3.1 79,940 2.3 19,601 2.2 3,200 3.4 8,927 60-64 3.5 4,025 3.8 1,538 3.3 3,234 2.6 213,784 3.0 76,620 2.0 17,461 2.5 3,636 3.9 9,157 65+ 5.7 6,555 12.4 5,084 8.0 7,840 5.3 434,171 7.8 197,935 4.0 34,579 7.2 10,472 11.8 31,264 Total 100.0 115000 100.0 41,010 100.0 98,000 100.0 8,254,200 100.0 2,554,000 100.0 855,920 100.0 145,440 100 264,137 Sources: World Development Indicators (World Bank, Washington, DC, 1997), PAHO Core Health Data System 2000, Living Standards Measutrement Study (LSMS) - World Bank, 1997-1999. 6 REPORT ORGANIZATION 18. The report is organized as follows: subsequent to this introductory chapter, chapter two provides a framework for analyzing youth development, presenting an integrative model of risk and protective factors for vouth development and subsequent adult health and well- being in the context of the Caribbean. Chapter three reviews negative outcomes observed among Caribbean youth. Chapter four presents findings of the analysis of risk and protective factors of negative youth outcomes based on qualitative and qualitative analysis of Caribbean data and information, as well as other sources. Chapter five puts forward an argument for investing in youth by presenting an analysis of cost estimations of the risk-v behaviors associated with youth. Chapter six presents a discussion on policies and programming related to youth in the Caribbean. And finally, Chapter seven provides conclusions, a proposed strategy and key policy entry points. 7 2. FRAMEWORK FOR ANALYZING CARIBBEAN YOUTH DEFINITIONS Youth 19. The literature is replete with caution on the use of a chronological age to distinguish phases of the life cycle. The definition of youth depends on the sectoral and cultural context; for example, health specialists may refer to youth as the pubescent period, which begins at different ages in different countries while Labor Ministries may use the minimum work age as the age when youth begins. The United Nations definition of youth is 15-24 years old. The majority of youth policies in the Caribbean, however, see youth as beginning at 15 and ending at 30 years (Alexis 2000). The reason for this extended period of youth in the Caribbean is the extremely high rate of youth unemployment with prevents young people from attaining adult status (Danns et al. 1997). 20. For the purposes of this study, youth is defined as spanning the adolescent period between 10 to 24 years of age, with youth and adolescents being used interchangeably.2 Adolescence encompasses the transition from childhood to adulthood. Biological processes drive the initiation of adolescence, its onset being defined by puberty (Feldman and Elliott 1997). In contrast, societal factors largely determine the initiation of adulthood. Because of the broad period it encompasses, adolescence can be divided into three subcategories: early adolescence (ages 10-14), during which intense physical and social changes corresponding with puberty take place: middle adolescence (ages 15-17), during which young people become increasingly independent; and late adolescence (ages 17 to mid-20s), which applies to those who for social or other reasons delay entry into adulthood (ibid.). Youth Development 21. Youth or adolescent development refers to the physical, social, and emotional processes of maturation that occur from the 10 to 24 year age period. The elements of this developmental period include: pubertal maturation, cognitive development, ability to understand a future time perspective, ability to extrapolate, experimentation (including gender role experimentation), and moral development (see Box 2.1). 22. Engaging in prosocial behaviors and avoiding health compromising and future jeopardizing behaviors leads to positive youth development (Roth et al. 1998). A sense of industry and competency, a feeling of connectedness to others and society, a belief in 2 The definition of youth used in this report deviates from that of the United Nations and the Caribbean by lowering the on-set of youth to age 10. This is necessary due to the ecological approach of the model, which identifies influences of youth behavior that begin as early as age 10. 8 controlling one's fate, and a stable identity are elements of positive development in adolescence. Risky behaviors predispose youth to negative outcomes (e.g., unprotected intercourse is a health risk behavior that predisposes to sexually-transmitted infections [STIs] and unwanted pregnancy). The outcomes of these risk behaviors - e.g. earlv non-marital childbearing, early school leaving, drug addiction, violence, etc. - compromise a young person's future and can have high societal costs in the short Box 2.1: Elements of Adolescent Development and long term. * Pubertal Maturation, which include three key changes: (a) the development of adult reproductive capabilities; (b) the Factors Contributing to establishment of sexual dimorphism; and (c) the completion Youth Development of organ system maturation. 23. While research and * Cognitive development, including a shift in cognition from concrete thinkin,g to the fomal operations of adolescence which pollcy on youth have tended eriosfadlcne,wlic pofolicy on uthe bhaveoral tallow for abstract reasoning skills as well as a capacity for to focus on the behavioral future time perspective, and thus the capability of aspects of youth development, understanding the long-as well as short-term consequences of recent work has shifted to the one's behavior. underlying causes of these behaviors (World Bank * Extrapolation and Experimentation, which represents a 2000b). Risk factors, also shift from concrete to abstract operational thought, and the referred taRisk fantecedents, increased ability to apply the lessons of daily life. areferdtho as f risk hantncrdeatse Extrapolation is the capacity to take the lessons learned from are those factors that f crease past experiences and applv them to new situations. The the likelihood of experiencing mechanism by which this aspect of cognition develops is negative outcomes (Resnick et through experimentation. Whether it is through cigarette al. 1997). Factors smoking, provocative clothing, a new hairstvle, or sexual predisposing negative behavior, experimentation is a concrete, experiential way of outcomes may be individual learning compared, for example, to information learned at (e.g. aggressive temperament), school which is more abstract when one studies the familial (e.g. substance abusing experiences of others. It is through a similar process of role families, familial mental experimentations that one learns and internalizes gender illness), or environmental appropriate behavior. (high crime and violence . Moral development: Moral development represents a neighborhoods). process through which individuals mature in dealing with complex value-based decisions. Kohlberg (1981) defined six 24. Counter-balancing stages through which individuals progress as they move from such risks are the resources early childhood to adulthood: (a) the first stage being (Patterson and Blum, 1996), "punishment/obedience", in which a child is motivated to assets (Benson 1997), behave in a certain way because he believes that if he does asstects(ensaton s 199 not do so he will be punished; (b) a second in which a child's 1998)c and resience (Masten actions are is motivated by self-gain; (c) a third stage, in which I .98)~ and resilience (Mas ten behavior is based on a desire to be liked; (d) a fourth stage in 2000) that likewise ar'se from which maintenance of social order, fixed rules, and authority the individual, familial and are the major motivations for behavior; (e) a fifth stage in social environments in which a which moral reasoning is based on a notion of social contract: young person lives. For "the greatest good for the greatest number."; and (f) the last example, individual and highest level in which decisions are based on a "universal characteristics that have been ethical principle" or justice. repeatedly found to be 9 protective include social skills, intelligence, and a belief in a higher power beyond oneself. Protective family characteristics include a caring parent, an authoritative parenting style, and smaller family size. Likewise, social environments associated with reduced risk include caring non-familial adults, collective self-efficacy, and neighborhood engagement. Thus, as a dynamic process one must concurrently consider both the factors that predispose to vulnerability and those that protect (direct effect) or buffer (indirect or mediated effect) a young person from harm. 25. It is important to note, however, that while risk and protective factors aid in understanding underlying causes of behaviors, the subjective experiences of adolescents and youth are tremendously varied. While the odds of negative behaviors are much higher for those individuals who have many risk factors, not all succumb. The concept of resilience may help to explain the reasons that youth outcomes are not foreordained. Resilience refers to the self-righting capacity of an individual to bounce back and keep going. It implies resistance to threat but not invincibility (Garmezy 1991) or invulnerability (Garmezy 1985). Rutter (1993) suggests that resilience is interactive with vulnerabilities. That is, resilience is developmental in nature, stemming from biology and experiences earlier in life while protective factors may operate in different ways at different stages of development. CONCEPTUAL FRAMEWORK 26. Figure 2.1 provides the conceptual framework used in this report to discuss underlying protective and risk factors associated with youth outcomes and behaviors and their subsequent adult outcomes. It is based on an "ecological" model of human development that sees human development and youth development taking place in overlapping inter-related spheres that include home, family, school and community (3arker 2000). The framework - which was constructed for the Caribbean based on what is known about the risks Caribbean adolescents face and their probable underlying causes - outlines nsk/protective categories at three levels: the macro environment, the micro environment, and the individual. Macro level factors are the macro systems and institutions that affect an individual but with which the individual does not have direct contact, whereas the microenvironment refers to institutions and individuals with which the adolescent interacts on a personal basis - it refers to his or her space or sphere of interaction. The characteristics that an individual possesses also act as protective or risk factors independently or by interaction with micro and macro environmental factors. Risk and protective factors are those forces that underlie or determine adolescent behavior. Adolescent behavior, risky or otherwise, deternines adult outcomes later in life. All of these concepts are briefly discussed in turn. Macro Environnmental Factors 27. The macro environment represents the "distal contexts of adolescence" (Feldman and Elliott 1997), that is, the adolescent's macro environment or context that is detached from him/her. Risk and protective factors related to the macro environment include the state of the national economy, poverty and inequality levels, the institutional framework (public institutions, policy and legal frameworks), political realities, the cultural and historical 10 background, the media, and gender (values, behavioral norms and customs) and social exclusion. For example: * The mass media, including television, radio, videos, movies, music, newspapers, and magazines play formative roles in the lives of youth worldwide (Feldman and Elliott 1997) and the Caribbean is no exception. The media serves to teach youth, and influences the beliefs, values, social and political views, attitudes, and behaviors of youth. Examples of risk-related factors related to mass media include portrayals of violence, risk taking and sex-role stereotypes. Mass media can also be a risk factor by impeding other activities such as schoolwork and academic performance. * The state of the national economy is important in the lives of youth since it is a primary source of opportunities to youth and their families. It serves as a protective factor when it is a source of well-paid job opportunities, financial resources, and tax revenues, which-provide resources for social sen-ices. However, the economy is a risk factor when it does not provide opportunities or is highly volatile and introduces high uncertainty and vulnerability into the lives of young people and their parents. This lack of opportunities, for example, is identified as a primary cause for high migration and increased involvement of young people in the drug trade. The economy is a larger challenge for youth in the Caribbean than in many other countries due to the small, island state nature of most countries in the region. Economies that are small and not well- diversified have more difficulty smoothing exogenous economic and natural shocks, and thus have a higher potential for job loss. * The nature of public institutions is another important risk/protective category operating at the macro level. Broadly, institutions are protective if they are transparent, efficient, effective and responsive. Conversely they present macro risk factors if they are corrupt, inefficient, and unresponsive to the needs of the populous. Education systems, health care systems, law enforcement and judicial systems - in particular - are public institutions that play an important role in the lives of adolescents in that they influence access to education and academic performance, morbidity and mortality, access to reproductive and sexual health care services, and safety and security. Specific risk factors related to health care for adolescents, for example, include high cost of health care, lack of access to availability of appropriate health care services, problems regarding confidentiality of care, and lack of health care providers who are specialized in serving adolescents. Protective factors related to schools include providing: relevant curricula for learning academics, technical skills and life-skills; and access to peer groups, friends, and organized activities for social development and emotional "connectedness." * Cultural and Historical Background. Many have argued that the British colonial legacy of many Caribbean countries has indirectly affected the youth of today by influencing family structure and maternal and paternal roles in child rearing. Weak and exclusionary public institutions are also blamed on the history of British colonialism (Trouillot 2001). The education system is a case in point. 11 It is an example of a national institution that does not provide equal services to the majority and contributes to excluding a large segment of the youth population. * Gender. Gender, in the context of risk or protective factors, refers to the values, customs and behavioral norms that account for sexual differentiation in identity and behavior. Gender is thus included as a macro environmental factor in that values, behavioral norms, and customs related to the differentiation of the sexes are shaped by society broadly. Gender is a risk factor, for example, if societal norms that dictate male behavior (e.g. men should be sexually promiscuous and bear many children) or female behavior (e.g. women should not enter the labor force) predisposes youth (and subsequendy adults) to negative outcomes. Gender is a protective factor if societal norms or culture dictate female behavior (girls should study hard) or male behavior (men should be responsible for providing for their children) predisposes youth to positive outcomes. 28. Risk factors in the macro environment can act collectively to socially exclude youth as a group. Social exclusion is a multi-dimensional concept that has at least four characteristics: (a) exclusion from economic means, including unequal access to goods and services that determine human capital; (b) unequal access to labor markets and social protection programs from both formal and informal institutions; (c) exclusion from participatory mechanisms that affect public service programs; and (d) unequal access to political rights and civil liberties (Gactitua Carlos Sojo and Davis 2001). Micro Environmental Factors 29. The micro level environment represents one's interpersonal proximal contexts. They include the structure and dynamics of the family; the values and social influences of peer groups, role models and social networks; and community and neighborhood in which youth live and interact - including schools, churches, health centers; and the physical environment. 30. Families. Families are critical in the lives of youth in that they are responsible for material care, socializing children, and providing psychological supports of solidarity and cooperation, acceptance, comfort and love (Barrow 2001). Parental expectations, evaluations, and encouragement/pressure also play a role in defining youth behaviors and outcomes (Feldman and Eliott 1997). Risk and protective factors are related to family dynamics and structure, with protective factors including: "connectedness," discipline, family resources (time, money, housing, etc.), extended family, two biological parents, parental presence (physical), family cohesion, and egalitarian gender roles and decision- making. "Connectedness" refers to a perception of closeness a young person has with a parent or family member; it is not based on doing things together but from a parent/family conveying psychological availability. Conversely, risk factors include low parental skills and education; scarce family resources; parental absence due to migration, job demands, or abandonment; abuse and violence in the household (physical, sexual and emotional); parental mental health; parental substance abuse, and the presence of a non-biological parent. 12 31. Social Networks, Peers, and Role Models. Social networks and supports are those friends, neighbors, friends of parents, etc. on whom youth can relv to help cope with stresses and problems and decide on actions and behaviors. Likewise, peer groups - groups of the same age cohort or generation, groups with whom the 'outh "hangs out", or groups of similarly stereotyped individuals3 - serve as an important source of values, directives, feedback, and social comparison (Feldman and Elliott 1997). Lastly, role models are those persons that youth choose to emulate. Protective risk factors include: having peers, social networks and roles models that are positive and provide connectedness, peers and role models with pro-social norms, low risk friends and being treated fairly by peers. Conversely, risk factors include participation in deviant culture ("the bad bovs"), perception of threat by peers, and prejudice. 32. Communities and Neighborhoods. The dynamics, structure and organization of conmunities and neighborhoods help shape the lives, behaviors, and outcomes of adolescents. Their influences range from the provision of transportation systems, to the perceived degree of physical risk and safety, to community spirit and support. Churches, schools, sports and health centers, and other social organizations - which can provide a range of activities and supports to youth - are also part of the community and neighborhood infrastructure. Protective factors related to community and neighborhoods include well functioning infrastructure, safe and secure spaces, trustworthy law enforcement officers, connectedness with organizations, and a clean physical environment. Conversely, risk factors associated with community include crime and violence, uncaring health center staff, the presence of tobacco, alcohol and firearms, and lack of basic infrastructure, such as safe transportation, and corrupt local police officers. Individual Factors 33. Individual risk and protective factors are those related to the physiologicaL cognitive, behavioral system, social, and environmental systems. The physiological system is critical in that it determines physical health and growth; the cognitive system determines how individuals assimilate information, interpret it and use it to make decisions; the behavioral system is key in that mortality and morbidity in adolescence is mostly behavioral based; the social system affects youth outcomes by establishing a social climate that favors specific behaviors; and social networks influence how adolescents deal with stressful events. 34. Some important risk factors at the individual level include: having a physical or mental disability, aggressive behavior or rage, having a learning disability, and behaving in an ambivalent and unmotivated fashion. Protective factors at the individual level include: spiritual belief- believing in a higher power beyond oneself, social skills, positive self-image and self-concept, self-confidence, having a positive and determined outlook, and being enterprising and hard-working. Perceived parental status is also a protective factor. 3 For example, typical stereotyped groups among students in the US and Canada include 'jocks, brains, loners, nerds', etc. 13 Negative Youth Outcomes 35. Negative youth outcomes decrease the hkehhood of having a healthy, happy productive adult life. For example, adolescent pregnancy may predispose a person to low levels of education; school drop out or exit influences the attainment of human capital which in turn affects job opportunities and earnings; youth unemployment affects a person's ability to gain experience, which in turn limits future job opportunities, earnings, and advancement; crime and violence leads to incarceration, which in turn affects one's ability to get a job, earn income, and enter into marriage, etc. 36. It should be noted that negative outcomes can also be risk factors. For example, dropping out of school/low human capital is a negative outcome. But it is also a risk factor in that school drop-out and low levels of human capital predispose youth to other negative outcomes such as unemployment, low earnings, and engagement in crime and violence. Similarly, sexual and physical abuse is a negative outcome, but it is also a risk factor in that it can predispose young people to mental health problems, risky sexual behavior, and ctirne and violence. Adult Negative Outcomes 37. Low levels of education, poor work experience, low earnings, unemployment, poor physical and mental health, substance abuse, violence (including domestic violence), and unhealthy relationships with spouse, partner, friends and others are all adult outcomes that are influenced by negative youth outcomes. 14 Pre! d,v,f- t *, vg*rl ; - \t' J '- ' 'l ~- M Zll EarIyf sexual VLow human . _/lXh)slcAl/-nlal \\>'; > 6 den ;; ; - i | i initlauon and - 0 Poz'erzy, low lTFtsrr-r ~. - . ehdrir/lJge -- - Abune and ,iulcnte . / HIV/.AIDS and: earnings ^clrxnfoq r {5pln=dhrllcf*-1P,e8enceO^n of Pasia and +tInemploymeni t 1a1 nlAnllF w r , SOCId shilla - PROTFteTnrF : , - _ ~~sexual abuse orpyia - , . , 1l - p \ e jni and ..... 2 ~ {C~re-eedne;s, . - . -/ chool !e lzing an mnd man alaltal.h S - \ Inielilgeme -/ - i2 biologicEl parenrs , < U~~~~~~Subsiancc abuse ' '>, - ; -VPseeerlie V acso; /n;r ewdne*F ,l hslnebla,K s; El _d , ' | ZCric indludcng ng memeic i fl - llcoh w1 ;nd finnms -rellmlour elilil l s - J IY imeandc . oln &V olu .0~~~~~~~~~~~~~~~~~~~~~~~~~~~~~voec c ; Crunc snd nlJlrnee /Wc11 (unkliZ,ning intrshEruclulc , t . . Z~~Unliealtby. b 3i-' ~~~~~~ - : 6 ~~~~~ - : - X | Z~~~~~vSubstance abuse -telationships with 1 IE3RK; COI;III1UNI15 N ElGHBORHOOD -. 3 ~~~~~~~and drug dealing r cnspo.e,pnnoer, ol -you~~~~~~~~~~~~~~~~~~~~~~~~~~~"oia xlso Figure 2.1: Caribbean Model of Risk and Protective Factors for Adolescent and Subsequent Adult Development 3. NEGATIVE OUTCOMES OBSERVED AMONG CARIBBEAN YOUTH 38. Despite the Caribbean's historical, political, cultural, and linguistic diversity, the negative outcomes observed among Caribbean youth are quite similar. These include: early sexual initiation and pregnancy, HIV/AIDS, sexual and physical abuse, school leaving (drop- out and exit), unemployment, crime and violence, substance abuse and drug dealing, and social exclusion. These outcomes are discussed briefly in turn. EARLY SEXUAL INITIATION AND PREGNANCY Early Sexual Initiation 39. The Caribbean Region is characterized by its very early onset of sexual activity. While other countries in the world (e.g. the U.S.) have a large proportion of sexually active adolescents, no other region in the world for which data are available have such an early age of sexual initiation (Blum 2002).4 According to the nine-country CARICOM survey, one- third of school-going young people were sexually active. But of these, over half of boys and about a quarter of girls stated that the age of first intercourse was ten years or younger and almost two-thirds before the age of 13. In Jamaica, according to the reproductive health survey for 1997 (RHS-97), by age 11-12 about 20 percent of boys and girls in the general population has had sexual intercourse. In Saint Lucia almost 45 percent of sexually active adolescents were engaged in first intercourse before the age of 10, according to the PAHO funded Saint Lucia 2000 Adolescent Health Survey.5 Early age of sexual initiation predisposes young people to early pregnancy and STIs/HIV infection (Blum 2002). 40. Another issue particular to the Caribbean is that of forced intercourse. In the nine- country CARICOM survey, of the one-third of adolescents who had had sexual intercourse, alnost half reported that their first sexual experience had been forced. The proportion was high for both girls and boys: 48 percent and 32 percent, respectively. While the problem of forced intercourse among girls is also problematic in other countries such as the US, the high incidence among boys is not common (Blum 2002). 4 Sub-Saharan Africa is also characterized by early sexual initiation, but in contrast to the Africa region, most early sexual experiences in the Caribbean take place outside of marriage. s The PAHO study, a school-based survey focused on age groups 10-19, surveyed 1526 students from 29 primary and secondary schools island wide. 16 Adolescent Pregnancy 41. Only four countries in the Americas have birth rates over 100 births (per 1,000 women age 15-19 years) and two of these are in the Caribbean (Table 3.1). Andgua & Barbuda has the highest adolescent pregnancy rates in the Americas, followed by Honduras, El Salvador and the Dominican Republic. But rates vary widely in the Caribbean. At the other end of the Table 3.1: Fertility Rates per 1,000 Women Age 15-19* spectrum, Trinidad and Tobago has the Country 1996 1998 2000 lowest rate in the Americas (16.7). Only Antigua & Barbuda 116.0 120.2 116.0 seven countries in the Americas have Argentina 66.3 62.6 58.8 Bahamas 62.5 62.9 57.8 rates lower that 45 births per 1,000 Barbados 52.1 50.5 49.0 women and six of these are in the Belize 110.9 103.6 96.4 Caribbean (Trinidad and Tobago, Canada 24.3 22.9 22.4 Guyana, Dorninica, Suriname, St. Chile 63.0 55.1 48.2 Vincent and the Grenadines, and Colombia 58.6 55.6 52.6 Costa Rica 86.0 76.7 69.4 Jamaica). Belize and Grenada have Dominica 28.9 27.4 25.8 reasonably high rates of pregnancy (96.4 Dominican Republic 110.4 105.9 101.4 and 83.4 respectively), and the other five Ecuador 82.9 76.8 70. / countries fall somewhere in the mniddle El Salvador 115.5 110.2 104.8 (Haiti, St. KCitts & Nevis, Bahamas Grenada 92.9 90.5 83.4 (Haiti, St. Kits & Neis BahamaGuatemala 108.1 103.6 99.0 Barbados, and St. Luca). In terms of Guyana 27.3 25.7 24.0 pregnancies, the CARICOM survey Haiti 75.4 71.9 68.3 revealed that about 10 percent of Honduras 127.2 118.2 109.3 school-going adolescents had been or Jamaica 66.2 53.5 40.9 had gotten someone pregnant (seven Panaco 65a8 50m9 45a7 Panama ~~~~63.9 55.9 48.0 percent in the case of girls and 12 Peru 67.8 61.3 54.7 percent in the case of boys). The St. Kitts & Nevis 77.2 70.5 63.8 proportion is probably higher among Saint Lucia 65.9 58.5 51.1 school leavers. St. vincent and the Grenadines 77.2 46.4 34.6 Suriname 36.9 34.5 32.0 42. Despite high levels of sexual Trinidad & Tobago 20.8 18.7 16.7 United States 55.6 61.5 58.2 activity among adolescents, Uruguay 52.0 51.1 50.2 contraceptive use remains low. Only a Venezuela 74.6 65.0 55.3 quarter of the CARICOM school going Source: www.paho.org/English/SHA/coredata sexually active sample were using some * The ratio between the number of live births born to mothers form of birth control and only slightly aged 15 to 19 years during a given year and the mid-year female population 15 to 19 years of age, usually multiplied bv 1,000. more worry about getting pregnant or ,_. causing a pregnancy. In Jamaica, more than 40 percent of sexually active adolescent girls reported that they were not using, or had not used a contraceptive at last intercourse, and 87 percent of teenage pregnancies had not been planned (World Bank 2001b). HIV/AIDS 43. Following sub-Saharan Africa, the Caribbean Region currently has the highest HIV/AIDS prevalence rate in the world - and data suggest that for one-third of all new 17 cases, the disease was contracted when the individual was 15-24 years.6 Out of the 12 countries with the highest HIV prevalence in the Latin America and the Caribbean (LAC) Region, nine are from the Caribbean (World Bank 2000a). Having spread to the general population, HIV/AIDS has reached epidemic proportions in Haiti, Bahamas, the Dominican Republic, and Guyana. Jamaica and Trinidad and Tobago have concentrated HIV/AIDS epidemics.' About 83 percent of AIDS cases are diagnosed in people between the ages of 15 to 54; one-third of all new cases are in the 25 to 34 year old age group (see Table 3.2). Given an estimated eight to ten year incubation, about one-third of those who have new AIDS cases contracted the disease when they were 15-24 years.8 44. The high incidence of HIV among youth has been linked to early sexual initiation and low condom use among young people. According to the nine-country CARICOM survey of school attending adolescents, almost half (47 percent) of sexually active youth reported not using a condom. The majority of Saint Lucia at-risk youth interviewed for the qualitative study indicated that they were worried about HIV/AIDS, however, the use and knowledge of contraception was low. In Jamaica, the level of knowledge about sexuality and contraception is reportedly high among adolescents, but it does not translate into preventive behavior, according to the RHS-97 (World Bank 2001b). Table 3.2: Reported Cases of AIDS by Age Group, Caribbean Region AGE GROUP < 1990 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 1982-2000 % < 1 78 21 29 34 37 47 33 39 44 32 43 32 469 3 1-4 47 14 13 25 17 28 36 69 41 49 63 61 463 3 5 -14 5 6 4 6 7 12 14 18 11 8 22 23 136 1 15 -19 34 13 14 11 20 25 21 43 21 23 49 24 298 2 20 - 24 186 74 80 87 70 88 128 111 100 108 166 109 1307 8 25 - 29 329 110 120 165 195 209 234 242 244 218 314 240 2620 15 30 - 34 315 120 152 182 192 210 312 299 286 360 389 280 3097 18 35 - 39 195 87 132 159 201 269 256 275 294 295 368 293 2824 16 40 - 44 140 57 96 93 124 124 192 222 220 209 292 220 1989 12 45 - 49 89 46 69 65 85 123 129 140 93 150 167 204 1360 8 50 - 54 71 20 50 34 67 54 87 107 90 103 122 111 916 5 55 - 59 43 22 23 35 33 59 41 69 67 81 87 75 635 4 60 + 48 22 33 38 44 35 73 78 59 80 77 80 667 4 Unkmown 121 50 49 89 25 15 26 16 33 30 27 54 535 3 Total(AllAges) 1701 662 864 1023 1117 1298 1582 1728 1603 1746 2186 1806 17316 100 Source: Quarterly AIDS Surveillance Reports submitted to CAREC's Epidemiology Division by CAREC member countries 6Among women, the majority of cases are in the 25 to 29 year-old age bracket followed by the 30-34 year age group; among men the majority of cases are in the 30-34 and 25-29 age cohort (PAHO/WHO, 1998 cited in World Bank, 2000a). 7According to World Bank (2000a), a generalized epidemic means that HIV has spread far beyond the original subpopulations with high risk behavior (that is engaging in unprotected sexual intercourse with many partners or sharing of unsterilized needles or other injecting equipment); a concentrated epidemic means that HIV/AIDS is still primarily affecting population groups practicing high-risk behaviors (among whom infection rates exceed five percent) but are set to spread more widely in the rest of the population. 8 Among women, the majority of cases are in the 25 to 29 year-old age bracket followed by the 30-34 year age group; among men the majority of cases are in the 30-34 and 25-29 age cohort (PAHO/ WHO, 1998 cited in World Bank, 2000a). 18 PHYSICAL AND SEXUAL ABUSE Physical Abuse 45. Many of the young people surveyed in the nine-country CARICOM study report a history of abuse in their lives. About a sixth state that they have been physically abused, with most of the abuse being attributed to an adult in their home. Evidence from Jamaica, Barbados and Dominica suggest that parents' use of harsh disciplinary action on children is common. A quantitative study on Sexual Decision-Making in Jamaica revealed that 50 percent of all respondents had reportedly been severely punished as children (beaten, punched, pinched, or hit with a heavy object (Wyatt etal 1993, cited in Le Franc 2001). Another study carried out in Jamaica, Barbados and Dominica suggested similar harsh disciplinary patterns, with the physical punishment of boys being particularly severe (Le Franc 2001). Making boys tough and controlling boys is typically the justification for the harsher punishmnent of the male child. 46. Cultural norms sanction the practice or corporal punishment to discipline children. Schools, for example, continue to use corporal punishment to impose discipline (Rock 2001, Meeks-Gardener 2001). A study of 29 schools in primary and all age schools in Jamaica, showed that in 27 of the 29 schools, 87 percent of teachers and children reported that beatings occurred as an act of punishment, with teachers using a strap, belt or ruler (MIeeks- Gardener 2001). Boys tend to be treated more harshly than girls within the school environment (Rock 2001). Corporal punishment is also used widely by parents to teach their children to be compliant in countries such as Barbados (ibid.) and Jamaica (World Bank 2001b). SexualAbuse 47. Similarly, many of the young people surveyed in the nine-country CARICOM study report a history of sexual abuse in their lives. One-tenth report having been abused sexually, most frequently by adults outside of the home or other teens, but many report abuse by adults in the home and siblings. There is remarkably little gender difference between males (9.1 percent) and females (10.5 percent) reporting sexual abuse. About one in eight report that they worry they will be sexually abused. 48. A 1993 study in Jamaica suggests a certain "normalcy" attached to the act of child sexual abuse (Rock 2001). The study, however, challenges popular beliefs about the abuse of children by stepfathers and mothers' boyfriends.9 The study found that a greater level of abuse was taking place in two-parent households or in households where the relatives of the father were raising the child. Rock's more recent (2001) study of child abuse in Barbados supports this assertion. According to study findings, parents were reportedly the main perpetrators of child abuse in all categories except sexual abuse: mothers made up the majority of perpetrators of physical abuse (49.4 percent), other non family members 9 Indeed, according to perceptions of Saint Lucia key informants of this study, the preponderance of loosely attached males within most single-parent families leads to a high level of sexual abuse of female adolescents within the home setting. It is so commonly perceived that stepfathers are acting as sexual predators on female youth, that in 2001 a calypso was written on this social problem. 19 comprised the majority of sexual offenders of children (55.5 percent)10 and mothers made up the majority of those who neglect their children (68 percent). Rock also found that the reported cases of child abuse and neglect were increasing in Barbados." SCHOOL LEAVING 49. As with other indicators, the number of out-of-school youth varies significantly across Caribbean countries. According to data compiled by the Commonwealth Youth Foundation's Situational Analysis of Youth in the Commonwealth Caribbean, the proportion of youth whose highest level of education is primary school is as high as 58 percent in Dominica, 54 percent in Belize, and 53 percent in St. Vincent and the Grenadines. In Jamaica in 1999, 2.5 percent of 12-14 year olds were not in school but by the age of 15-16 years, the proportion of school leavers was almost 17 percent, which reflects a significant drop-out rate at the secondary education level (Samms-Vaughan 2001). Secondary enrollment rates also remain low in the Dominican Republic. In 1998, net secondary enrollment was 17 percent for boys and 36 percent for girls; in urban areas the rates were 40 percent for boys and 47 percent for girls (World Bank 2001b).12 50. Across the Caribbean, more boys than girls tend to fall behind and leave school. Taking the case of Jamaica, in 1996/97 and 1999/2000, a slightly higher proportion of boys than girls were enrolled at the early childhood and primary school levels; at grades 7-9 females accounted for just over 50 percent of enrollment; and at grades 10-11 the gender gap widened in favor of females, with a percentage gap of 8.8 and 5.2 between male and female enrollment in 1996/97 and 1999/2000 respectively. In St. Vincent and the Grenadines for the 1991-92 school year, the ratio of female to male students was nearly 1.5 to one (Barker 1995). And gender gaps in repetition and drop-out in the Dominican Republic are among the widest in Latin America (World Bank 2001b).'3 UNEMPLOYMENT 51. As in other parts of the world, unemployment in the Caribbean is primarily a youth phenomenon (see Tables 3.4 and 3.5). Across countries in the Caribbean and elsewhere, youth unemployment rates - that is the number of 15-24 year olds looking for work divided by the sum of 15-24 year olds either working or looking for a job - are double to triple adult 10 The data indicated that 19.8 percent of sexual offenders were the children's fathers, 13.8 percent were the step-fathers, and 10.9 percent were other family members. " A total of 763 cases were referred to the Child Care Board between April 1989 and March 1990; from April to March 1997-98 the cases reported were 1,132, and 1,113 between April to March 1998-99 (Rock, 2001). Under-reporting of cases is suspected, however, given that reporting is not mandatory. 12 Not surprisingly, net enrollment rates are significantly higher among the non poor than the poor (World Bank 2001b). Also, the proportion of boys who do not attend secondary school is similar for the non-poor and the poor after controlling for wealth variables. 13 Completion rates for boys from the richest 20 percent of households are higher than for girls, while completion rates for girls from poorer households are higher than for boys. This suggests that poor boys are left behind or are pressed to drop-out of school to provide income support to the family, whereas traditional domestic work typically carried out by poor girls is more compatible with schooling. 20 unemployment rates. However, international comparisons indicate that some Caribbean countries - Barbados, Trinidad and Tobago, and Jamaica - have particularly high rates. Indeed Jamaica - at 33 percent - has the highest rate in the Americas (among those countries for which data were available). 52. The difficulty in finding jobs in the Caribbean is not limited to vouth. In many non- Caribbean countries, youth are a higher share of the unemployed than in Caribbean countries. Table 3.6 indicates that youth are more concentrated among the unemployed in Chile and the United States, for example. However, caution should be taken in these comparisons since the years presented in the table were also years of growth for both those countries so more youth were likely to be looking for work.4 In those Caribbean countries where all unemployment is high, many youth are "discouraged workers" meaning that they would like to work but do not even bother looking for a job since they know that they will not find it. Thus, youth unemployment is likely to be underestimated in high unemployment economies. Nonetheless, youth in the Caribbean comprise 20 to 30 percent of the labor force but represent 40 to 60 percent of the unemployed (with the exception of Barbados). Table 3.4: Youth and Adult Unemployment in the Caribbean Youth (15-24 years) Adult Unemployment Youth as Share of Unemployment Unemployed Country Year All Male Female All Male Female All Male Female Antigua & Barbuda 1991 13.0% 13.1% 12.8% 4.2% 4.0% 4.4% 47.0% 47.5% 46.0% Anguilla 1992 13.7% 14.1% 13.0% 4.0% 4.0% 3.9% 55.1% 56.3% 52.9% Barbados 1999 17.9% 15.2% 20.9% 7.4% 5.2% 9.6% 36.6% 41.80%o 33.3% Belize 1999 18.4% 13.4% 25.8% 8.2% 6.1% 12.1% 50.8% 47.7% 53.5% Dominica 1997 28.1% 28.9% 26.7% 14.4% 15.3% 12.6% 40.9% 39.5% 43.8% Grenada 1998 23.9% 21.1% 28.2% 9.2% 5.3% 13.5% 49.0% 59.8% 43.8% Guyana 1992 21.1% 17.2% 27.7% 5.2% 3.2% 8.8% 66.9% 72.0% 62.3% Jamaica 1999 25.4% 19.1% 31.8% 8.9% 5.4% 12.8% 52.6% 57.2% 50.1% Saint Lucia 1998 30.6% 27.7% 34.0% 12.5% 9.9% 15.4% 50.0% 54.2% 46.4% Saint Vincent & the Grenadines 1991 26.7% 24.7% 30.0% 11.2% 10.8% 11.9% 55.3% 54.2% 57.1% Trinidad & Tobago 1999 20.2% 17.9% 23.6% 8.8% 7.2% 11.2% 42.8% 44.1% 41.6% Source: ILO 53. Youth unemployment rates are higher for female than males, although their proportion of the total unemployed labor force tends to be less (see Table 3.5). This means that fewer young women than young men are in the labor force but that within their respective gender groups, a larger share of females is unemployed. In the English-speaking Caribbean, the gender differential is greatest in Belize, followed by Bahamas, Jamaica, and Guyana. Gende;r differentials in the Dominican Republic are even greater, with rates for young rural women age 20-24 years being almost triple those of rates for young rural men. Lastly, as the Dominican Republic data indicate (Table 3.5) unemployment is primarily an urban problem. And male urban youth have the highest share of total unemployment (concentration factor of 2.63). 14 Due to data limitations, it is impossible to distinguish between those who are actually looking for work and those who are the "discouraged workers" and thus not bothering to look. 21 Table 3.5: Unemployment Levels by Age Group, Urban-Rural Residence and Sex (Maria, move the table to after Table 3.4) Urban 15-19 20-24 25-34 35-44 45-54 55-70 Total Unemployment Youth relative to total Male 29.4 19.6 8.4 5 5.2 5.8 11.2 2.63 1.75 Female 53.1 40.5 22.2 17.8 14.4 13.8 25.3 2.10 1.60 Rural 15-19 20-24 25-34 35-44 45-54 55-70 Total Unemployment Youth relative to total Male 17.2 9 5 1.1 l.I 6.1 6.2 1.54 0.80 Female 49.8 33.9 23.2 19.4 14 8.9 24.4 1.97 1.34 Source: World Bank (2001b) based on ENGIH-98 CRIME AND VIOLENCE 54. Based on homicide rates, the LAC Region as a whole is the most violent region in the world. At 22.9 per 100,000 people in 1990, homicide rates for the Caribbean are almost double the world average of 10.7 per 100,000'5 - and as in the rest of LAC available data indicate that homicide victims and perpetrators are disproportionately men.'6 Within the Caribbean, Jamaica's homicide rates are the highest (35 homicides per 100,000) and levels for the Dominican Republic and Trinidad and Tobago exceed the world average (11.7 and 12.6 homicides per 100,000, respectively) (Ayres 1998). Violence also appears to be mounting in the larger islands; for example, it increased six fold in Trinidad and Tobago from the early 1980s to the early 1990s. Violent crimes tend to be geographically concentrated in poor urban communities (ibid.), with Kingston reportedly having one of the highest murder rates in the world.'7 55. Department of Corrections data for Jamaica show that young people (age 17-30) commit most offenses, with youth (age 15-24) contributing significantly to crime and violence (Table 3.7). Youth age 17-25 commit 56 percent of all crimes, almost 50 percent of murders, 44 percent of manslaughters and 42 percent of burglaries. And available information for Jamaica indicates that perpetrators of crime tend to be young men. In 2000, 20-25 year old males were the principal offenders in all types of major crimes in Jamaica and accounted for 37 percent of all murders committed in that year, according to the Planning Institute of Jamaica (PIOJ) 2000 Economic and Social Survey. 15 Rates are for 1990, which was the last year for which sub-regional Caribbean data were available. 16 Honiicide victims and perpetrators in the Americas are disproportionately men ages 15-24 years (PAHO, 1993, cited in Barker, 1998). '7 The Sunday Gleaner, October 17, 1998. 22 Table 3.6. Youth and Adult Unemployment, Youth Unemployment as a Share of Total Unemployment, 1990, 1996, 1997, 1998 (Maria, move the table to after table 3.6 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Unemployment Total Unemployment, Youth Total Unemployment, Youth, Country _____% of total labor force) (% of total labor force ages 1 -24 Relative to Total Unemplo ment _________________ 1990 1996 1997 1998 1990 1996 1997 1998 1990 1996 1997 1998 Latin Am erica _ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ _ _ Argentina 7.3 17.2 14.9 12.8 . .. Barbados 15 15.6 14.5 12.3 30.7 28.5 29.5 24.6 2.05 1.83 2.03 2.00 Bolivia 7.3 4.2 ... 4.5 7 ... 0.62 1.67 Brazil 3.7 7 7.8 9 6.7 12.6 14.4 .. 1.81 1.80 1.85 Chile 5.7 5.4 5.3 7.2 13.1 12.8 13 16.7 2.30 2.37 2.45 2.32 Colombia 10.2 12 12.1 15 16.3 18.7 19.9 24.2 1.60 1.56 1.64 1.61 Costa Rica 4.6 6.2 5.7 5.6 8.3 11.8 11.6 11.7 1.80 1.90 2.04 2.09 Ecuador 6.1 10.4 9.2 11.5 9.1 20.1 18.9 23.5 1.49 1.93 2.05 2.04 El Salvador 10 7.7 8 7.3 .. 13.1 13.3 . . 1.70 1.66 Honduras 4.8 4.3 3.2 3.9 ... . 6.3 ... . 1.62 Mexico .. 4.3 3.4 2.9 .. 7.7 6.3 5.3 .. 1.79 1.85 1.83 Panama .. 14.3 13.4 13.6 ... 27.3 28.7 . . 2.04 2.11 IParagZuay 6.6 8.2 ... 15.7 ... . 2.38 ___ ____ Uruguay 8.5 ... 10.1 20.5 . . 24.3 2.41 ... 2.41 Venezuela, RB 10_4_____11_ 11___2 19___4 ____ 19.8 21.3 1.87 ..1.74 1.90 C aribbean__ _ _ __ _ _ _ __ _ _ _ _ _ _ _ __ _ _ __ _ _ _ Dom-iinican Republic .. 16.6 15.9 ... 30.3 ... . 1.83 Jamaica 15_7___16 16___5 ______ 34.4 33.4 33.3 _____ 2.15 2.02 2.15 'Fritiidad and Tobago 20 16.2 15 14.2 36.4 28.5 .. 26.9 1.82 1.76 1.89 Bahamas, The ______ 9___8_ 7___7_ 22.2 15.7 ... 2.27 2.04 Saint Lucia .. 16.3 20.5 21.6 .. 35.2 36.6 44 .. 2.16 1.79 2.04 Surinam-e 15.8 11 10.5 10.6 36.6 24.6 25.1 23.1 2.32 2.24 2.39 2.18 O ther _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ United States 5.6 5.4 4.9 4.5 11.2 12 11.3 10.4 2.00 2.22 2.31 2.31 Canada 8.1 9.6 9.1 18.3 111.2 1 12 111.3 110.4 1.53 11.59 1.78 1.82 iSouth Africa 19__2_7__5__1124 5.. 162... 1.79 Source: World Development Indicators 23 56. Young men also tend to be the main victims of homicides. Based on 1990 data, a 1993 Commission on Youth in Barbados found that youth were much more likely to die from homicide and purposefully inflicted injuries than any other age group. Young people made up nearly two-thirds of those found guilty of crimes; males were four times more likely than females to be found guilty of a crime, with the sex differential having increased every year since 1960 (Braithwaite 1993, cited in Pantin 2000). In Jamaica, among patients seen in emergency units of public hospitals with trauma and injuries related to acts of violence in 2000, the highest proportion of patients were 20-29 year olds (31.6 percent), followed by 30-39 year olds (29.8 percent), and 10-19 year olds (22.3 percent) (PIOJ, based on Ministry of Health data, cited in World Bank 2001b).18 57. The nine-country CARICOM survey of school age youth, as well as the qualitative information from the Dominican Republic confirms the presence of violence in the lives of youth. One-fifth of males in the CARICOM survey had carried weapons to school in the previous 30 days of the survey and nearly as many had been in a fight using weapons. Also, gang violence in high, with one in five school going boys and one in eight school going girls indicating that they had at some time belonged to a gang. Out-of-school youth interviewed in the Dominican Republic substantiate the presence of gangs and violence in their communities. Youth tend to join criminal and drug dealing gangs to compensate for lack of formal employment opportunities or as a strategy for confronting the violence in their communities. Gangs and political parties were the organizations with whom youth mostly identified. 58. Rage is apparently a common sentiment among Caribbean youth, with over 40 percent of teenagers reporting such emotions, according to the CARICOM survey of school-going youth. Two out of five report that sometimes or most of the time they think about hurting or killing someone else and almost five percent reporting that they almost always think about hurting or killing others. Males consistently report rage significantly more often than their female counterparts for every age group of teens. About one in eight of youth surveyed have tried to kill themselves, with no appreciable differences between males and females or different age groups. SUBSTANCE ABUSE AND DRUG DEALING 59. According to a United Nations International Drug Control Programme (UNDCP) funded study, drug and substance abuse and youth involvement in drug 18 It is important to note that while young people are more likely to be victims of violence, most Caribbean countries tend to have youthful populations thus explaining the concentration among of homicides among youth. Comparing trends of homicide victims for the US and Trinidad and Tobago, for example, shows that as the population ages in Trinidad and Tobago, so does the risk of dying by homicide. This is not the case in the US where the share of homicide victims tends to be concentrated among youth despite an aging population. 24 dealing are significant problems facing at-risk youth in the Caribbean (Barker 1995). While data and information are scanty, the study - which involved St Vincent and the Grenadines, Trinidad and Tobago, St. Maarten and Jamaica - sumrnmarized the situation as follows: 'vBoth among in-school and out-of-scboolyouth, there is a widespread social acceptance of alcohol and ma4fjtana in the Caibbean. Youth interviewed infocusgroup discussions tended to rank drvgs according to their acceptability, with alcohol being the most heavily used and accepted, marijuana second and cocaine last. Both marijuana and alcohol were seen as social!y acceptable, while cocaine and crack were seen as more dangerous and more extreme in their side effects and their implications". Table 3.7: Crime in Jamaica by Age Group, 1998 (17-25) as (17-29) as share of all share of all Offense <17 17-20 21-25 26-30 31-35 36-40 41-45 45+ Total crimes crimes Murder 0 17 5 17 6 1 0 0 46 47.8% 84.8% Manslaughter 0 11 9 16 4 4 1 0 45 44.4% 80.0% Felonious wounding 0 28 73 101 69 31 9 4 315 32.1% 64.1% Sex offenses 0 11 24 32 9 11 3 0 90 38.9% 74.4% Burglary 0 13 30 23 20 9 6 2 103 41.7% 64.1% Robbery 0 39 26 23 24 6 0 0 118 55.1% 74.6% Breach of firearms act 0 72 24 26 19 5 4 0 150 64.0% 81.3% Shooting with intent 0 3 1 0 0 0 0 0 4 100.0% 100.0% Larceny 0 121 148 69 38 13 7 3 399 67.4% 84.7% Arson 0 0 1 0 0 1 1 0 3 33.3% 33.3% Forgery 0 23 12 20 15 0 0 1 71 49.3% 77.5% Unlawful possession 0 8 7 3 0 0 0 0 18 83.3% 100.0% Breach: drug laws 0 176 161 126 48 21 7 4 543 62.1% 85.3% Breach:other offenses 0 152 71 85 32 13 8 5 366 60.9% 84.2% ALL CRIMES 0 674 592 541 284 115 46 19 2271 55.7% 79.6% Source: Pantin (2000) 60. The study also found that the group most at-risk of substance abuse and involvement in drug dealing were out-of-school youth ages 13-19, particularly male youth. By country examined, the study revealed the following: St. Vincent and the Grenadines. Statistics from 1990 to 1994 found that about 12-16 percent of all inmates had been imprisoned for drug-related charges; other theft and larceny charges are also likely to be drug-related. The majority of the inmates were 16-30 year olds. While there are no statistics on substance abuse among out-of-school youth, a 1993 survey of 1,428 students in St. Vincent (representing 81 percent of 11-16 year olds) found that alcohol was the most widely used substance, with 89.9 percent saying they had used alcohol, while 34 percent had used in the past 30 days. Only 11.5 percent reported they had used marijuana, while less than one percent had ever used cocaine. 25 * Trinidad and Tobago. While there is no data on substance use rates among out-of-school youth, recent studies have found fairly high rates of substance use among in-school youth, as well as widespread access. In general alcohol and marijuana are the most widely accepted and the most widely available. One 1992 study of youth in primary and secondary schools found that 14 percent of youth in primary schools said that marijuana was easy to obtain, and 12 percent said the same for cocaine. At the secondary level, 38 percent said marijuana was easy to obtain and 13 percent said cocaine was easy to obtain. In terms of substance abuse in schools, various studies carried out between 1985 and 1988 found that among 11-19 year olds, between 80.4 percent and 91.1 percent had used alcohol; between 6.3 percent and 10.6 percent had used marijuana; and between 1.1 percent and 3.3 percent had used cocaine. * Jamaica. While no data was available, anecdotal evidence points to a major problem in substance abuse and drug dealing among out-of-school youth in Jamaica. The most recent survey on drug use among in-school youth was carried out in 1987 and found that 76.3 percent had used alcohol, 28.3 percent had smoked ganja. Higher percentages appear to drink marijuana brewed at tea. Additionally, 5.5 percent had used cocaine. Various qualitative studies have concluded that young out-of-school males from low- income families are the group most likely to use drugs. Similarly, anecdotal evidence suggests that many youth are involved in drug trafficking and drug dealing. Some youth report that drug dealers are currendy role models for many youth, especially males. 61. Both at-risk and control youth groups in the Saint Lucia qualitative study suggested that alcohol use was widespread and in most cases began in the early to pre-teen years. According to the 2000 PAHO adolescent health study for Saint Lucia, 63.3 percent of in-school teens surveyed had taken an alcoholic drink in the year preceding the study and almost one in 10 drank alcohol on a monthly or more frequent basis.19 SociAL EXCLUSION 62. Numerous authors and researchers have described or referred to Caribbean youth and at-risk youth as feeling powerless and excluded from the mainstream of Caribbean societies (Danns et al. 1997, James-Bryant 1992, Deosaran 1992, Lewis, 1995, West Indian Commission 1993, Barker 1995). This is not surprising given that the social integration of youth involves the insertion into the work force, and political, social and cultural life, as well as a smooth transition from dependence on the family to independence (Morales 2001). In the case of many Caribbean nations - with their inequality of educational opportunity, high levels of youth unemployment 19' The 2000 PAHO-funded Saint Lucia Adolescent Health Survey surveyed 1,526 students from 29 primary and secondary schools island wide. 26 and precarious employment - many youth face extreme difficulties in completing this passage, which are key components of future healthy adult life and well-being (Danns etal. 1997). 63. According to the Saint Lucia qualitative data, a large number of at-risk youth feel excluded from decision-making in the development of the island and even from their own communities. In addition, at-risk youth - especially males from ghettos - are branded and socially excluded because of the communities in which they reside, further promoting their isolation. Qualitative data collected among at-risk youth in the Dominican Republic suggest similar pattems. Interviews there revealed the following: Thisyouth 's social life takes place in an atmosphere that lacks such minimum senrices such as electriciy, water, adequate homes, clubs, sportsfacilities, libraries, health services. While neighborhoods have schools, these are few and do not meet demand. Thus the social life of youth is extremeIy deficient. Even when community-based organifrations existed in their neighborhoods, the youngsters were excluded. For example, in rural areas, young women who are pregnant or have children, cannot access cultural communiy groups that offer technical education because thesegroups are targeted toyoungfemale virgins with no sexual experience. The strongest oiganig.ations (drug dealers and gangs) dominate the environment in many poor communities. They are the ones that set the rules of thegame in these settlements. 64. Youth played an active role in the birth of politically independent Caribbean (Lewis 1995) but disillusion among youth followed.20 Post-colonial Caribbean youth have found themselves in societies in which "the rhetoric of self-reliance, of new visions for youth, of education as a vehicle for democracy, of youth entrepreneurship, all these promises did not materialize in viable amounts" (Deosaran 1992). Youth had come to realize that they were living in a political culture where "nepotism crowns geriatric politics" (ibid). Indeed young people found that " in large measure, the politics of colonialism have given way to a political independence which provides its own entrenched elites, leaving a blockade against change and youthful succession" (ibid). 65. Disillusion and distrust appears to have lead to indifference. According to Barker (1995), many youth - particularly at-risk youth - do not use the programs set 20 "Throughout the Caribbean during the 1930s it was the bulk of the young people who were among the chief architects of the labour revolts of that time" (Lewis, 1995:9). The social unrest of the 1930s not only gave birth to the labor movement in the Caribbean but also provided the political leadership for the independence movements in the region. In the 1970s many young people - particularly students - across the region supported the black power movement in an attempt to realize Bob Marley's call to emancipate Black people from mental slavery and as a response to the residue of racism still ernbedded in the social structures of the region Young people played an active role in both the attempted coup in Trinidad and Tobago in 1990 and the Grenadian revolution in 1979. 27 up for them by Government and NGOs because these youth have lost trust in institutions. Dominican Republic informants suggest that youth indifference is a major problem among those at-risk. According to these sources, attracting youth to community organizations is increasingly difficult due to disinterest among youth. Similarly Saint Lucia at-risk urban youth interviewed voiced disinterest and negativity in community activities. The data indicate that, as in other parts of the world, those youth who most need special services and supports are precisely the youth most reluctant or least likely to use these services. 28 4. SOURCES OF POSITIVE AND NEGATIVE YOUTH OUTCOMES 66. This chapter identifies the primary risk and protective factors that contribute to or impede positive youth development in the Caribbean. Consultations with government and civil society groups that work with youth revealed that the problems that face youth are well known, but the causes behind the observed negative youth outcomes remain a mystery. A better understanding of the influences that result in negative youth behaviors is needed for appropriate program design and policy. 67. The most pertinent risk and protective factors in each of the categories in Figure 2.1 are discussed. Although each category and risk or protective factor is discussed independently, it is important to note up front that there is a high degree of interconnectedness among the risk/protective categories. Most of the supporting evidence in this chapter is drawn from three sources: Blum (2002), Luther, et. al. (2002), and Barker (1995). The first source is a background paper prepared for this study that uses data from school children in 9 CARICOM countries to examine the connection between family, school, community, self and risky behaviors. Due to an agreement with the participating countries, country-by-country results may not be presented. However, Table 1.1 found in Annex I shows that the regression results are very similar across countries, allowing us to generalize across the sample countries. Luther (2002), which was also prepared specifically for this study, reports findings from focus groups and youth experts in Saint Lucia and the Dominican Republic who discussed the factors that lead to the challenges facing youth today. Finally, Barker (1995) - a study prepared for the UN - reports discussions with focus groups and youth experts about the use and sale of drugs in St. Maarten, Jamaica, St. Vincent, and Trinidad and Tobago. The methodology used in the background papers prepared for this report are discussed in Annex 2; the methodology for Barker (1995) can be found in the source. IND1VIDUAL 68. Individual characteristics that impede healthy behavior are not solely biological but are also learned characteristics - namely poor self-esteem, rage, ambivalence, and hopelessness. 69. Self-esteem. A positive self-image is a fundamental factor in protecting youth from consuming drugs or alcohol, engaging in violence, or initiating sexual activity. The factors that impede the development of self-esteem are largely based in the household: maternal 29 emotional abandonment (Luther 2002),21 an absence of parental nurturing (connectedness) (Blum 2002), unskilled parents (Luther 2002), and sexual abuse in the household that is known and accepted by other adults (Luther 2002). Additionally, the exclusionary nature of the school system - both in expelling children from school who do not "pass" the entrance exams and the social ranking in secondary schools by the color uniform worn - and poverty that includes coming from the "wrong" neighborhood were identified as negative influences on self-esteem. 70. Rage. Rage is a primary factor behind youth tobacco, alcohol, and drug use, engagement-in violent activity, and premature sexual activityv22 Holding all else constant, fewer than ten percent of school-going boys and five percent of school-going girls who do not feel rage smoke tobacco or consume alcohol while fewer than twenty percent use drugs. However, among those school-going youth who do express feelings of rage, the use of tobacco and alcohol doubles for boys and triples for girls while drug use approaches thirty percent (Figures 4.1 and 4.2). Similar increases are seen with violence and sexual experience where 20 percent of boys and 13 percent of girls who are happy engage in violence compared to 70 percent of boys and 40 percent of girls who feel rage. Sexual experience, which is a high 35 percent for boys and 13 percent for girls who attend school, doubles with male rage and increases 2.5 times for girls who feel rage. When controlling for age, these same propensities emerge. With respect to suicide, feelings of rage increase suicide thoughts or attempts by 14.6 percent, especially among boys (Blum 2001). 71. The sources of rage include family, institutions, and limited economic opportunities. An aggressive family is one of the primary sources of rage, while connectedness with parents is one of the primary protective factors.23 Over half of school-going youth who feel rage have been physically or sexually abused by family members while 38 percent of those who feel rage have not suffered abuse (Table 4.1). On the other hand, feeling connected to one's family decreases feelings of rage by half, especially for girls (Blum 2002). This is constant across age. Connectedness to other adults and religious institutions also decreases rage while the school and justice systems contribute to rage. Expulsion from school due to "failing" entrance exams or wearing the uniform of a less prestigious school instills in young people feeling of anger toward the system (Luther 2002, Barker 1995). This is exacerbated in poor areas where youth feel that police authorities are aggressive and prejudiced. Finally, the lack of job opportunities in a stagnant economy brings out youth anger (Barker 1995, Luther 2002). 21 Maternal emotional abandonment alludes to single mothers giving up on their children and holding them responsible for their own failings, thus contributing to low self-esteem (Luther 2002). 22Nearly 40 percent of girls and 47 percent of boys in the English speaking Caribbean think about hurting or killing someone - a proxy for rage. This propensity increases and deepens with age (Blum 2002). The estimated odds-ratio between rage and risky behaviors is significant at the one percent level as follows: violence (2.44 - 3.23, higher for boys); sexual initiation (1.7-1.8); and substance abuse (1.24-1.63 for ages 13-15 and 16- 18) (Blum 2002). 23 The estimated odds ratio when regressing the probability of feeling rage on the parental abuse variable ranges from 1.27 to 1.53, with a higher value for younger children (age 10-12). This is significant at the one percent level. The farnily connectedness estimate ranges from 0.44 to 0.51, again with the largest effects for the youngest children (Blum 2002). 30 FIGURE 4.1: Predicted Probability of Risky Behavior due to Rage, Boys 80% 70% 60% 50% 40% 30% 20% 10% smoking alcohol drug use violence sexual E Olow rage * high rage I experience FIGURE 4.2: Predicted Probabilty of Risky Behavior due to Rage, Girls 80% - 70% 60% - 150% - 40% - 30%- 20% smoking alcohol drug use violence sexual expetience [1E] low rage U high rage] Table 4.1: The Relationship Between Experiencing Abuse and Emotional Distress Emotional No Physical Sexual Both (%) Distress Abuse (%) Abuse (%) Abuse (%) Depression 45.7 65.4 61.9 69.7 (50.4%/o)* Rage 37.8 54.7 53.5 51.2 (40.1%)* Suicide Attempt 9.1 20.1 23.1 28.9 (12.10/o)* Source: PAHO Adolescent Health Survey, 2000 *Percent of total sample reporting 72. Ambivalence. A key observation of those who work with youth is that young people are less willing to be proactive in support of the public good, instead preferring to put their energies toward personal needs. Many youth programs depend on the participation of young people, who were key to political struggles in the 1 970s (Williams 2002, Alexis 2000) and to putting youth on the agenda in the 1980s (Williams 2002, National Youth 31 Council-Saint Lucia). Due to increased individualism and consumerism - which may be traced to US media images and inequality that is highlighted by the tourist and drug trades - young people put energies into themselves (Barker 1995). When voluntary community action takes place, the motivations are personal, rather than collection. This is clearly expressed by a young man in the Dominican Republic who said, "we fght so that they can fix our streets becauseyou buy a pair of new sneakers and this street with all the dirt damages them." (Luther 2002). 73. Hopelessness. Ambivalence may be a reaction to the hopelessness felt by young people who feel that they have no chance for happy, productive lives since the institutional and economic systems do not offer any chances for advancement (Barker 1995). In particular, youth said that corruption in public institutions lead to an inefficient use of resources and a failure of the state to respond to their needs, whether medical, security, educational, or social protection. Additionally, the exclusionary nature of the school system denies many children the opportunity for secondary or college-level education, which youth identify as a key input to finding good jobs in the future. Even those who do obtain education will enter a highly competitive job market where jobs are scarce and "well-paying" jobs are even more difficult to find. MICRO-ENVIRONMENT 74. The micro-environment - those institutions and influences that the young person confronts daily - are a source of both risk and protective factors, as discussed in Chapter 2. In the context of the Caribbean, the research revealed the importance, first and foremost, of the family. Other important micro-environmental forces are peers, roles models, social networks, and the community/neighborhood. Family 75. The family is both the strongest protective factor and risk factor in youth development. It is protective factor in that family connectedness (Resnick, et al., 1997; Blum & Rinehart, 1997), appropriate levels of parental discipline (Barker 1995), moral guidance, protection from dangers in the adult world, and economic support allow young people to acquire personal and social skills while young (Luther 2002). However, parental displays of negative behaviors (drug use, alcohol abuse, violence, low commitment to family), physical, sexual, and emotional abuse by family members or within the home, and the absence of parental guidance and support are negative risk factors. These can damage self-esteem, truncate youth personal, academic, and social development, and teach youth to perpetuate these same behaviors. 76. Parental connectedness. School-going youth who feel close to their parents have lower participation in substance use, suicide, violence, and sexual activity (Blum 2002). Girls who feel close to their fanmilies are about 15 percentage points less likely to engage in these negative behaviors while boys are about 10 percentage points less likely (Figure 4.3 and 4.4). Regression results show that this is the most consistently important protective factor of 32 those in the analysis, having a positive impact on youth across all the nrsky behaviors (Blum 2002). FIGURE 4.3: Predicted Probability of Engaging in Each Activity by Level of Parental Connectedness, Boys 90% 80%-_ 70%-_ 60% - _ __ 50% 40% - .__ _. 30%/ 20% - __ 0% _ smoking alcohol drug use violence sexual expenence Ob igh iElow FIGURE 4.4: Predicted Probability of Engaging in Each Activity by Level of Parental Connectedness, Girls 100% / 80% 60%0- 40% - . 20% -___ smoking alcohol drug use violence sexual experience | ahigh alow 77. Parental connectedness is likely to directly and indirectly influence young people's decision to engage in negative behaviors. The direct influence may be a desire of the child to not disappoint caring parents. Specifically, young people who perceive their parents as having expectations that they can complete school not only do better in school but also participate less in risky behaviors than others (Resnick, et al., 1997, Luther 2002). Furthermore, young people who believe that their parents would be opposed to the early 33 onset of intercourse are less likely than their peers to become sexually active.24 Indirectly, a lack of parental connectedness leads to more rage and lower self-esteem, which drive young people toward risky behaviors. 78. The building blocks of parental connectedness include adult parents and resources. Interviews with youth consistently report that adolescent mothers do not have the skills to be good parents (Barker 1995, Luther 2002), both because of their inexperience in adulthood and because childfathers (the father of the child of the adolescent mother) are less present and supportive than are older fathers (Russel-Brown 1994). Poverty also lowers parental connectedness since parents may need to spend the time working or compensating for absent public services (poor public transportation, absence of running water, absence of electricity) that precludes spending time with one's child and building a relationship. 79. Physical, sexual and emotional abuse in the home. A primary risk factor that leads to risky youth behavior is physical, sexual, and emotional abuse by parents or by non- family members who have access to the household. At-risk youth witness or experience domestic violence, abuse, and incest (Luthe'2002). Parental abuse increases the likelihood of boys' and girls' use of tobacco and alcohol, and has even larger effects on drug use, violence, and early sexual initiation. For example, 16 percent of school-going boys who are not abused use drugs while 32 percent who are abused by their parents use drugs; for girls, drug use increases from 13 percent to 18 percent with parental abuse (Figures 4.5 and 4.6). For school-going girls, sexual experience doubles if they are abused in the home. FIGURE 4.5: Probability of Engaging in Risky Behavior due to Parental Abuse, Boys 50% - 40% 30% 20%- 10% smoking alcohol drug use violence sexual experience Ellow *Ehigh 24 Recent research suggests that most of these perceptions come from non-verbal rather than from direct verbal messages (McNeely, Shew, Beuhring, Sieving, Miler and Blum, in press). Parental behaviors and interactions, rather than words appear to be more effective. 34 FIGURE 4.6: Probability of Engaging in Risky Behaviors due to Parental Abuse, Girls 30% - 25%/- 20%- 10% _ 5% 00/O- *1'- eg-- - _ _ _ _ smoking alcohol drug use violence sexual expenence |O1low EIhigh| 80. Child abuse can be attributed to poor parental skills, poverty, and culture. Poor parenting skills are especially relevant among adolescent parents, who have not developed as adults themselves and are unable to cope with their own children. Violence is a common response to stress and anger in Caribbean countries, feelings which are accentuated by poverty. Moreover, the acceptance of violence is reinforced through culture. Caribbean researchers hypothesize that the slave history in the English speaking Caribbean has institutionalized the culture of physical and mental abuse (Patterson 1975, Barrow 2001). Mothers were traditionally abusive of their children in preparation for the slave market, to prepare them for their future life, and this abuse persists today. These authors also hypothesize that men were not family fathers, only serving as biological fathers, during the slave period, so they did not feel connectedness to their own children or partners. This, in turn, lowers inhibitions on abuse by the father, making the behavior more common. 81. Risky parental behavior. Parental involvement in substance abuse and violence has negative demonstration effects on youth. One of the primary correlates of youth substance abuse and sexual initiation is parental substance abuse, particularly among children age 10-12 (Blum 2002). The early sexual initiation may result from abusive behavior of intoxicated parents or parental friends (Barker 1995). Both violence against others and self- inflicted violence (suicide) are correlates in youth violence and suicide, especially among young children (Blum 2002). 82. The sources of risky parental behavior are likely to evolve from their own experiences as youth and from poverty. The inter-generational transfer of risky behaviors is well-known as one group of youth become tomorrow's problem adults and teachers of tomorrow's youth. Poverty exacerbates the situation by increasing anger and hopelessness within adults as well. 83. Presence of two biological parents.25 Two parent-families have more economic and emotional resources as well as time and energy to devote to their children than do single 25 Access to extended family has also been found to be highly protective (Burton, et al., 1995). In many African tribes, it is clear to whom (other than mother or father) a young man or woman will turn in trouble. In many clans around the world, aunts and uncles are often referred to as mother and father. In highly mobile Western and migratory societies of the developing world where young men and women leave their villages for large urban centers, this source of protection is becoming less available. 35 parents. Single parents have little time to devote to their children as they must both work and provide for the children. However, the presence of two adults will allow a division of labor, resulting in higher overall family income and more time to directed toward childcare.26 This increases connectedness and thus decreases engagement in risky behaviors. According to Samms-Vaughan (2001), children have higher academic and cognitive scores when both biological parents are present, followed by two surrogate parents, and one biological parent; having a biological parent combined with a surrogate parent is associated with children's poorer academic and cognitive scores, especially when the surrogate parent is the father (ibid.).27 Samms-Vaughan hypothesizes that children's higher achievement with both biological and surrogate parents may be a result of the stability of these unions, which is transferred into the child's emotional stability. 84. Finally, barrel children, whose parents have both migrated, are at a particular risk as they do not have the protection of either parent. Due to better economic opportunities in other countries, migration of parents is common. Children are left behind with relatives or friends who receive payment from the parents until the parents are able to pay for passage for the children to join them. However, payment is not guaranteed and the waiting period may be very long, thus exposing young people to the influences of non-parental adults. The abandonment may lead to rage toward one's own parents, while the treatment of guest children may subject them to negative influences or abuse. 85. Household poverty. Although higher household income does not guarantee that youth will not engage in risky behaviors, it does alleviate some of the factors that lead to the behaviors or allow families to compensate for mistakes made by the adolescent. As discussed above, poverty may lead to absent parents (either working long hours or migrants), thus breaking family connectedness. The desire to help bring resources into the household lead some youth to engage in the drug trade and the drug use and violence associated with it. In the Dominican Republic, the primary reason that poor youth cite for school dropout is to work to support the family (Luther 2002). Even if they do not work in the drug business, youth from poor families live in neighborhood that are drug sale points (Luther 2002), thus surrounding youth with the negative influences. Finally, if a young person does become addicted to drugs or pregnant, poor families have few recourses, especially since public services are scarce. Thus, poor youth are permanently scarred while those from wealthier families have the resources to compensate for the implications of their poor choices. Peers, Role Models and Social Networks 86. Peers, role models, and social networks can be supports to or substitutes for absent family supports. Youth choose to spend the majority of their free time with their friends. Most of these relationships are positive, but youth spoke of the negative influences related to friends and role models/protectors who lead them into risky behaviors. 87. Peers and Social Networks. Since poor (urban) youth live in violent cornmunities where parents are often not present, gang membership was identified as a support structure, 2G Two-parent families are associated with less poverty than single parents, mother-headed households - usually a half to two-thirds less (Patterson & Blum, 1996; Blum, et al., 2000). 27 All findings were highly significant (p<0.001) even when controlling for social class. 36 in terms of personal safety, identity and companionship (Luther 2002, Barker 1995). In these violent neighborhoods in the Dominican Republic, for example, young people say that they are largely confined to their homes out of fear of walking in the street; simply association with a gang provides some level of protection. Gang activities, such as drug use and sale also gives a sense of identity as a "bad boy", as they say in the Trinidad and Tobago (Barker 1995). Out-of-school boys identified peer pressure as the prinary reason for their involvement in drug sales. Finally, as stated by a young man in Jamaica, "the boy does not have anyone to talk to. .. so, theseyouth may be bad, but at least they talk to him." (Barker 1995). 88. Social exclusion drives one to turn inward to one's neighborhood and social networks. As a Jamaican youth explained, "Youget labeled 'inner co". . . ghetto ' . . a lot ofpeople think thatghetto is ony crime and tviolence" (Barker 1995). This prejudice toward those who live in the poorer neighborhoods is clear in the labor market where being from the wrong neighborhood precludes one from obtaining a job; leading to even more dependence on one's own community (Luther 2002). However, the community is not a stable source of support as rnigration continuously changes the structure of the local networks (Barker 1995). 89. Role Models. Role models may be a protective factor, but negative role models are a risk factor. Most youth identified parents, entertainers, or teachers as role models, but drug dons are also a source of admiration due to their wealth (Luther 2002). The drug don, and his approachability and interest in recruiting children, make him a particularly dangerous role model as youth easily become engaged in his business, with clear negative implications for youth behavior. Political figures were not identified as role models, instead they were identified as being "corrupt", "only for themselves", or "unworthy of their positions" (Luther 2002). Community and Neighborhood 90. The physical environment in which youth live and the institutions that they confront daily are very powerful influences on the lives of youth. The institutions covered in this section include schools, the church, community organizations, and the physical neighborhood. 91. Schools. At the individual level, feeling connected to school is a very powerful protective factor. Boys and girls who feel connectedness to school - through a teacher or by working hard - have a probability of less than 10 percent of engaging in risky behaviors, as compared to those who do not have any connectedness; among those without school connectedness, their participation in risky activities is as follows: drugs (55 percent and 30 percent, respectively), alcohol (60 and 80 percent, respectively), violence (70 percent) or sexual activity (50 and 65 percent, respectively). Among girls and boys who feel connected to school, the probability of sexual activity falls by 30 percentage points for boys and 60 percentage points for girls (Figure 4.7 and 4.8). The good school performance may not solely be due to the education system but is likely to also capture positive home and community support; youth say that their school attendance and performance is highly contingent on their parents' interest in their success and in monitoring their school attendance (Luther 2002). To give credit to the school system, though, 88 percent of students feel connected to a teacher, who also gives positive reinforcement. Finally, students 37 who perform well will feel good about themselves and their future and do not want to jeopardize either by undertaking risks that may have long-term effects. 92. Religious Organizations. Religion was identified by many youth as an important protective factor in their lives. Several interviewees in a juvenile detention center in Saint Lucia identified God as their primary role model, and church attendance is identified as an important activity (Luther 2002). Thus, both spirituality (individual) and the act of belonging to a church community are important influences (Leffert et al. 1998). This is supported statistically by the strong negative correlation between religious beliefs and church attendance on the one hand and substance use, violence, and sexual initiation on the other." Although the magnitude of the prevention is not large, averaging a decrease of male risky behavior by five percentage points and female behavior by 10 percentage points, the role of religion as a protective factor against youth negative behaviors is indisputable (Figures 4.9 and 4.10). This may be directly, as membership in an association is likely to be contingent on not engaging in these behaviors or perhaps through the decreased feelings of rage in religious people.29 Figure 4.7: Probability of Engaging in Risky Behavior Due to Level of School Connectedness, Boys 100%/ 60% - 40% 20% - 0%/ smoking alcohol drug use violence sexual |I high * low] experience 93. Community Organizations. Youth groups and community groups are also important in the Caribbean, forming the basis of youth organization in some countries (National Youth Council Saint Lucia). Although these groups play important roles in community cohesion (such as the sports club in Barbados), education (the community youth groups in Saint Lucia), or advocacy, they also have the potential to be exclusionary (Luther 2002). For example, in the Dominican Republic, some clubs are based on personal characteristics, such as virginity, which necessarily excludes those already at risk. 28 The odds ratios for the correlation between religious beliefs and behaviors are 0.92 for violence, 0.9 for sexual initiation, and 0.86 for substance abuse. These are particularly significant (at the one percent level) for those age 13-15. 29 The odd-ratio estimate of the correlation between religious beliefs and rage is 0.91 and significant at the one percent level. 38 Figure 4.8: Probability of Engaging in Risky Behavior Due to Level of School Connectedness, Girls 100% 80%- 60% 40% 200/ 0% smoking alcohol drug use violence sexual El high U low experience 94. Physical Environment. The neighborhood environment in which Box 4.1. Boys in the Drug Trade - their young people live can predispose them Stories to risky behavior. For all the reasons previouslv expressed by the "I had a good home . .. it's hard to get work, you interviewees, they perceive that the need a lot of subjects in school ... the only thing mtenvironmentheyperceive that suro yyou can do is sell. . you know, for whatever fast environment that surrounds young mny"(ot,Tiidd people 'm poor communities is violent, m ( where survival is determr~ined by the "When there is. .. loss of a job (by someone at rules of the strongest, whlich are usually home), you see some friend out there and he has a involved in crimninal activities. "GntPsg,o new pair of sneakers and so you think about the about like Rambo with a knife in their mouth easy way out. So you sell (drugs) so satisfy your tying to surmvee" Youth values are then ego" (youth, Trinidad) distorted and survival becomes their strongest mandate. They state that the "The standard of living may be low at home... distribution and use of drugs are and marijuana (cultivating) is a quick wav of getting common activities. Poor money" (youth, St. Vincent) neighborhoods are drug distribution Source: Barker (1995) points that are dangerous but conducive to fast money. Gangs in these areas reign free and unhampered, always imposing rules by force. Everyone fears their actions and aggressions and negotiations like these usually take place: 'We won't tell, but don't hurt us" MACRO-ENVIRONMENT Finally, the larger environment that surrounds youth has strong influences over them that interact with the risk and protective factors at the individual and micro-environment levels. 39 The categories of most importance for the Caribbean, as identified by the research are: the economy, poverty and inequality; legislation and institutions, law enforcement and judicial system, culture and history, and gender. Figure 4.9: Probability of Engaging in Risky Behavior Due to Level of Religious Attendance, Boys 90% 80% - 70% -_ 60% - 30%- 20% 10% ___ 0% smoking alcohol drug use violence sexual experience | 1high *Elow Figure 4.10: Probability of Engaging in Risky Behavior Due to Level of Religious Attendance, Girls 100% - 80%- 60%- 40% 20% 0% smoking alcohol drug use violence sexual IO high U low Iexperience 40 Economy 95. The nature of the small economies in many Caribbean countries is a source of rsk for youth. Smaller countries cannot diversify production, so jobs are concentrated im a few industries, namely agriculture, tourism - both of which are very susceptible to international market forces - and services. This presents two challenges for youth. First, there is little demand for highly skilled workers so labor market specialization is rare and wages will not nse (Barker 1995).3° Second, unemployment is high and job creation is low, so vouth have a more difficult labor force entry experience than do youth in countries where a greater diversity of jobs exist. Even the larger, more diversified economies like Jamaica, Trinidad and Tobago, and the Dominican Republic have difficulties producing jobs with a living wage, leading to high youth unemployment there as well. 96. Due to these structural problems in finding jobs, the culture of migration continues. With jobs scarce and few opportunities for higher education (the exceptions being the Dominican Republic and the University of West Indies campuses), the skilled labor force leaves to search for education or job opportunities elsewhere. As explained by a young migrant with a master's degree in economics, when asked why he chose to live in the United States rather than Saint Lucia, his response was "What would I do there?' Youth are giving up on their countries, searching elsewhere for the support and the lifestyles that they cannot get at home. 97. Youth who do not migrate find the combination of youth unemployment and poverty pushing them to work in the drug trade, which has a high demand for unskilled labor. The Caribbean is increasing as a drug trans-shipment port between Latin America and the US or Europe.31 The scarcity and low pay of legal jobs, the attraction of the "easy money," laws protecting those under 18 from prison (Luther 2002), and the marketing to youth of drug dons (Barker 1995) makes this job opportunity very attractive to youth. Poverty and Inequalty 98. Youth from poor areas identify poverty as a key source of risky behaviors. Interviews reveal that young men and women feel that they need to work to support their families (Luther 2002). Given their low levels of education, especially if they have been excluded from the education system by earning low exam marks, they have few options except informal sector work, drug trade, or the commercial sex work/sexual exploitation (Barker 1995).32 Also, the lack of income leads to parental absence and aggression, which has implications for youth behaviors. Interviews with young uneducated poor women in Jamaica reveal that they fully understand reproductive health, but their best income prospects are from pregnancy and child support (Barker 1995). Finally, the income inequality demonstrated by drug dons, foreign tourists, and the media encourages the 30jobs do exist, but youth do not feel that they are fairly remunerated. For example, a young unemployed man in Jamaica explained, "There are lots ofplaces that want to payyou nothing (for working). Thy use and abuseyou." (Barker 1995) 31 "Illicit Drug Markets in the Caribbean." 32 Increasingly, the public health field refers to prostitution of adults as sex work or comnmercial sex work and prostitution of children and adolescent under age 18 as sex exploitation. 41 engagement in the easy money activities, including drugs and prostitution (Barker 1995, Luther 2002) (Box 4.1). Public Policy and Institutions 99. The Education System. The existing education system in the English-speaking Caribbean was inherited from the British colonial education system in both structure and content. Students are exposed to technical and vocational subjects only when they are deemed as unable to perform academically, effectively categorizing technical vocational students as an underclass. 100. The structure of the educational system directly induces risky behavior. The Common Entrance Exams (CEE) in most English-speaking countries are a clear threat to young people as their performance on this exam determines their worth to society. Those who "pass" the exam - which is not entirely correct since the passing score is a function of the number of places available in secondary school, not necessarily a minimum level of competency - are implicitly told that they are valuable to society and are permitted entrance to the next level which improves their probability of success later in life, thus having a positive effect on self-esteem and discouraging risky behaviors.33 However, those who enter secondary school are not free from judgment since school placement is based on the points achieved from the CEE. Consequently, youth define themselves and each other based on the uniform they wear and the school they attend"4. The sense of achievement of having made it through this competitive process adds to their self-worth, and conversely hurts those who do not pass. Students with the highest sense of self worth and confidence from the focus groups were those who had achieved tertiary level education. Thus, the system induces risky behavior by forcing children to leave. Those who do not pass the exams are effectively told that they do not have value and that the government's investment in them, and in their futures, ends at a young age. This rejection and denial of opportunities that will lead to a successful life understandably leads to rage, depression, and risky behavior. 101. In both the Dominican Republic and the English-speaking Caribbean, youth felt that the school curriculum was not appropriate to prepare youth for the labor market. The Youth Senator for the Opposition in Saint Lucia (Senator Ricky Alexander) describes the curriculum as having an academic bias that develops no talent or skill in students and does not nurture them, so that they can make a meaningful contribution to the society. He described the quality and the dimensions of education now on offer as unsuited for the economic and social realities of our time. Students are taught academics to prepare them for the future without them having tangible employment prospects, and with them also lacking any marketable skills or any entrepreneurial spirit. Further, academically strong youth are confronted by the inability of their impressive academic certificates to ease their entry into a "good" job. Activities like drug dealing and other profitable criminal activities, as well as migration, become viable options to meet their expectations of personal success. 33 The system is perhaps more egalitarian but also darnaging in rural Dominican Republic, where there are not enough spaces for all secondary school students. This is solved by some students leaving school on their own choice (Luther 2002). 34 All Saint Lucian secondary students wear different uniforms that allow societal differentiation of students and furthers aids the development of academic elitism and discrimination. 42 102. Classrooms are sources of violent conflict. At-risk youth, especiallv males, voiced negative views of teachers and authority figures within the education system. Even though most youth (88 percent, Blum 2002) feel connected to a teacher, youth report the unfairness of corporal punishment and physical fights with teachers (Williams, 2000). Males, in particular, felt that they were being ostracized and were not provided with adequate support by teachers. Of greatest concern were the teachers' ability to arbitrarily punish and report to parents. Another issue that further alienates at-risk youth is the holding back of low- achievers. The students are held up to ridicule by their peers, leaving at-risk youth prone to truancy and eventual drop-out of the educational system (Luther 2002). 103. Immigrant children are systematically excluded from the school system. In the Dominican Republic and St. Maarten, for example, the requirement of national birth certificates for school enrollment and under-provision of schools in immigrant neighborhoods excludes these most vulnerable children and youth (due to poverty, few networks due to recent migration, linguistic isolation) from the system completely. Together with unstructured free time, poverty, and absent parents, these youth are particularly vulnerable to risky behaviors (Barker 1995, World Bank 2001a). 104. The Health Care System. Youth interviewed cite lack of confidentiality as a key nsk factor in seeking health care services. Problems related to the health care facilities are particularly important given high levels of HIV/AIDS, low contraceptive use among sexually active adolescents, and teenage pregnancy. According to a review of international experiences in the provision of services to at-risk youth, health care programs tended to lack youth-sensitive services (Barker and Fontes 1996). Given that many of the health problems youth face are "sensitive" (e.g. sexuality), having primary and secondary health care professionals who are understand the needs of youth are critical to reducing risky behavior related to adolescent health. 105. Law Enforcement and the Judiciary. Youth in the Dominican Republic and Saint Lucia are untrusting of the legal and judicial systems in their neighborhoods. They report that police are prejudiced against youth and treat them badly. This is particularly the case in poor neighborhoods where poLice assume that all youth are engaged in the drug trade or crime. However, despite the poLice force, youth feel that poLice fail at their jobs of providing security. Instead, drug dons run the neighborhoods, especiaLly after dark. A similar distrust is felt of the judicial and more general poLitical system where youth feel that all authorities are corrupt and untrustworthy. Culture and History 106. The Caribbean has a culture of aggression, substance use, and adolescent childbirth that dates back to colonial times. Many of these countries produced sugar cane and alcohol products. As a Barbadian explained, "we grow sugar cane here, eveyone drinks rum, they always have." However, alcohol is not seen as a drug (Luther 2002). The attitude toward marijuana 43 is similar; it is seen as a social drug that is medicinal and not harmful or immoral (Barker 1995).3 107. Physical violence, whether in the homes or schools, is also attributed to the colonial culture, especially in the English-speaking Caribbean countries. As discussed above, the school system is based on the English system, in which corporal punishment is an element of school discipline. This system survived after colonialism and is not questioned today, thus institutionalizing certain forms of violence. Violence in the home by the mother is also identified as a form of discipline. Historical anthropologists attribute it to the slave mother disciplining her children in a manner in which they would be disciplined when they began working. Finally, the more general domestic violence, particularly that by men, is accepted as a gender role. 108. The structure of the household in the English-speaking Caribbean is also attributed to slave culture. Families were discouraged as they would be broken up in the sale of slaves, but women were encouraged to bear many children (capital production for the slave owner). Thus, men were excluded from the family and were not encouraged to be participating fathers. The high number of out-of-wedlock births, the propensity for men to float among several partners, and the absence of expectations for men to be responsible partners and fathers leads to the unstable family situations of today. The many problems of single female headed households are well know, thus setting up the conditions for children to engage in risky behaviors. 109. The household in the Dominican Republic is very different, with a single, tight family where family honor is paramount. This does not imply that single mother households do not exist, but the steady state of a man who floats among many households is less prevalent. However, single motherhood is more of a stigma in this highly Catholic country, where pregnant, unmarried daughters are regilarly expelled from the household or treated as domestic servants in return for living with her child in her parents' house. This familial exclusion leads to risky conditions for young mothers (Luther 2002). Gender 110. Gender is a risk factor for Caribbean male and female adolescents in specific ways. Male school-going students were much more likely to report violence involvement than females (odds ratios 10-12 years old: 2.37; 13-15 years: 2.96; 16-18 years: 3.03); twice as likely than their female counterparts to report having had sexual intercourse; less likely to report suicide attempts than girls across all age groups; and consistently more likely to report rage for every age group of teens (Blum 2002). Sexually active males are less likely than their female counterparts to always use contraception. 111. Behavioral differences between male and female adolescents, which are rooted in norms and values, can lead to negative outcomes. Being a man in many Caribbean societies, 35 Despite the cultural acceptance of marijuana, it is illegal in the Caribbean. In the 13 country data collection exercise by PAHO, marijuana use was reported by less than two percent of school-going children; a very unlikely statistic. The researcher thought that the respondents may have under-reported use due to the illegality of the narcotic. 44 for example, means providing economnically for one's children as well as sexual prowess and multi-fathering. But these norms are contradictory for low-income men in particular who do not have the economic means to provide for many children. As a result, many Caribbean men are ostracized from their children. Men can enter into illicit activities (violence and drug dealing) as a means of earning income. The absence of fathers can also lead to negative outcomes for the children. A study on the effects of early childbearing in Barbados shows that fathers' close relationship with children was associated with higher academic achievement (Russell-Brown et al. 1994). Societal norms also dictate that men adhere to rigid codes of honor and bravado, which obligates them to compete, fight and use violence (Barker 1998). Male bravado is reflected in men's resistance to use condoms. For a very long time, men in Jamaica have scoffed at using condoms, claiming that real men preferred to "ride bare back" as it is commonly put (World Bank 2001). 112. Gender is also a risk factor for women. For example, higher rates of sexual abuse among girls represent a fundamental risk factor for females. Moreover, men's inability to meet the expectation of economic provider means that a large proportion of women need to raise children on their own, leading to greater levels of poverty and vulnerability among these women and their children. The children of single mothers are also more likely to go unsupervised and be exposed to negative peer groups that prey on children (e.g. gang leaders). The expectation that women be more passive than men means that women have a more difficult time negotiating condom use, thereby exposing them to HIV/AIDs and STIs. INTERCONNECTEDNESS OF FACTORS 113. The discussion of the risk and protective factors for each level of influence - macro, micro, or individual - has not been linear, instead revealing a high degree of inter- dependency among those areas of influence. It is thus difficult to sort out the marginal effect of each influence.6 However, a grouping of inter-dependent characteristics can demonstrate the group's marginal influence on behavior. 114. Rage and skipping school is likely to be a result of parental abuse (among other factors). Figure 4.11 compares the probability of boys and girls engaging in violent activity or drug use if they possess all three of these characteristics, relative to not possessing any. The table clearly shows that the joint effect of the three characteristics is not as great as the sum of the individual effects, suggesting correlation among the characteristics. While not possessing any of these risk factors is correlated with less than 20 percent of the school aged youth engaging in violence or drug use, possession of all three increases the likelihood of violence of young men to more than 90 percent, for example. 36 Ideally this would be accomplished in a mutli-variate regression, but high collinearity among the factors precludes this option. 45 Figure 4.10: Probability of Engaging in Risky Behavior, Presence of Multiple Risk Factors, Girls and Boys (%) 100 40-- 20 0 violence drug use violence drug use male male female female |0 no risk factors * three risk factors 115. The dependency among protective factors is also clear. Figure 4.12 shows the implications of "connectedness" for youth violence and drug use. This attempts to not assign a marginal effect to school, religion, and family, but instead allows that connectedness in one sphere may be correlated with this feeling in the other two spheres. Again, the results are much stronger when jointly considering the protective factors; i.e. the concept of connectedness. Figure 4.11: Probability of Engaging in Risky Behavior, Presence of Multiple Protective Factors, Girls and Boys (%) 80 70- 60° - 50- 40- 30 - 20 10 0 violence drug use violence drug use male male female female 0 three protective * no protective 46 FINAL THOUGHTS 116. Youth respond to the incentives and environments that are taught and presented to them, suggesting that youth themselves are not the problem. Instead, the environment im which they exist and their support structures either force riskv conditions upon them, such as school leaving for young English speaking Caribbean students who do not do well on their CEEs, or set up conditions where engagement in risky behavior is a reasonable option, such as the case of the drug trade when unemployment is rampant. There is also a high degree of interconnectedness among the different risk/protective categories, suggesting a more holistic approach to working with youth to improve their situations. However, parental involvement, both emotional and a physical presence, is one of the most important protective factors. Unfortunately, due to the changing economy, migration, and socialization, this resource is ever scarcer. 47 5. THE COSTS OF RISKY ADOLESCENT BEHAVIOR 117. Risky youth behaviors do not only impose costs on young people and their families, but also on the economy and society at large. This chapter estimates the cost to society of school dropouts, adolescent pregnancy, youth HIV/AIDS, youth unemployment, and youth crime and violence in as many countries as the data permit.37 The numbers presented in this chapter are, at best, a rough estimate of the costs of risky adolescent behavior to society. They underestimate the total costs due to the difficulty in putting a price on the psychological and emotional costs of risky behavior and the cost externalities that their behaviors create, i.e. those costs that are indirecdy related to deviant youth behavior. 118. Economic costs for each behavior is generated.38 Such an exercise may be distasteful since it collapses complex human behaviors into prices and uses labor productivity to put a value on a person's life. However, this chapter does not pretend to fully measure the costs imposed by a youth engaging in risky behavior since the impossibility of measuring a human life is recognized. Instead, the chapter only attempts to measure the productive value of the individual and the measurable costs associated with various behaviors. The costs presented are only a lower bound, implying that the total costs to the behaviors are much higher. Furthermore, most of the cost discussed in this chapter are the opportuniy cost of the engaging m risky behavior, namely the lost productivity due to early deaths, limited work lives, low human capital accumulation, and an absence of opportunities. The methodology for the cost estimates is given in Appendix 2. 119. Despite the lower bound estimates presented in the chapter, it was important to at least make an effort to express costs in economic terms. The purpose of this chapter is simply to give conservative, rough estimates of the cost to society of youth in risky situations - it does not claim that the answers are easy nor does it pass judgment on governments who have not addressed these issues. Despite these under-estimates, it is clear that the costs to society, mosdy in term of foregone productivity, reaches into the billions of dollars. SCHOOL LEAVING 120. Early school desertion imposes a high cost on the Caribbean. As discussed in earlier chapters, school not only provides the human capital that can be sold in the labor market, but it also is the source of more general education such as social interactions, building social 37 ross-country comparisons should not be made since the sources of the data used for each country differ, thus not making them comparable. 38 Economic costs - the foregone value of the productive input - is used rather than financial costs, which measure the actual money spent or lost due to the behavior. Thus, the former includes the foregone labor market output of youth who are in prison, for example, while the latter would not include this as a cost. 48 capital, and identifying guiding principles for one's life. Simply being in a school environment is largely a positive force. Thus, early school departure may not impose large direct costs on society (holding constant the other negative behaviors that school leavers tend to engage in) but they do impose high indirect costs in the form of foregone labor earnings for the individual, lower tax revenues for the state, and lower GDP for the economy. 121. The personal and economy-wide gains to a population with a post-secondary education are far greater than those with only a primary or secondary education. The area between the top and middle lines as shown in the figures found in Annex 3 represents the marginal gain to lifetime earnings39 of a university education compared to only a secondary education. The differences are large for men and women in all countries presented. However, the benefit to lifetime earnings of an individual with a secondary education, relative to only a primary education, is not as clear. First, the gap between the middle line and the bottom line - comparing secondary lifetime earnings to primary - is not as large as the comparison between secondary and post-secondary, thus implying that the net gains are not as large. Second, the marginal benefit to women seems to exceed that of men, as women in all countries have a premium to secondary education, though it may not emerge until later in their work life. Finally, for some Guyanese, Jamaican and St. Lucian men, the lifetime earnings from a secondary school education does not differ from those with just a primary school education. This may reflect the inability of secondary school to prepare young people for the labor market; it may be that all skills that are valuable to the labor market are learned during primary school and that skills learned while working as a teen earn a higher premiurm in the labor market than do skills learned during secondary school. 122. The cost of early school leaving in terms of foregone earnings at the individual level - which may also be understood as foregone GDP for the country - reaches into the hundreds of thousands of dollars per individual.40 In the Dominican Republic, Jamaica, and Trinidad and Tobago, the benefits of a secondary education are clear for both boys and girls, as shown in Table 5. 1.4l For example, in the Dominican Republic, the net lifetime earnings of secondary education relative to only primary is US$45.6 thousand for a boy and US$24.0 thousand for a girl. This implies that the productive capacity of the economy is severely under-utilized due to secondary school leaving. The benefit of post-secondary education is even more dramatic, where the net earnings (productivity) are in the millions of dollars, such as for Guyanese girls. 39The top line in each graph is the amount of earnings per year that an individual with university education receives over the lifetime. The second line is the total earniigs of a person with secondary school and the bottom line is the earnings per year of an individual with cnly primary school. The area between each line is the net benefits to lifetime earnings of the next higher level of education. 40 An alternative measurement is to estimate returns to each level of education and use the coefficients from a linear regression to estimate earnings. The weakness of this approach is that it assumes that the returns to experience for each education level are constant - which is clearly not the case as shown by the graphs. Since education and experience are the primary explanatory variables in a Mtincerian wage equation and all the information from these variables are captured in the graphs, the graphs are used. The estimates from the Mincerian wage equation are given in the Appendix, for reference. 41 The estimates assume that the wage elasticity of demand is zero. 49 Table 5.1: Net Lifetime Earnings Relative to Primary School per School Leaver, (in thousands of US$) Dominican Trinidad & Republic Guyana Jamaica Saint Lucia Tobago 1998 1999 1997 1995 1992 Men Secondary $45.6 $16.4 --- $46.2* University $194.8 $675.,9 $216.3 $520.7 $205.1 Women Secondary $24.0 $314.5 $38.8 $525.1 University $99.7 $1,051.4 $139.4 $1,886.8 * men and women. Source: For the first four countries, the numbers are derived from labor market and household surveys; author's calculations. Trinidad and Tobago is from World Bank (2000b). 123. The per capita productivity loss to the country as presented in Table 5.1 assumes that the marginal dollar earned by the young man or woman today is equivalent to a dollar earned in the year 2045, at the end of the young person's work life. It may be more appropriate to discount the net lifetime earnings in order to take into consideration the lower value that a dollar earned in 45 years has relative to one earned today. These discounted values are also useful in a cost benefit analysis when considering whether or not to implement programs to lower school leaving. The discounted lifetime earnings - presented in Table 5.2 - still show that additional education today has benefits for the future.42 Table 5.2: Net Discounted Lifetime Earnings Relative to Primary School per School Leaver, (in thousands of US$); discount rate of 6%. Dominican Trinidad & Republic Guyana Jamaica St. Lucia Tobago 1998 1999 1997 1995 1992 Men secondary $27.4 $11.4 --- $5.2 university $137.0 $660.6 $156.9 $420.4 $14.5 Women secondary $16.9 $238.6 $20.6 $279.3 uriversity $86.9 $1,036.3 $115.4 $1,562.7 Source: household surveys for the first fours countries; World Bank (2000b) for Trinidad and Tobago. 42 The discount rate is a proxy for the rate of time preference, interest rate, and savings rate. The rate of time preference differs by person, as the poor tend to have a much higher rate of time preference; i.e. a dollar in 45 years is worth much less than a dollar today; due to the need to meet immediate consumption needs today. On the other hand, the social rate of time preference may be much lower. The difference between the social and private rate of time preference gives an incentive for governments to intervene in private decisions. For example, the discounted value of a higher education may be very low to a student from a poor family who would greatly value the labor income that he/she brings into the family today. However, society sees the long- term benefits of this young persons labor market contributions over the future as well, so the benefit to staying in school is high. To bridge the difference, the State would intervene to either force or compensate the young person such that the private discount rate is more aligned with the social discount rate and the young person chooses the socially (and privately) optimal behavior. 50 124. The estimates in Tables 5.1 and 5.2 may be an underestimate or an overestimate of the total losses due to school leaving. On the one hand, wages only capture job productivity, but even when controlling for higher income, higher education is correlated with lower crime, healthier lifestyles, cultural development, greater volunteerism, and a multitude of other factors (Haveman and Wolf 1984). These non-monetary benefits are estimated to be equal to the marginal value of additional education, thus doubling the estimated return to education. Furthermore, this is still likely to be an underestimate due to the difficulty of assigning a value to life. On the other hand, these estimates may over-estimate reality. They assume that the wage elasticity is zero so that increased employment would not decrease earnings. However, various studies (Arango and Maloney 2001) show that this is not the case. Also, it is unlikely that the economy could provide highly skilled jobs to a population with 100 percent university completion rates. Nonetheless, the estimates do give a rough picture of the richness of human capital that could even partly be realized by investment m youth education. ADOLESCENT PREGNANCY43 125. The cost of adolescent pregnancy includes not only the immediate needs of the mother and child, but also the costs to their family, the father and his family, taxpayers, and society. These costs are not limited to the birth period, but include both direct costs - which are paid by the mother, family, or taxpayers over the life of the mother and child - and indirect costs in the form of foregone earnings of the mother and the child when he/she becomes an adult her/himself. The potential costs to an adolescent birth, as compared to adult mother, may include: * Lower lifetime earnings of the mother- Lifetime earnings may be lower for adolescent mothers due to early school dropout; fewer opportunities for advanced education due to poverty (single mothers tend to be poorer) and childcare demands; fewer employment options due to childcare demands; and less accumulated job market experience since young women truncate their human capital accumulation at a younger age. Evidence from the United States shows that teen mothers have higher lifetime earnings than women who are in their early twenties when they bear children; this is attributed to longer work hours of young mothers since they are often the sole provider for the child (Maynard 1996). However, evidence from Barbados suggests the opposite - adolescent mothers earn 22 percent less than do women who have children at an older age, primarily due to earlier school dropout of adolescent mothers (Russel-Brown 1994)." They are as likely to be employed. * Lower remarriage possibi1ities- virginity in marriage is valued so adolescent pregnancy may decrease the likelihood of remarriage, thus increasing household poverty. An opinion survey from the Dominican Republic shows that 65 percent of youth believe that a woman should be a virgin upon marriage (Tejada 1992). 43The method for calculating costs for this section was developed by Mavnard (1996). 44The results for Barbados should be taken as a rough estimate since the analysis did not control for (i) the age difference between adolescent mothers and non-adolescent mothers which will affect earnings and (ii) the characteristics that decrease earnings and may be correlated with adolescent pregnancy, but not due to it. 51 However, this does not necessarily disproportionately affect union formation by adolescent mothers; in Barbados, for example, teen mothers were no less likely to form a union than were older women (Russel-Brown 1994). * Unpaid child support - teen mothers are less likely to receive child support than are mothers of older children since the fathers are more absent, which increases household poverty. Adolescent women are more likely to have young partners, whose earnings ability is low and who are likely to form unions elsewhere (in the Dominican Republic, nearly 30 percent of adolescent boys have more than one sex partner; Tejada 1992). In Barbados, 44 percent of fathers of children whose mother was an adolescent when she gave birth pay child support, compared to more than 60 percent of men whose children have older mothers (Russel-Brown 1994). The burden of supporting the child is thus shared by the mother, her family, and society. * Higher health care costs - complications in teen births are higher since their bodies are less developed to cope with the stress of childbirth. Also, children of teen mothers tend to have more health problems (Maynard 1996). This imposes costs not only on the mother and her family, but also on the public health system. * Disadvantaged children - due to the higher poverty of teen mothers and the absence of a father figure, children of teen parents have more behavioral problems (Russel-Brown 1994), less educational attainment (Russel-Brown 1994), a higher likelihood of being teen parents themselves (Maynard 1996), and a higher likelihood of engaging in violent crime (Grogger as cited in Maynard 1996, Baker 1996). These contribute to higher poverty for the adult child his/herself as well as a transfer of these behaviors to their own children. * Higher demands on the social system - the poverty associated with teen pregnancy and the expulsion of young mothers from their family households lead to an increased demand for foster care, government transfers, child-nutritional programs, food programs, and government housing (Maynard 1996). * Lower tax revenues - the lower earnings of the mothers and their children will result in lower tax revenues for the state. * Social exclusion andpoor mental health - young unmarried women who give birth may be cast out of their household and communities, such as in the Dominican Republic. 126. The total net lifetimecost of adolescent childbirth in Caribbean, defined as women age 15-19 for this section, is as high as US$1.9 billion in the Dominican Republic for each annual cohort of adolescent mothers. This figure is comprised of two components: the net annual cost to society of adolescent child birth, which accrues to each year of a woman's and her child's life after the child is born; and other costs that accrue to events that occur as a results of the teen pregnancy (such as the higher incarceration of young men). These costs are not the total cost to a young woman of raising a child but instead are the additional costs that accrue to the mother because she gave birth as a teen. 127. The net annual cost of an adolescent childbirth, as compared to a non-adolescent childbirth, ranges from US$198 in Guyana to US$2,008 in St. Kitts, not far from the 52 US$2,162 estimate for the United States (Table 5.3).45 The high costs in St. Kitts are attributable to higher wages and child support (which are a function of wages) and the higher cost of healthcare while these are low in Guyana. The total cost per year of all new teen mother births ranges from US$284,000 in St. Kitts to US$22 million in the Dominican Republic, where teen births rates are high and growing among a large population. Costs are similarly high in Jamaica and Trinidad and Tobago due to the larger populations and higher birth rates among young people than in the other countries in the table. Finally, the total lifetime costs of all adolescent women in the year 2000 who gave birth in their teens rather than in their twenties, ranges from US$3.6 million in Guyana to US$1.9 billion in Dominican Republic, again reflecting the difference in population size, birth rates, foregone mothers' wages, and healthcare (Table 5.3) - this represents an enormous cost to society in terms of lost labor market productivity and direct costs of early childbearing. These high figures do not even include the emotional and psychological costs to the mother, child, father, and familv that are associated with adolescent pregnancy. Table 5.3. Estmated Costs of Teenage Pregnancy over Non-Teen Pregnancy, US$ Total lifetime costs Total lifetime cost of one Cost per year per pregnancy* cohort of teen mothers Per teen All teen pregnancies pregnancy in oneyear Barbados $1,288 $580,654 $63,466 $28,610,419 DR $525 $22,615,119 $45,055 $1,941,904,643 Guyana $198 $199,961 $3,574 $3,602,916 Jamaica $737 $3,550,052 $13,266 $63,918,244 St. Kitts $2,009 $284,492 $51,137 $7,242,852 St. Lucia $891 $499,755 $16,036 $8,997,612 T&T $1,189 $1,429,844 $26,983 $32,443,929 * Excludes the foregone earnings of the child when he/she is an adult in the labor force; adding this cost was too subjective. Source: wages from ILO; cost of social programs from World Bank (1996); cost of incarceration from World Bank (1996); incarceration rates from UN; health care costs from PAHO; teen pregnancy totals from PAHO. CRIME 128. The total cost of crime committed by youth cannot be accurately estimated since many of the crimes include unmeasureable losses, such as those resulting from murder, sexual offenses, and drug trafficking. Abstracting from the costs to property, life, the future income of the youth, the families of the criminal, and the psychic costs - i.e. the 45 The category "per teen pregnancy" is the additional cost that accrues to a teen birth in terms of foregone earnings, lost child support, social program benefits, and higher medical costs; the category "all teen pregnancies in one year" multiplies the first column by the number of teen pregnancies in the year 2000; "total lifetime costs per pregnancy" is the sum of 18 years of child support, mother's labor market remuneration, social programs and benefits, and higher medical costs and 32 years of work after the child leaves home; and "total lifetime cost of one cohort of teen mothers" is the product of column 3 and the number of teen births in the year 2000. 53 unmeasureable costs - a price can be put on the opportunity costs of crime in terms of lost labor market output and the direct cost to the justice system. 129. Data for Trinidad and Tobago show that the most basic direct and indirect costs of a crime amount to TT$42,217 (about US$11,813). These cost can be disaggregated into arrest (TT$11,196), court appearances (TT$11,104), and six months of incarceration ($TT9,205), which equals TT$31,500 (near US$5,000) in public expenditures per person arrested. It should be noted that these are public costs for Trinidad and Tobago and that other countries may spend more or less on the police or judicial system so their costs may differ greatly from those of Trinidad and Tobago. The remaining TT$10,717 can be attributed to the foregone production of the criminal while he/she is in prison (World Bank 1996). 130. The absence of arrest and prosecution data for Trinidad and Tobago does not permit the calculation of the total costs each year to Trinidadian taxpayers, but prosecution data from Jamaica and Barbados allow a rough estimate. Assuming that the costs of arrest, court appearances, and incarceration are of the same magnitude in Jamaica and Barbados as in Trinidad, and that the average prison stay of Jamaicans and Barbadians is also six months (despite the higher magnitude of violent crime in Jamaica), the costs would equal one tenth of one percent of GDP in Jamaica and 4.12 percent in Saint Lucia (Table 5.4).46 This figure is an underestimate as it does not consider the damage to life, property, and the criminal's human capital. Including rough estimates of protective measures for citizens to protect themselves from being victims of the crimes increases the expenditures on crime from US$5,036 to US$34,000 (where US$3,969 are fixed costs and the remaining are annual recurrent costs). Table 5.4: Estimated Public Cost of Youth Crime, in Local Currency Jamaica Saint Lucia Marginal cost of youth crime $227,046 $18,827 Total cost of youth crime $287,439,809 $77,938,872 Cost of youth crime as % of GDP 0.11% 4.12% Source: Marginal costs from World Bank (1996) 131. Crime is a deterrent to tourism;, one of the most important industries to many Caribbean countries. A recent paper shows that a one percent increase im the crime rate reduced tourist flows by one half to three-quarters percent (Lavantis 1998). Applying these parameters to youth crime, if youth crime decreases one percent, the tourist flows to Jamaica and the Bahamas will increase by more than 36,000 tourists per year. This is equivalent to over US$40 million in Jamaica and US$31 million in Barbados, a 4.0 percent and 2.3 percent increase in tourist revenues, respectively (Table 5.5). 46 The cost of crime is the sum of the direct costs of crime of all youth in 1994 (the most recent year of the crime data) and the total foregone earnings while the young person is in prison for six months. The number of youth crime convictions per year is given by Pantin (1998) for Jamaica and ECLAC (2001) for St. Lucia. 54 Table 5.5: Estimated Increase in Tourist Flows and Expenditures due to a One Percent Decrease in Youth Crime Jamaica Bahamas Number of new tourists 45,920 36,340 Total new earnings due to more tourists $40,680,911 $31,943,672 New earnings as % of tourism receipts 4.01 2.34 Source: tourist flows and receipts from the Caribbean Tourism Organization; number of crimes from UN. HIV/AIDS 132. The cost of HIV/AIDS attributable to youth is difficult to measure since the period between contraction of the illness and symptoms may be anywhere from five to 10 vears. Statistics show that the majority new HrV/AIDS cases are not reported by youth, but rather are reported by those in the age group 25-39. Given the incubation period, these individuals are likely to have contracted HIV during their years as youth - primarily due to unsafe sexual activity. Thus, in measuring the cost to society of youth behavior that result in HIV/AIDS, both the youth themselves and those who contracted HIV during youth should be considered. 133. Two costs are associated with HIV/AIDS: direct and indirect. The direct costs attributable to the illness vary since there is no cure. Instead, costs may simply be treating other illnesses that afflict an individual with AIDS, estimated as US$200 per day per AIDS patient in Jamaica, for example, to the full "cocktail" that may cost $7000 per patient per year (World Bank 2000a). Table 5.6 shows the per capita costs of HIV/AIDS programs, where the costs accrue to the whole population (since the use of public funds to treat HIV/AIDS patients in the latter two categories is paid through taxes), ranges from US$4 - $6 per year for pure prevention programs to US$40-US$119 per year for prevention and treatment. This is equivalent to an increase in health spending by 15% (Bahamas) to 439% (Haiti). Although Table 5.6 does accrue to the whole population, not just youth, it shows how costly prevention and care can be among the at-risk youth population. Table 5.6: Per capita costs of HIV/AIDS and program costs as a proportion of current health spending Preventative program Preventative + basic Preventative+basic care care program + HAART (at $7000) Per % increase in Per % increase in Per capita % increase in capita health capita health cost health cost expenditures cost expenditures expenditures Bahamas $8 1% $69 9% $119 15% Haiti $6 33% $18 100% $79 439% Dominican $4 4% $15 16% $106 116% Republic Guyana $6 13% $22 49% $81 180% Jamaica $4 3% $15 10% $40 27% Trinidad and $4 2% $16 8% $41 21% Tobago Source: World Bank (2000a) 55 134. Foregone labor market productivity - a measure of indirect costs of youth HIV/AIDS - under the worst case scenario where no HrV/AIDS treatment is given, reaches up to one-half of one percent of GDP. Assuming that all new AIDS patients will not receive any treatment and will die within one year - a very liberal assumptions since AIDS patients are treated in many countries and the World Bank's new HIV/AIDS lending programs will further spread prevention methods and treatments - the loss to productivity of new AIDS cases in one year is less than one-tenth of one percent for most countries in the sample (Table 5.7). The total costs to society, and especially to the family and friends of the AIDS patient is much higher, of course. When measuring the loss of labor productivity in the year 2000 for allAIDS patients since 1982, under the assumption that all men and half of the women would have been in the labor force (a safe assumption since the illness primarily affects people in their productive years), the loss to GDP in just the year 2000 ranges from 0.1 to 0.37 percent of GDP. Table 5.7: Foregone economic output due to AIDS deaths Foregone output due to AIDS Foregone output in 2000 due to all deaths in 2000 AIDS deaths since 1982 Local as % of Local as % of currency in US$ GDP currency US$ GDP Antingua and Barbuda 132,360 49,022 0.0074% 1,091,968 404,433 0.061% Bahamas 1,668,788 1,668,788 0.037% 16,496,874 16,496,874 0.37% Barbados 8,591,353 4,295,676 0.17% 6,443,514 3,221,757 0.13% Dominican Republic 13,186,927 803,345 0.0041% 139,680,555 8,509,314 0.043% Guyana 5,109,568 28,008 0.0044% 132,889,970 728,444 0.12% Jamaica 69,349,581 1,624,069 0.022% 316,407,463 7,409,813 0.099% St. Kitts & Nevis 791,403 293,112 0.089% 593,552 219,834 0.067% St. Lucia 13,436 4,976 0.0007% 675,146 250,054 0.036% Suriname 8,740,202 6,609 0.0025% 139,843,230 105,744 0.040% Trinidad and Tobago 9,158,784 1,453,822 0.023% 83,155,942 13,199,781 0.21% * Only those countries that reported wages were included in the calculations. Source: ILO unemployment and wage data; UNAIDS HIV/AIDS rates by age, 1982-2000. 135. Finally, the effects of HIV/AIDS on the next generation are very high. Children (age 0-4) with HIV/AIDS make up 3-4 percent of all reported AIDS cases. These children are most likely to have contracted the disease from their mothers, who are young women of childbearing age. The costs of treating the ill child and the contribution of the child to society as a healthy adult are foregone. Additionally, for each death due to AIDS, approximately two AIDS orphans are left behind (children whose parents or mother died of AIDS). These children impose similar costs to society as those born to single mothers (lower productivity as adults, higher violence rates) but they do not have a parent to counteract these costs. 136. Many other costs, such as the time volunteered by caregivers, the psychic costs, emotional costs to the patient and to family during and after the illness, and so forth are 56 difficult to measure so are not estimated here. This further highlights that underestimates of the cost of HIV/AIDS is underestimated. UNEMPLOYMENT 137. Youth unemployment is more costly to society than adult unemployment due to the interrupted human capital accumulation early in the work life. In the short run, youth unemployment is three times higher than adult unemployment, thus leading to larger foregone productivity. Also, unemployed youth, as discussed in the last chapter, are more prone to violence and substance abuse, leading to other costs on society. Longer run implications of youth unemployment include lower future income as skills are lost during the unemployment period and lower GDP for the country as youth migrate to labor markets where opportunities exist. 138. The foregone productivity due to an idle factor of production - youth unemployment - ranges from zero to more than seven percent of GDP in various Caribbean countries. If youth unemployment were eliminated, the increase in GDP would range from 1.36 percent in Barbados, to 7.54 percent in Jamaica, where 2.87 percent is due to additional male labor and 4.67 percent is due to additional female labor (Table 5.8). Men contribute more to GDP than women since more men are employed in the labor market than are women and men eam a higher wage than women. The addition to GDP in the other countries in the sample falls between these extremes. Table 5.8: Increase in GDP (%) due to a Decrease in the Youth Unemployment Rate, Wage Elasticity Equal to Zero Youth unemployment Caribbean and US Zero youth equal to adult youth unemployment unemployment unemployment rate equal Boys Girls Boys Girls Boys Girls Antigua and Barbuda 1.22 0.67 0.69 0.3 0.51 0.22 Barbados 0.60 0.76 0.26 0.31 0.35 0.37 Dominican Republic 1.88 2.40 0.71 0.4 1.12 0.91 Guyana 1.27 1.23 0.68 0.44 0.57 0.46 Jamaica 2.87 4.67 1.22 1.46 1.74 1.98 Saint Lucia 2.54 2.60 1.97 0.76 1.47 1.13 Trinidad & Tobago 1.65 1.48 0.69 0.55 1.0 0.72 Source: ILO unemployment rates and wage data; author's calculations. 139. Since it is unrealistic for any unemployment rate to be zero, especially that of youth who have little experience to contribute to the labor market, the losses to output are estimated for a youth unemployment rate equal to the adult rate and equal to the youth unemployment rate in the United States. Also, a wage elasticity of 2 is applied since as employment is created, the wage rate will fall (Maloney and Arango 2001). If the unemployment rate of youth were equal that of adults, GDP would still grow by one-half to five percentage points in the sample. If it were the same as in the United States, the alternative job market for many Caribbean youth, GDP in the Caribbean would increase by 0.72 to 1.72 percent (Table 5.8). 57 FINAL THOUGHTS 140. Rough estimates show that losses to society from risky youth behaviors - both in terms of direct expenditures and foregone productivity - reach into the billions of dollars. These figures suggest that an investment in preventing any one of theses behaviors would have great returns to the country, particularly in the form of higher productivity. However, we do not pretend that an easy solution or the resources are available to fully solve any of these problems. Also, we do not suggest that costs were fully and accurately measured here since many of the costs associated with idle youth, early pregnancy, or lost life are not measureable. Instead, the chapter clearly shows that youth are a valuable input to the health of the economy and the country and that their engagement in risky behavior does have costs far beyond the individual, impacting the youth's famnily, friends, and fellow citizens as well. 58 6. YOUTH DEVELOPMENT POLICIES AND PROGRAMS 141. Over the years, concerns have grown over youth issues in the Caribbean and the need to promote youth as active players in national development. Without exception, Caribbean governments have responded bv establishing ministries or departments to coordinate youth development activities and most have put in place policies and related programs (Dunns et al. 1997). Non-governmental agencies, and to a more limited extent the private sector, have also stepped in and developed programs to work with youth and assist them in overcoming the issues they face. Available evidence from Caribbean countries suggests that much is being done; however, the proliferation of programs, the crosscutting nature of youth issues, and lack of systems to monitor and evaluate programs makes it difficult to assess the effectiveness of these programs. The fact that many at-risk youth are out of school unattached to any institutions and hard to find presents the additional challenge of identifying the nature of the problems faced by youth, their needs, and how to design and tailor policies and programs to reach these young people and meet their needs. This chapter looks briefly at progress on youh policies in Caribbean countries and factors related to the success of moving the youth agenda forward. It also presents examples of how the public, non-government, and private sectors are responding to youth needs in the region. POLICY CONTEXT 142. Youth policy responses in Caribbean countries have varied considerablv. As Annex 4, Table 4.1 illustrates, almost all countries have a youth-specific policy in place (The Bahamas, Belize, the Dominican Republic, Guyana), are in the process of revising their policies (amaica, Saint Lucia), have a draft policy accepted at the level of Cabinet (Saint Lucia) or have draft policies (Dominica, Grenada, Trinidad and Tobago). Barbados, Montserrat and Antigua and Barbuda are the only nations that have not moved to develop a youth-specific policy. Since 1995, the Commonwealth Youth Programme (CYP) has been at the forefront in promoting an adequate policy framework on youth development in the Caribbean, and to this end has provided advice and technical assistance to countries on policy design and implementation (the CYP's activities are discussed later in this chapter). 143. Institutional arrangements - which influence the thematic thrust of the policies as well as working arrangements with other government agencies dealing with youth issues - also vary. Most Caribbean countries have placed their youth focal point in education ministries (Antigua and Barbuda, Barbados, Dorhinica, Haiti, Jamaica, Saint Lucia, St. Vincent and the Grenadines, The Bahamas), whereas Suriname has given primary responsibility on youth to housing ministries. Guyana and Trinidad and Tobago have specific youth ministries linked to sport and culture, and Grenada's focal point in the Ministry of Youth, Sports and Community Development. The Dominican Republic is the only country that has a youth-only secretariat. The scope of policies also differ, with some countries (St. Vincent and the Grenadines, Saint 'Lucia, and Guyana) having very broad goals and others (amaica, Trinidad and Tobago, and Domninica) having very specific (and in most cases numerous) objectives corresponding to their stated goals. Jamaica's youth policy, its thematic priorities and institutional arrangements are described in Box 6. 1. 59 Box 6.1: Youth Policy in Jamaica Jamaica established its National Youth Policy in 1994. The policy identified the following goals: (a) to strengthen and expand education and training; (b) to irnprove work ethics and training and promote entrepreneurial skills; (c) to increase awareness of nutrition, STDs, sexual and reproductive health, hygiene and sanitation, substance abuse and unwarranted risk taking; (d) to prevent drug abuse; (e) to enhance recreation and leisure; (f) to improve attitudes and decrease anti-social behavior; and (g) to develop strategies for youth participation in decision-making and social and economic development. A National Advisory Council on Youth was established in 1996 to monitor and evaluate the implementation of the National Youth Policy and to advise the Governmrent on matters relating to youth development, but the Council is now defunct. During the 1990s and up to the present, responsibility for youth ping-ponged from the Ministry of Local Government (MLG) to the Ministry of Education and Culture, to the MLG and back again to the Ministry of Education and Culture. Although formal responsibility for youth is now firmly vested within education, in reality both agencies share the responsibility for planning and implementation of youth policies and programs with the Ministry of Health. In 2000, the Social Development Commission, a statutory body under the MLG established a Youth Development Strategy for 2000 and beyond, which aims to achieve: (a) better coordination and integration of programs, services, and activities geared toward youth development through the establishment of a National Center for Youth Development; (b) more effective and sustainable mobilization of resources to fund youth development programs and activities through the mechanism of a National Youth Development Foundation; (d) better expansion of and support for successful youth development programs and activities; and (e) increased representation and participation of youth m decision-making through national youth umbrella organizations. The National Center for Youth Development (NCYD) was created as a Secretariat operating under the MLG in November 2000. The NYCD, which is now a part of the Ministry of Education, Youth and Culture, is intended to be the vehide for the coordination of all youth programs and services and to be the common meeting point for youth and the agencies and ministries that provide services to them and is envisaged to work in partnership with NGOs and other state agencies and ministries and the private sector. The primary functions of the center will be research and policy advice, program design and development, program coordination and monitoring, information dissemination, program funding. According to the CYP, which work-s closely with Commonwealth countries to implement their youth policies, the National Center has been an effective coordinating body at the national level. In 2002, the youth focal point shifted back to the Ministry of Education and Culture. Jamaica's youth policy is currently under revision. Source: Based on Blank (2000). 144. A well-formulated youth-specific policy - no matter how good it looks - is not the panacea.47 Capacity, having in place information systems to identify the needs of youth and the flexibility to tailor programs accordingly, and finding the right balance between coordination and implementation are all important ingredients for dealing with a 47 Having ratified international treaties related to youth is also not a good indicator of progress on youth in practice (see Annex 4, Table 4.2). 60 crosscutting issue such as youth development, as the experience in the Caribbean demonstrates. 145. The Dominican Republic is a case in point. The country's youth policy has been lauded within Latin America for the substance of its policy as well as its process of formulation (Rodriguez 2000, Russell and Sol6rzano 2001). In 2000, the country approved its General Youth Law (Ley de Juventud No. 49/2000) based on which the Secretariat of State for Youth was created. The law establishes a budget allocation of one percent of tle national budget to the Secretariat, as well as a 'Youth Initiatives Fund' for local youth policies, to be financed by a budget allocation of four percent of municipal budgets (Rodriguez 2000). From 1999 to 2000, the Secretariat's budget tripled and was expected to increase tenfold from 2000-2001 (US$15 million) and further double from 2001-2002.4g But the Secretariat is also falling into the pitfall of trying to implement its own programs; it is putting in place a national scholarship program that threatens to consume all its resources and would compete with other public and private institutions widh similar programs. Venezuela was in a similar situation in 1977 when it created a Ministry of Youth. The Ministry had strong political support and was well funded with petrol dollars. But the Ministry was dissolved a decade later due to notorious inefficiency, lack of experience in public management and competition from other ministries responsible for education, health, employment etc. (ibid.). 146. By contrast, Barbados has no youth-specific policy but has the reputation of having the most effective public program on youth. This is due in part to the political will and commitment of policy makers. But it is also due to a well-designed, well-functioning program. The work of the Youth Affairs Division is grounded in youth status surveys conducted every five years, a school leavers tracking system, and research on youth in other thematic areas. The division is also granted the autonomy to tailor its programs accordingly. Another example of an effective program is that of Dominica, which only has a draft policy at the moment. However, it has a cadre of youth officers at the local and municipal level to identify the needs of youth and feed this information back to the national level as a key input into program design. 147. Another important ingredient in youth development is having a strong voice for youth at the local leveL This is the case of Saint Lucia, which has a long history of voluntary youth organizations. Specifically, 162 youth organizations operating around the island under the umbrella of the National Youth Council keep the Government on its toes. 148. Lastly, youth programs that have moved from a risk- or problem-based orientation to a youth development perspective are experiencing success. Youth programs have traditionally focused on providing youth with leisure and sport activities and promoting their participation in the provision of community services (Alexis 2000). While these types of activities have nurtured strong and positive characters in young women and men, and contributed to making youth well-adjusted, productive citizens, there is increasingly a shift 481t also establishes a 'Youth Institutional System' (SistemaLInstitutionaldeJuventud) comprising all the main institutional actors responsible for implementing youth programs. It is also the only law of its kind in Latin America to have established budgetary resources for program implementation. The Secretariat will be staffed with 1000 people throughout the country and establsh Youth Houses (Casas de laJuventud) in the country's 30 provinces. 61 towards youth as key actors in development processes of their societies (ibid.). This will mean moving from seeing youth as passive tecipients of programs and policies to understanding and fulfilling the needs of young people as citizens in relation to their societies and involving them in broad development processes of their nations. YOUTH SERVICES AND PROGRAMS 149. As noted earlier, governments, non-governmental organizations (NGOs) and to a more limited extent the private sector, provide services to youth (see Annex 4, Table 4.3, 4.4 and 4.5 for example). Typically government addresses youth issues through education, social safety net programs, labor and training, family services, sports, and culture. NGOs are also active across sectors. For example, the NCYD has a database of 141 organizations that provide different services to young people (see Annex 4, Table 4.6 for a sampling).49 These programs play an important role in addressing the needs of specific groups of at-risk youth, including street children, children in inner city communities, teenage mothers, young fathers, drug addicts, children with disabilities, and other special needs groups. However, there is a general lack of evaluative data on the success of these different interventions. These organizations are also plagued by problems conmmon to civil society organizations in other countries - lack of staff, limited space for programs, scarce and uncertain funding sources, and limited administrative capacity. A brief description of the types of services being provided by different sectors is provided below by theme, drawing primarily on information from Jamaica (Blank 2000) and Trinidad and Tobago (World Bank 2000b). Education 150. Problems associated with out-of-school youth and joblessness have sparked demand for educational reforms in the Caribbean. In the Commonwealth Caribbean a number of countries - The Bahamas, Barbados, the Organization of Eastern Caribbean States (OECS) countries and Trinidad and Tobago - have responded by developing comprehensive reform approaches whereas others - Belize, Guyana, Jamaica and the Turks and Caicos Islands - have followed an approach directed at specific levels of the education system (Miller 1999). In the case of Trinidad and Tobago, for example, a comprehensive reform of the secondary education system aims to achieve universal access, convert double-shifted schools to single shifts, extend the amount of time spent in the classroom, and employ a new standard five- year curriculum (World Bank 2000b). According to the recently released white paper on education, Jamaica's educational reform targets include: five years of secondary education for all students entering Grade 7 by 2003 and beyond; and five percent annual improvement in the number of students passing English and Mathematics in the Caribbean Examinations Council (CXC) (in relation to the total Grade 11 sitting).50 While it is beyond the scope of this report to comment on the status of educational reform, an impact assessment of reforms in OECS countries carried out late 2000 indicates that a relatively high degree of success in implementing change at the early childhood and primary education levels; but 49 PIOJ, Economic and Social Survgv ofJamaica, 1999. 50 http://www.moec.gov.jm/white_paper.htm. 62 moderate to low degree of progress in harmonizing education systems, secondary education, terms and conditions of teachers, and education financing (Miller et al. 2000). 151. It is important to note that while limited, ministries of education often provide other educational programs in addition to their academic training. For example, Jamaica's Ministrv of Education and Culture implements several programs for in-school youth, including guidance counseling programs; the Peace and Love in Schools program, which aims to promote non-violent methods of conflict resolution; Health and Familv Life Education Programs; and isolated initiatives, such as the Kingston Secondary School Drummers, that use music and the cultural arts to promote literacy, provide training and reduce dropout among students. The Mico Youth Counseling Center offers day and evening programs for parents, children, and adolescents (in or out-of-school) who have emotional and/or behavioral problems. Training and Skills Development 152. Training and skills development is the focus of many youth programs, given high levels of unemployment. Several large youth training and employment programs in Trinidad and Tobago reach a total of about 15,000 youths annually at a total cost of some TT$50 million (see Table 4.9). The most important ones include the Youth Training and Employment Partnership Program, a limited liability company established and funded bv government; the Junior Life Centers, Adolescent Development Community. Life Centers, Skill Training Centers and Hi-Tech Centers operated by the NGO Service Volunteered for All (SERVOL); and, the Youth Development and Apprenticeship Centers (former youth camps), run by the Ministry of Social and Community Development. Some of the training offered in the private sector is profit-oriented, small scale and non-regulated by the government. Over 500 institutions are registered with the Ministry of Education as providers of technical and vocational training, but few have been through any process of accreditation or validation, making quality an issue of concem. Large companies also provide skills training to imnprove the human resources base for their respective industries. 153. The HEART Trust National Training Agency (NTA), a statutory body under the Ministry of Education, Youth and Culture, is responsible for coordinating Jamaica's technical and vocational education and training system and providing skills training. HEART/NTA supports a wide range of training-related activities, both residential and non- residential training. Total enrollment in HEART programs was equal to approximately 31,000 in 1999/2000; since approximately 70 percent of trainees were under 24, the program reached about 10-15 percent of "unattached" youth. HEART also provides six months to one-year educational program aimed at raising the academic level (to at least the Grade 9 level) of applicants who were unsuccessful in passing the entrance test for regular HEART/NTA programs.5" During the 1990s, HEART Trust/NTA expanded non- traditional vocational training programs for youth, which aim to link training with work experience, and develop positive work attitudes. Other public agencies involved in training 51 Enrollment in the regular HEART/NTA programs requires that applicants are age 17 and above and pass an entrance test set at the Grade 9 level of education. 63 programs include the Social Development Commission, which implements the Special Training and Employment Program.f2 154. Limited evidence from evaluations carried out in Trinidad and Tobago indicates that training is generally useful, but meets the demands of the market only to a certain degree. Some indicators of success include: requests from private sector industrial and business employers as well as state agencies and NGOs for the customization of its integrated training package, high participation by vulnerable groups, and strong demand by clients. Several tracer studies have demonstrated positive effects of technical training on beneficiary employment rates, earnings, rates of self-employment, labor force participation, pursuit of further studies, literacy and numeracy, and character (for example, motivation and attitude). SERVOL graduates have also fared well, with studies showing 41 percent fully employed, 27 percent employed part-time and two percent self-employed. Social Protection 155. Across the Caribbean Region several social safety net programs provide benefits to young people. Programs operating in Jamaica amounting to an annual expenditure of about US$33 million include school feeding program, school fee assistance, grants to tertiary education students, welfare programs (including Food Stamps), and economic and social assistance (see Annex 4, Table 4.8). The World Bank's report on youth development in Trinidad and Tobago argues for more effective targeting of social safety net programs there (see Annex 4, Table 4.9). The Trinidad and Tobago Public Assistance Program, for example, demonstrates some inefficiencies, such as lax application of eligibility criteria and duplication of benefits, which result in disincentive to enter the labor market, and with improved targeting could be expanded to include poor, male-headed households with children. Micro-Enterprise Development 156. While less in number, other youth programs support entrepreneurship and business development. The Jamaican Government facilitates access to micro-enterprise credit among young people through the Micro Investment Development Agency, which initially targeted disadvantaged people between the ages of 18 to 25. Youth participation rates however, have been disappointingly low (about 10 percent of the total beneficiaries). In a similar experience, the Community Development Fund established by the Social Development Commission initially focused on youth as the target group, but did not succeed in obtaining many clients among youth.53 Junior Achievement, a program funded by the private sector firm Hewlett Packard and operating in Saint Lucia reportedly is having success. The Barbados Youth Business Trust, an NGO with similar objectives, has also been successful. 52The programs helps youths acquire marketable skills and encouraging attitude change and personal development among out-of-school youth, 18 years and older, who are unskilled and unemployed, and channel their participants into skill training programs in HEART institutions or community colleges. 53 In response to these experiences and with the hope of making self-employment a viable altemative for disadvantaged youth, HEART Trust/NTA recently modified its program curricula to include entrepreneurial skills training as requisite part of all of its training programs. To expand the number of persons able to teach entrepreneurial skills, HEART Trust/NTA has provided training for trainers. The impact of these initiatives is not know at this point. 64 Both programs teach entrepreneurship, economic self-determination, business skills development in schools and focuses on preparing youth self-sufficiency in job creation rather than employment seeking. Lastly, the Commonwealth Youth Credit Initiative - which was approved by the Commonwealth Heads of Government - represents an important and innovative regional intervention, which was created to respond to youth unemployment across the Commonwealth. Family and Youth Services 157. Governments also support family and youth services, although these programs tend to be poorly funded and weak. The Trinidad and Tobago Government operates or supports services for youths who lack an appropriate family care environment or who have come into conflict with the law. In addition to institutional care, which is relatively expensive, the government has created mechanisms such as non-material family support and probation to allow the youths to remain within their families when possible. However, the former type of intervention (institutionalization) has historically suffered a variety of limitations - lack of qualified personnel, stigmatization of beneficiaries and difficult reintegration in the community, little family involvement, inadequate accommodation arrangements, and high costs - and the latter type of service (family support and probation) is severely restricted in scope. In Jamaica, the Children's Services Division of the Ministry of Health has responsibility for children in need of care and protection (abandoned, abused and neglected), adolescents with behavioral disorder and those who have committed offences. There are four types of alternative care services for children in need of care and protection: children's homes, foster care, places of safety, and adoption. Programs for SpecialAt-Risk Groups 158. Different conditions of risk among adolescents (for example, school failure, adolescent pregnancy, drug abuse, institutionalization because of delinquency, etc.) appear to be related to each other and to an underlying set of antecedents. However, aside from Early Childhood Development services and orientation regarding good parenting provided by NGOs, there are few mechanisms of detecting and preventing risk behavior as the child advances through primary education and into adolescence. Although the youth employment training programs have the general goal of keeping youth out of trouble, they offer little concrete in the way of targeting specific risk behavior. Other specialized preventive efforts tend to concentrate on single risk factors, as do rehabilitative projects for older children and adolescents. NGOs tend to be the main force behind interventions to reduce early pregnancy, combat drugs, and deal with street children. Community, Sports, and Leisure 159. "Youth work has traditionally been carried out as a means of providing young people with avenues for collective leisure, exploration, talent development, and service to community" (Alexis 2000). This orientation is reflected in both the location of youth issues within the public structure as well as programming. In Saint Lucia, for example, youth is located within the Ministry of Education but covered by the Department of Youth and Sport. Youth initiatives supported by the Department are thus linked to sport and sporting 65 facilities. Taking the case of Trinidad and Tobago, youth-serving organizations there have also relied on sports as well as recreational and cultural activities to engage youths and promote positive behaviors. Both the government - through the Ministry of Sport and Youth Affairs and the Ministry of Social and Community Development - and the private and voluntary sectors have supported these types of initiatives, and although they succeed to some extent in occupying youth's idle time and contribute to socialization, they have limited potential to transfer useful skills. In this regard, the organizations could take greater advantage of the ability of sports and culture to attract at-risk youths by creating links to other services (for example, alternative education and skills training). 160. In Jamaica, the Social Development Commission and the Jamaica Constabulary provide support to more than 1,200 youth dubs with over 25,000 members. Parents who are poor reportedly say that youth clubs have a positive impact on youth, particularly in rural areas.54 Additionally, the Social Development Commission, Insport, the Sports Development Foundation, and private companies provide support for a program of sports infrastructure and community competitions in basketball, football, cricket, netball, track and field, and swimming. More than 300 communities participated island wide. Over 200,000 persons participate in Insport youth/community club level football, athletics, cricket, and netball activities alone. 161. Art, theater, and other cultural activities are increasingly used as vehicles to reach youth and deliver messages on youth development. For example, the Ashe Performing Arts Ensemble in Jamaica uses theater to convey messages on self-esteem and personal development, sexual and reproductive health, and parenting. Through workshops and performances, the NGO reaches inner city youth between the ages of 10 and 24 years and parents of all ages. National Youth Services 162. National Youth Services, which are organizations in which youth volunteers provide services in poor communities, operate in countries such as Barbados, and Jamaica. The Jamaica National Youth Service, for example, a statutory organization under the auspices of the MLG, targets youth between the ages of 17 and 24 who are out of school and unemployed. Through "re-socialization" and the development of appropriate work attitudes, the program hopes to provide a bridge from school to career. Recruits are given one month of a core curriculum that stress personal development and socialization followed by eight months work exposure. National Youth Service workers are then assigned as teaching aids, community health workers, early childhood caregivers, to the Cadet Corps and in information technology. The program served approximately 1,600 young people in 1999/2000. It recruits young people who did well in secondary school; i.e., those who completed grade 11 and passed four CXC subjects. National Youth Councils 163. National Youth Councils (NYCs) are umbrella organizations or youth volunteer NGOs that provide services in their respective communities. The councils operate in Belize, 54 World Bank, Jamaica: Consultations with the Poor, 1999, cited in Blank 2000. 66 Grenada, Guyana, Jamaica, Saint Lucia, St. Vincent and the Grenadines, and Trinidad and Tobago. The St. Vincent NYC, for example, was established in 1966 and has a membership of 57 member associations and clubs supported by dues, fees and some limited public and intemational funding. Saint Lucia's NYC - which is reportedly the strongest council in the Caribbean - is a grouping of 162 youth organizations from Saint Lucia's 18 branches. Seventeen of these branches are community-based and distributed across the island, while the other branch is comprised of student councils from schools around the island. According to the Saint Lucia Council, its biggest concern at this time is financial sustainability given declining international resources, difficulties with attracting and employing personnel required, and the increasing dominance of individualism within the fabric of Saint Lucian society, which discourages voluntarism. Given that they are often dependent on donor resources, the nature of their activities has changed somewhat as the councils have tailored their work around donor priorities (e.g. HIV/AIDS, mentoring, and job preparation). 164. It should also be noted that NYCs have produced important youth leaders. Several Saint Lucian national - as well as international leaders - at one time served in the directive body of the Saint Lucia NYC. See Box 6.2 on a historical and future perspective of NYCs in the Caribbean. Box 6.2: Perspectives on National Youth Councils in the Caribbean "National Youth Councils have been seen as significant youth structures for the expression of youth views and for taking the desires of youth to the corridors of power and decision making. NYCs have a relative long history in the region. As far back as the 1950s, young people sought to develop structures for addressing youth issues and issues of national development from the perspective of youth. The establishment of National Youth Councils was seen as an approach that would create avenues for young people. The Councils were formed with an interest to advocate on behalf of youth. They were guided strictly by youth and were often in stark opposition to governments and other agencies that maintained a paternalistic relationship with youth. While youth interest in National Youth Councils reached its peak in the 1 980s, the period of the sixties and seventies was on of political ferment in the region. Young activists were sufficiently sensitized to the political and developmental issues, which guided public opinion and policy at the time. As young people they thought it their responsibility to posit youth views on current issues. National youth leaders emerged, not because they were provided with opportunities but because they created opportunities to voice the concerns of their peers. Significantly, very few of the National Youth Councils in the Caribbean were affiliated to the partisan political structures of the countries. The forthrightness of their leaders often placed them in starkl opposition to the political status quo. However, their soundness, articulate expressions and strong personalities made them potential targets of the recruitment into political parties, which many of them pursued successfully. It must be understood that National Youth Councils are youth structures established by youth to serve the interest of youth. They ought not to be the youth voice of any established structure working with youth. It is essential for NYCs to be independent of all external forces, working collaboratively with them but maintaining its autonomy. Through an NYC, structures working with youth should receive the perspective of youth. They should not dictate but should be dictated by the NYCs. The young people must desire to maintain that level of autonomy and independence." Source: Alexis (2000). 67 EXISTING REGIONAL PROGRAMS Commonwealth Youth Programnme 165. The Commonwealth Youth Programme (CYP) is the youth department of the Commonwealth Secretariat, which carries out decisions made by Commonwealth Heads of Government. CYP has a regional office located in Guyana. It has 18 country members and has covered the Caribbean since 1974. The CYPs main activities include training and empowering youth workers, providing technical assistance to governments on developing and implementing youth programs, supporting the economic enfranchisement of youth, and acting as a regional repository of information on youth in the Caribbean. Funding for CYP activities has come mainly from Commonwealth Governments. But more recently, CYP has collaborated with the UNDP, UNICEF, UNAIDS and other partners. According to CYP staff, funding conditionalities have changed considerably over the years, having been more flexible in the past. At present, funding tends to be earmarked according to donor priorities such as HIV/AIDS. 166. The CYP has contributed significantly to youth development in the region. The following are noteworthy: (a) It is the only international agency that has in its Board of Directors a youth representative from each member country. The CYP's Regional Advisory Board comprises two representatives from each member country, a senior government official (usually the highest-ranking government official on youth, e.g. an under/permanent secretary or a Director of Youth) and one youth representative per country selected by the member country. (b) It has been instrumental in developing national youth policies and programs in the Caribbean. Since 1995, CYP has provided direct technical assistance to governments - at present only four countries Barbados, Antigua and Barbuda, Montserrat and St. Kitts do not have youth-specific policies. (c) The CYP has played a central role in producing youth who specialize in youth issues. Through its Diploma and Certificate in Youth Work, the CYP Caribbean Centre has trained over 3000 youth who are dedicated to technical work on youth. (d) The CYP's Commonwealth Youth Credit Initiative identifies young people with business ideas, trains them in business management and personnel 68 development, and helps them conduct market surveys and develop business plans.55 Caribbean Federation of Youth 167. The Caribbean Federation of Youth, based in St. Vincent, was formed to act as a representative body for youth organizations in the Caribbean and to address problems faced by youth at the sub-regional and international levels, coordinate the work of national youth organizations in the Caribbean and assist them in policy formulation and management practices, and strengthen the integration process of Caribbean youth through networking, information sharing, and youth exchanges. The Federation operates through the direct support of National Youth Councils, which are responsible for implementing the Federation's work at the national levels. FINAL THOUGHTS 168. In many ways, governments, NGOs, and to a more limited extent the private sector, have attempted to respond to the needs of youth in the Caribbean, including low-income youth. Jamaica and Trinidad and Tobago, for example, have long histories of creative NGO and governmental efforts to assist at-risk youth in particular. Saint Lucia's NYC is exemplary in creating an active voice for youth and in ensuring that the Government of Saint Lucia is responsive to youth issues. 169. As a whole, it is difficult to know the impact of these programs. As pointed out by Alexis (2000), even though the Caribbean has a solid track record of organized youth activity and numerous programs, it does not have adequate systems nor the data and rigorous analysis to monitor the effectiveness of these programs. The crosscutting nature of youth and the multitude of programs in place to address youth also means that monitoring and evaluation is not easy. 170. In terms of effective policy frameworks for youth, a youth-specific policy can be an effective tool for putting the youth issue firmly on the agenda of policy makers and creating ownership over youth development - particularly if the youth policy is approved through the representative wing of government (i.e. Parliament in the Commonwealth) rather than receiving only Cabinet approval, as is the case of some of the youth policies. But clearly, a well-worded policy is not enough. As countries move to involving youth as active participants in development, programs with systems in place and the analytical rigor to identify the needs of youth and the flexibility to tailor programs accordingly, will be more effective. As always with a crosscutting issue, finding the right balance between coordination and implementation is another important element of an effective policy framework. 55 A panel of small business experts reviews business ideas; worthwhile ideas get a non-collateral loan at market interest rate. So far over 150 young people from Guyana have received loans from the programrnme. St. Lucia, Grenada and Belize will launch the programme before the end of 2002. 69 171. Lastly, as pointed out in earlier chapters, many youth do not take advantage of existing policies and programs, even when they exist. The chief reason is that they no longer have faith in the system. Thus, even when services exist, there is a large population of at-risk that is generally does not make use of them. The situation suggests that if programs and services for youth are strengthened and expanded, they must be promoted in creative ways. As one youth leader from Jamaica put it: "The drug 'dons' (traffickers) promote themselves to the youth. We have to promote our programs too if we are to get the youth's attention" (Barker 1995). As countries move forward and evolve in addressing the problems faced by youth in the regions, these will be some of the challenges. 70 7. CONCLUSIONS AND POLICY DIRECTIONS The House is on Fire 172. While the transitional period from childhood to adulthood is unquestionably a challenge for many, the majority of Caribbean youth make the transition unencumbered. Yet as the report demonstrates, there are serious social and economic consequences associated with not addressing the minority group of youth who are at-risk of negative behaviors or are suffering the impact of their negative circumstances - not only for the youth themselves and their families, but for society-at-large. As noted in TimeforAction, Report of the West Indian Commission: "While Caribbean Youth involved in crime and drugs or infected with AIDS remain a minority, it is the resources which must be diverted for their treatment and the loss of their creative potential and energies which make this minority of national, and indeed regional, concern" (West Indian Commission 1992). 173. As pointed out in writings from the Caribbean, youth are "tomorrow's adults", "the pillars of tomorrow",,56 Indeed, investments in youth have potentially high payoffs at the individual, familial and societal levels. Young people who contribute positively to society create positive extemalities that improve the economic, cultural, and social environment for all. Policy makers and govenmments thus have a catalytic role in ensuring that youth are exposed to a full spectrum of opportunities to enable them to become productive healthy adults. 174. The main risks facing Caribbean youth - teenage pregnancy, school leaving, unemployment, crime and violence, substance and drug abuse, and social exclusion - are not uncommon in developing as well as many developed countries. But as the study findings indicate, some risk outcomes are particular to the Caribbean, for example: * Sexual and physical abuse is high in the Caribbean -and socially accepted in many Caribbean countries. Corporal punishment continues to be widespread in Caribbean schools and homes - particularly among boys. And according to the nine-country CARICOM study, one in ten school-going adolescents have been sexualy abused. The high incidence among boys stands out vis-a-vis other countries. Even more noteworthy is the "disturbing pattern of cultural 'normalcy' in child and physical and sexual abuse" in the Caribbean (Barrow 2001). * The onset of sexual initiation in the Caribbean is the earliest in the world (with the exception of Africa where early sexual experiences take place within martiage). Early sexual debut is known to predispose young people to early pregnancy, HIV/AIDS and other STIs. * The region has the highest incidence of HIV/AIDS outside ofAfrica - and youth are an at-risk group. Among other things, HIV/AIDS is linked to cultural values about sexuality, which are particular to the Caribbean. * The incidence ofrage amongyoung people is extremely highr. 40 percent of school-going CARICOM students reported feelings of rage. High rates of sexual 5 Danns et al (1997), Alexis (2000). 71 abuse and physical abuse among children likely play out in rage among young people, which can affect their school performance and lead to violence. * Youth unemployment is especially elevated in some Caribbean countries. International comparisons indicate that Barbados, Trinidad and Tobago, the Dominican Republic andJamaica have high rates. IndeedJamaica - at 33 percent - has the highest rate of unemployment in the Americas. * In contrast to the U.S., which has high levels of youth violence, the proportion of Caribbean adolescent males who carry firearms is extremely high. Fully one- fifth of students had carried a weapon to school in the 30 days previous to the survey and nearly as many had been in a fight using weapons. Gang violence is also high in the Caribbean, with 20 percent of male students and 12 percent of female students at one point having belonged to a gang. * While data on drug use are scanty, anecdotal evidence suggests a widespread social acceptance of alcohol and marijuana in some Caribbean countries, both among in-school and out-of-school youth (Barker 1995). Out-of-school youth ages 13-19 years are most at-nisk of substance abuse as well as drug dealing (ibid.). Further complicating the situation, the Caribbean is a major trans-shipment point for drugs entering the U.S. and Europe. 175. Rough estimates show that losses to society from risky youth behaviors such as teen pregnancy, school leaving, crime, and HIV/AIDS - both in terms of direct expenditures and foregone productivity - reach into the billions of dollars. For example, the total costs over the lifetime that are attributed to each cohort of adolescent mothers is estimated to be US$64 million in the case of Jamaica. Clearly, this calls for immediate attention and well thought out strategies and actions on the part of policy makers. Youth are Not the Problem 176. A clear message arising out of this report is that youth are not the problem but a product of their environments. For the most part, they rationally react to the situation in which they find themselves. For example, drug dealing could be rational if no other forms of employment exist, the family needs money, and the drug lord provides protection and a sense of belonging. What is a young person to do if he or she has a mother who abandons him/her emotionally, a father who is not present, grades that are too low to continue in school, drug barons in the neighborhood, living in poverty, and no job options? In countries like Jamaica, the job market situation is so tight and the reputation of youth from certain neighborhoods so bad, that even rehabilitated youth who have turned their lives around, have extremely limited options (Addiction Alert, personal communication). 177. Evidence here suggests the following factors underlie the behaviors and outcomes associated with youth in the Caribbean: * Family. The family is the strongest protective and risk factor for youth behavior and outcomes. It is protective in that family connectedness, appropriate levels of parental discipline, moral guidance, protection from dangers in the adult world, and 72 economic support, allow young people to acquire personal and social skills while young. Conversely, parental displays of negative behaviors (substance abuse, violence), physical, sexual, and emotional abuse by family members, and the absence of parental guidance and support are risk factors. * Schools. Connectedness to schools is highly protective against all risky behaviors including using drugs and alcohol and engaging in violence or sexual activity. For example, among school-going adolescents, the probability of sexual behavior falls by 30 percentage points for boys and 60 percentage points for girls if they are connected to schools. Conversely, the school system can have devastating effects on those youth with low academic achievement by not granting them a place in school and, as a corollary, making them feel socially excluded and "worthless". * Poverty. Young people in disadvantaged situations are forced to find work and often have few options except informal sector work, drug trade, or prostitution. Poor parents - particularly those who are single parents - are more likelv to be absent from the household, and leave youth and children unattended and unsupervised. Young girls in some countries - often at the encouragement of their mothers - will engage in opportunistic sex to relieve poverty and contribute to household income (Williams 2001). And childbeanrng is still used a strategy for gaining economic support in countries like Jamaica. Lastly, the income inequality made obvious by the presence of drug dons, foreign tourists, and the media encourages the engagement of youth in "easy money" activities, including drugs and prostitution. * Gender. Gender;7 - which is linked to family dynamics and formation - is a central risk factor in Caribbean societies. About 85 percent of children in Jamaica and Saint Lucia are born out of wedlock. The absence of fathers in the lives of children (which dates back to slavery when men were not permitted to pay the role of father and spouse) is linked to contradictory societal norms that, on the one hand, encourage multi-fathering and sexual prowess but, on the other hand, only allow men to be fathers if they provide economic support to the children. Gender norms and values have important intergenerational effects in that the children of absent fathers are more likely to fare poorly in school. Men's inability to meet the expectation of economic provider also means that a large proportion of women need to raise children on their own, leading to greater levels of poverty and vulnerability among these women and their children. Moreover, the children of single mothers are more likely to go unsupervised and be exposed to negative peer groups that prey on children (e.g. gang leaders and others) and to adopt their illicit practices (crime, drug dealing and prostitution). 178. As the above paragraph indicates and consistent with the international evidence, factors underlying negative youth behaviors and outcomes are highly interrelated. The empirical analysis of risk and protective factors carried out using the nine- 57 As defined previously gender, in the context of risk or protective factors, refers to the values, customs and behavioral norms that account for sexual differentiation in identity and behavior. 73 country CARICOM data also demonstrates the interconnectedness of family, school, and community risk and protective factors. Results here also show that changing any one of the risk factors will help to reduce negative outcomes. Youth Programs Abound - But Are They Effective? 179. Available evidence suggests that much is being done in the area of youth development, with government and the NGO sector both active in different ways. Innovative private sector and private-public sector initiatives for youth also look promising. But limited information on the situation of youths themselves - particularly out-of-school youth who are 'unattached' to formal institutions - and on the nature and effectiveness of the multitude of programs that exist makes evaluation and informed planning difficult. Further complicating matters is the crosscutting nature of youth itself, which implies a need for effective coordination across institutional lines - a challenge under the best of circumstances. 180. Lastly, regional initiatives such as the Commonwealth Youth Programme (CYP) are noteworthy and appear to have even more potential. Notable achievements include the progress made in assisting member countries to develop youth policies, and in building a cadre of youth who are qualified to work on youth issues. Moreover, the CYP's governance structure - in which youth are members of the Board of Directors on equal footing with senior government officials - ensures that youth actively participate in setting the youth agenda in the Commonwealth Caribbean. CARIBBEAN YOUTH DEVELOPMENT - ENTRY POINTS FOR ACTION 181. The situation that many disadvantaged Caribbean youth find themselves calls for decisive action on the part of policy makers in a number of key areas. And as the previous section indicates, the problem is not the youth themselves, but the familial, community, social and economic environment in which youth live and operate. Thus the challenge for policy makers is to create an environment and facilitate a process that maximizes the protective factors while reducing the risk factors affecting youth development. Going back to the conceptual framework at the beginning of the report suggests public action in two spheres: * The macro-environment, including the macro economy, public institutions - the educational system, the public health care system - and social/cultural norms and values, which among other things influence gender roles and relations, family structure and dynamics. * The micro-environment, including families, communities, neighborhoods and local institutions. 182. Given resource constraints, the issue of efficient targeting of actions is always a concern. Barker and Fontes (1996) suggest a three-tiered approach for defining youth at-risk groups and their needs: 74 * Youth in Primary Risk are those youth who live in situations of disadvantage and poverty, are at-risk of leaving school or otherwise compromising their healthy development. These youth are still living with their families, and are attached to a school or another social institutions but are at-risk of losing their connections and suffering from a situation that jeopardizes their successful transition to adulthood and integration into society. This group faces general risks because of socio-economic circumstances but specific risk behaviors have yet to manifest themselves. * Youth in Secondary Risk are those youth who have moved from a general to a specific risk (e.g. by leaving school, working at an early age, being involved in a gang, facing physical or sexual abuse in the home, etc.) and are in danger of entering into a harmful situation. These youth have some connections to family or social institutions but these are weakening. * Youth in Tertiary Risk are those youth who are suffering the impact of particular situation (incarceration due to delinquency, drug dealing, adolescent motherhood) and have lost their connections to family, communities and social institutions. Services for this group include protective or intensive services, which are often residential-based. 183. With this in mind and taking into account intervention points at the macro and micro environments, the report suggests that Caribbean policy makers focus on the following negative youth outcomes: sexual abuse, physical abuse, early sexual debut and early pregnancy, AIDS/HIV prevention, access to education and school retention, crime and violence, and substance abuse. A discussion of entry points in the macro and microenvironment for addressing these issues follows. It should be noted that appropriate interventions points for each country differ based on the specific conditions of that country. Thus, the discussion does not provide a set of conclusions by country but instead presents intervention points and qualifies them with guidelines for the types of conditions that should exist for the entry point to be warranted. Reform the Education System and Maximize the Protective Effects of Schools 184. The education system - and its manifestation in the microenvironment, the local school - can be highly protective during adolescence and thus represent a key intervention point for policy makers. Schools represent more than academics and learning. They are a source of social interaction and socialization. Thus efforts should be aimed at improving access and retention and the quality of education, as well as using schools as a mechanism for positive socialization and social change. Actions directed at improving the formal education system and the positive effects of schools would benefit youth generally as well as primary and secondary at-risk youth. Types of actions would include: (a) Increasing the number of physical spaces, where lack of space is a constraint (e.g. Saint Lucia, Jamaica). 75 (b) Applying voucher programs along the lines of Mexico's PROGRESA, where financial deprivation and the direct costs of schooling (e.g. school fees, transportation) are the pivotal constraints or where the opportunity costs of going to school are high. (c) Reducing overcrowding by providing for sufficient number of qualified teachers (Samms-Vaughan 2001). (d) Improving the quality of teachers by strengthening teacher training and mcreasmg m-service training (ibid.). (e) Re-thinking the rigid model of education inherited from the British, which clearly underserves a segment of the adolescent population. Experience from the U.S. indicates that holding students back, for the most part, does not serve students well. (f) Reforming the school curriculum to include learning modules on life skills,5 basic job skills,59 and reproductive and sexual health. (g) Eliminating corporal punishment in schools - which constitutes abuse - but maintaining discipline and imposing boundaries, which is important in the development of youth. (h) Putting in place educational activities and school-based campaigns to change attitudes on violence and teach conflict resolution. (i) Contribute to reducing sexual abuse and exploitation by institutionizing permanent school-based information and education campaigns to teach children and adolescents the difference between healthy and unhealthy sexual relationships, as well as their rights and responsibilities to report sexually abusive and exploitative relationships. 185. While attractive, full service schools - which in countries such as the U.S. provide a range of recreational and extra-curricular activities (including health services on-site) - are not inexpensive. Moreover, most Caribbean education systems already have a number of deficiencies that would take higher priority - e.g. increasing the number of school places, reducing crowding and improving the quality of teachers. Thus at the risk of overburdening the school system and diverting precious resources away from basic reforms, this report suggests that schools develop partnerships with NGOs and community organizations to provide parallel extra-curricular services for youth that serve to reinforce the life-skill lessons learned in school as well as providing recreation and safe spaces for youth. Lastly, vocational education should be in partnership with the private sector, which is better suited to identify areas where a shortage of skilled workers exist, and the specific skills required. 58 Life skills curriculum includes communications, conflict resolution, decision making and problem solving, developing effective and affective relationships, childrearing and parenting, and values and beliefs as they affect decision-making and choices. 59 Expcriencc show that youth need help looking for jobs, marketing their skills, preparing for job interviews, improving human interaction and communications, and building effective relationships on-the-job. 76 Upgrade the Public Health Care System 186. As in the case of schools, the public health care system has a central role to plav in addressing a range of critical issues affecting adolescents - including accessibility to reproductive and sexual health services, addressing sexual and physical abuse, helping people deal with rage, etc. But to be effective existing public health care service providers require new protocols, tools, and techniques to work with youth and their family members (Russell and Sol6rzano 2001), including mental health approaches.60 Medical and nursing school students and graduates also need to be trained in these new protocols. Indeed, a review of international health outreach and health promotion programs for at-risk youth found that many staff encountered difficulties in addressing issues such as adolescent sexuality due to their own value systems and conflicts (Barker and Fontes 1996). Protocols should take into account the need for confidentiality and the differentiated needs of male and female patients. 187. The nursing and medical professions should play a pivotal role in condemning unhealthy sexual practices among children and adolescents by lobbying to make it a public health issue. In the U.S., the nursing and medical professions were central in creating public awareness of this social issue. Given that sexual abuse and exploitation is rooted in social and cultural values, the nursing and medical professionals can play a similar role by showing that sexual abuse is unacceptable and indeed an issue of public health. Actions directed at improving the public health care system and the positive effects of schools would benefit youth generally as well as primary and secondary at-risk youth. Institutionalize National Level Adolescent Mentoring System 188. A third central policy area concerns building a national level mentoring system - which would primarily benefit primary and secondary at-risk youth. 'Connectedness' to an adult, any adult (equivalent to having a 'craZyforyouperson) has been found to be the single most important protective factor of youth development. And in the U.S., mentoring programs have been found to be the single most cost effective mechanism for creating 'connectedness' among at-risk adolescents. Effective mentoring programs are professionally run and involve one-on-one pairing of adults with children/adolescents (during the formative years), and the provision of necessary supports to make the relationships effective. Mentors develop a relationship with the child or youth, work to build the child or youth's self-confidence and sense of belonging, and spend time with and provide guidance to the child or youth. 189. NGOs and the private sector have a central role in implementing and supporting mentoring programs. Some U.S. firms, for examnple, give employees four hours of paid leave per month for the purpose of mentoring. Within the Caribbean, the Big Brothers Big Sisters International mentoring program is operating in Antigua, Barbados, Caymen Islands, and 60 Issues of rage, sexual abuse, and suicidal tendencies require new mental health protocols oriented to both victims and perpetrators, the former to help them overcome their trauma and the latter rehabilitative therapy (Rock 2001). 77 Grenada.6' Governments should thus provide the incentives to ensure that these programs operate effectively and have broad coverage. Reform and Strengthen the Legal, Judicial and Policing Systems 190. The high incidence of sexual and physical abuse, crime and violence, gang violence and substance abuse in the lives of adolescents point to the need for improvements in the legal, judicial and policing systems of Caribbean countries. Most Caribbean countries have put in place laws against incest, child sexual and other forms of abuse (Le Franc 2001) but police and society generally turn a blind eye to these offenses. Other issues related to juvenile justice include the legal definition of 'a child'; the age of criminal responsibility, arrest, trial (pre and post) and detention; the management of detention centers and children's homes, and non-custodial alternatives (Singh 2001). For example, in the Dominican Republic, laws protect minors under 18 years from being arrested, legally processed and going to jail, thus creating a perverse incentive for drug dealers to target adolescents in criminal and illicit drug activity (Luther' etal 2002). Researchers have also called to attention the appalling practices of juvenile justice in the Caribbean and the imprisonment of child offenders owing to the lack of facilities for young delinquents (Singh 2001, Thompson-Ahye 2001). Or, as in St. Lucia, abandoned children or those who have been removed from their parents home share facilities with petty criminals, thus exposing children who are at risk to higher degrees of risk. Lastly, the high incidence of school going males carrying weapons suggests issues related to the availability of firearms in the Caribbean. Some areas for intervention include: (a) Improving juvenile justice by reviewing and harmonizing laws, establishing and strengthening family courts; training legal practitioners; modernizing the court system; and using alternative custodial sentences (Thomspon-Aye 2001). (b) Increasing weapon controls by: (i) making it more difficult for youth to obtain firearms; and (ii) establishing disarmament policies. In the U.S., schools have put in place disarmament policies; firearms are also banned at specific youth events (McAlister 1998). Countries such as Colombia reported 20 percent decrease in death rates when laws were put in place to disarm the public (ibid). (c) Reforming the police62 by seeking to reduce police corruption, strengthening the accountability of police, and improving community relations,63 which are seen as the most promising approaches to improve police effectiveness.6'4 Directed patrols in crime hotspots also appear to have 61 For more information, see http://www.bbbsi.org/. 62Unless otherwise stated, the section on policing is based on Nield (2001). 63 Improving community relations and police legitimacy has led to the public cooperating in the identification of suspects and witnesses, in the investigation of cases, and making cases based on witnesses and material evidence (Nield 2001). 64 While the effect of policing in preventing crime is a subject of considerable debate, there is a consensus that the police force is a key institution in improving the prosecution of offenders and reducing the fear of crime. 78 a positive effect in reducing crime in high-risk areas.65 Indeed, evidence suggests that the most effective long-term strategy for crime prevent on includes changing both the style and substance of policing practices, the latter referring to how respectfully police treat suspects and citizens (Sherman 1998, cited in Neild 2001). Experiences with community policing suggest that this mechanism can be effective in improving the perception of public safety and image of the police but not necessarily to reduce victimization rates (Buvinic and Morrison 2001). With respect to sexual violence among adolescents, governments must make the police accountable for investigating and prosecuting perpetrators. 191. Interventions in the area of the judiciary and policing would benefit the population at large but are likely to have a greater impact on the tertiary at-risk group. Use tne Media and Social Marketng 192. Communication and education campaigns and the mass media should be used to change norms and values related to the following key risk areas for youth: sexual abuse and exploitation; early sexual initiation; corporal punishment and physical abuse; and alcohol consumption and drug use. They can also be used to teach effective parenting skills, promote the participation of fathers in the rearing of their children, and reflect positive roles models and images for youth. National communication campaigns that are goal- and process-oriented, audience-focused and employ multiple channels of communication can be effective in changing social norm and values and behaviors (Suarez and Quesada 1999). 193. Social marketing - which draws on commnercial marketing principles - has been used as a highly effective tool worldwide to change social norms and behavior. Using vehicles such as mass media, social marketing has been used in meeting social objectives related to nutrition, family planning, and health (controlling drug use, smoking, use of seat belts, etc.). Social marketing can be used to broadly target the population or specific groups (e.g. mothers, fathers of primary at-risk youth). Make Family and Fathers a Top Public Policy Issue 194. The family is one of the most important risk factors in the development of Caribbean youth, and thus a central entry point for public policy. As a first step, governments need to put family and fathers firmly on the public agenda to demonstrate the critical nature of the issue. Secondly, it must put in place incentives to make parents accountable for their children, through the legal system, tax breaks, etc. For example, parents need to be held responsible and prosecuted for sexual abuse and the sexual exploitation of their children. The education system, the public health system and the media 65 Research indicates that measures to expand and increase: the power of police forces is not only expensive but has limited effect. Moreover, expanding police powers poses the threat of increasing levels of violence, undermining democratic processes, and further eroding the confidence of the criminal justice system if there is no oversight from pohtical and judicial authorities, communities and civil society (Neild 2001). Other measures that have not been found to be effective include: more rapid response to telephone calls, random patrolling and increasing the number of reactive arrests (ibid., Buvenic and Morrison 2001). 79 can also play a role in promoting health families, and in teaching fundamental parenting skills. For example, studies have shown that the levels of physical and sexual abuse are significantly reduced where parenting skills are taught after the birth of children and programs are family-focused rather than child-centered (Le Franc 2001). As for fathering, a number of Caribbean NGOs actively work on this issue. But as in the case of families and parenting, public policies should explicitly promote responsible fathering and access of fathers to their children. 195. The private sector can play a key role in promoting pro-family work policies. To illustrate this point, private companies could provide parents - both mothers and fathers - with a specified number of hours of paid leave to attend parent-teacher meetings (e.g. two hours a month). Strengthen Community and Neighborhood Supports 196. Youth Funds to Support NGO and Community-Based Youth Initiatives. NGOs, local organizations, churches in the Caribbean - which provide a range of services to youth and their families - are a good alternative to public services. These organizations have the advantage of greater flexibility and capacity to adapt and innovate, as well as greater credibility because of their proximity to the people and communities they serve. Moreover, local organizations and NGOs are often the only source of support for youth in the tertiary at-risk category. Govermments should therefore directly support these organizations. One altemative would be to establish a competitive youth fund to finance initiatives addressing youth issues. Criteria for selection could include effectiveness, innovation and sustainability. For example, the Dominican Republic is currently setting up a seven million dollar fund to support early childhood development programs at the local level.66 Given very limited evaluation data on the effectiveness of local youth initiatives, putting in place an effective monitoring and evaluation system would be a prerequisite for funding. 197. Integrated Services for Youth. Caribbean countries should consider the 'integrated services model' to improve outcomes among adolescents. The integrated service model - which is being used in the U.S. and elsewhere - involves establishing a collaboration between service providers (govemmental, non-governmental and private sector) and the communities in which youth and their families live. Such initiatives have the objectives of: (a) reforming the usually fragmented system of services and supports for youth and their famiies; (b) providing an integrated and comprehensive range of services for youth and their families; (c) increasing community participation, ownership and control over local initiatives; and (d) increasing transparency. The provision of integrated services provision is complex in that it involves systemic change, new governance structures, and long-term investments in community development and local level capacity building. But they have also been found to be the most sustainable and successful interventions for youth and their families. The Bank 66 The selection conmuittee comprises representatives from civil society, academics, community leaders etc. although the Government of the Dominican Republic has overall oversight responsibilities. 80 is currently financing a social collaborative pilot in three municipalities in Chile, which aims to strengthen supports to youth, children and their families.67 MOVING FoRwARD - NEXT STEPS A Regional Approach 198. To ensure a coordinated, concerted and sustained effort, this report recommends a region-wide approach to youth development in the Caribbean. Clearly, policy-making and programming on youth need to take place at a national level. But youth is a tricky issue in that it is crosscutting and, for the most part, lacks an organized and vocal constituency. A regional effort would allow for oversight and ensure that the topic remains firmly on the regional agenda. A regional thrust is also justified based on the commonalities of youth issues across countries, and the economies o4f-scale that could be achieved in aligning efforts - in terms of improved efficiency in the provision of services and increased cross-country learning. 199. As for next steps the report recommends a high level regional conference in the Caribbean to discuss details and implementation of actions, and define interventions based on each Caribbean nation's country context. The regional conference would convene top- level decision makers in relevant sectors, e.g. education, public health, the judiciary, labor, etc. and should not be limited to youth departments and ministries. The meeting is proposed for September 2002 to be held in the Caribbean. Institutionalizing Youth Development 200. As the above section clearly demonstrates, youth development is a crosscutting issue with implications across key sectors such as education, health, justice, labor, local development, etc. Effectively dealing with issues that crosscut numerous sectors and agencies is difficult. Efforts to mainstream issues such as gender or the environment have met similar challenges, with limited success in many cases. Although different institutional options exist, the literature is not clear on which arrangements work best. However, experience clearly shows that delegating the subject of youth to a single agency or department, such as a youth department - which tends to have limited resources and clout - is not effective. 201. Ultimately, Governments must identify an effective mechanism for holding relevant ministries accountable for results on youth. 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"A review of the issues arising from selected quantitative and qualitative literature on youth in the Caribbean," LCSPG/World Bank, draft. Washington, DC: World Bank. Williams S. (2001). "The Mighty Influence of Long Custom and Practice': Sexual Exploitation of Children for Cash and Goods in Jamaica," in C. Barrow (Ed.), Children's Rights Caribbean Realities. Kingston: Ian Randle Publishers. World Bank (1996). Poverty Reduction and Human Resource Development in the Caribbean. Washington, DC: World Bank. World Bank (1999). Consultations with the Poor. Washington DC: The World Bank. World Bank (2000a). HIV/AIDS in the Caribbean: Issues and Options. Washington, DC: The World Bank. World Bank (2000b). Trinidad and Tobago. Youth and Social Development. An Integrated Approach for SocialInclusion. Report No. 20088-TR. Washington DC: The World Bank. World Bank (2001a). Dominican RepublicPovertyAssessment. Washington, DC: The World Bank. World Bank (2001b). A Review of Gender Issues in the Dominican Republic, Haiti and Jamaica. Report No. 21866-LAC. Washington DC: The World Bank. Wyatt, G.E. Le Franc, E. Tucker MB, Bain B. Mitchell-Keman, Simeon, D. (1993). Sexual Decision Making Among Jamaicans: Final Report. Submitted to Family Health International. 86 ANNEX 1. Annex 1: Methodological Description for Chapter 4 The evidence for Chapter 4 is based on two studies commissioned by the World Bank: (i) qualitative data collection and analysis of the reasons that youth engage in risky behaviors and the implications and (ii) quantitative data analysis to identify the risk and protective factors responsible for risky youth behavior. This appendix discusses the data and methodology behind the results from each study. Qualitative Data Collection and Analysis Qualitative data were collected in the Dominican Republic and St. Lucia in the period February - April 2002 by the Instituto Dominicano de Desarrollo Integral with the National Youth Council of St. Lucia. The data collection comprised of two components: focus group discussions with youth and structured interviews. (i) Focus groups Twenty-six focus group discussions were conducted: 12 in the Dominican Republic and 14 in St. Lucia. Each group had 6-10 participants. Treatment and control groups of youth were interviewed. Adults were interviewed for purposes of triangulation and to get their own views. The participants of the focus groups were as follows: Dom2inican Republic * Urban young men age 14-24 (two groups) * Rural young men age 14-24 (two groups) * Urban young women age 14-24 (two groups) * Rural young women age 14-24 (two groups) * Rural adults/ peers (one group) * Urban adults/peers (one group) * Control groups age 14-24 (one urban, one rural) St. Lucia * Urban young men age 14-24 (two groups) * Rural young men age 14-24 (two groups) * Urban young women age 14-24 (two groups) * Rural young women age 14-24 (two groups) * Rural adults/ peers (two groups) * Urban adults/peers (two groups) * Control groups age 14-24 (one urban, one rural) The criteria for the selection of the treatment groups required that the young person had at least one of the following characten'stics: * Belongs to a lower socio-economic population (including drug pushers, gang leaders, persons who rely on the sex trade) * Has abandoned school more than a year before the time of the interview * Is not employed or working in a family business (except for those "employed" in criminal behavior) Page 1 of 6 Annex 1: Methodological Description for Chapter 4 * Is not an active member of a formal community group nor participates frequently in its activities (could be affiliated with informal youth groups: gangs or groups that gather for informal leisure activities) * Is sexually active The control group participants did not have any of the above characteristics. A two-step process was used to recruit the focus group participants in the Dominican Republic. First, the consultant selected the neighborhoods and communities that would participate in the study, using the socio-demographic studies available regarding slums in the National District. Similar areas were chosen for the urban zone on the basis of socio- econoric status, with an effort to control for differences in poverty levels. All the neighborhoods selected were poor, where poverty is reflected in all its aspects. Rural communities were chosen from zones with similar characteristics to the urban comnmunities. Second, once the poverty-stricken urban zones in Herrera, Los Alcarrizos, and Capotillo were selected, as well as the rural communities such as Elias Pinia and Bayaguana, the consultant recruited young participants through neighborhood leaders who personally made the contacts with participating candidates. Money for transportation was given to all the participants. In St. Lucia, the recruitment process was done in coordination with the National Youth Council. Various government agencies and NGOs assisted in identifying the target groups. The selected participants represented a broad cross-section of St. Lucian youth and adults, both in terms of territory and the composition of the groups. Professional facilitators were used in both countries. The sessions lasted approximately one hour and a half. It composed of (i) administrative issues (objectives, clear statement of the ethical issues, request of verbal authorization to participate, confidentiality of the discussions, and respect for one another's' views), (ii) a warm up session, (iii) conversations based on a semi-structured interview guide, and (iv) a closing session and next steps. (ii) Structured Interviews Twelve one-on-one interviews were held with key informants on youth issues in the Dominican Republic and 25 were held in St. Lucia. The interviewees included men and women from government, civil society, and the private sector who work with youth. The individuals interviewed ranged from a prime minister to leaders of community youth programs to religious figures. Care was taken to interview both decision makers as well as program implementers. The objective of the focus group was both triangulation (for the focus group results) and to get the perspective of those who work with youth. For the individual interviews, key informants with experience working with youth or with strong knowledge regarding youth's reality, were selected. Specialized or specific informants from government institutions or non-government institutions, as well as specialists on specific areas such as youth training and education, drugs, and sexuality were selected. Page 2 of 6 Annex 1: Methodological Description for Chapter 4 The interviews were based on a structured interview guide. They lasted approximately one hour. Qualitative Data Analysis Using PAHO survey data of school-going children in nine CARICOM countries, the determinants of risky youth behavior was analyzed using parametric and non-parametric methodologies. (i) Data The data is a cross-country cross-sectional survey done in 1997-2000 by PAHO in collaborative with the ministries of health in nine countries and the WHO Collaborating Centre in Adolescent Health at the University of Minnesota, Minneapolis, MN. While all 19 CARICOM countries were invited to participate, the following nine joined the regional survey: Antgua, Bahamas, Barbados, British Virgin Islands, Dominica, Grenada, Guyana, Jamaica, and St. Lucia. The final core survey contained 87 multiple choice questions dealing with: school performance, school environment, alcohol and other drug use, sexual and reproductive history, physical and sexual abuse, moral behavior (honesty), violence, mental health and suicide, religiosity, family characteristics, relationships with others, general health, health care, and nutrition/body image.1 Data were collected in schools from 10-18 year old children. Statisticians at the ministries of health carried out sampling procedures in each country. The sample size within each country was selected so that the sample was representative of school-going teenagers within each country and to ensure a power of 0.80 to detect differences among countries. The total sample included 15,695 students age 10 to 18 (sample sizes and share of total population are given in Table A.1). It should be noted that these are not nationally representative samples of school-age young people since they do not represent youth who leave school prior to graduating from secondary school. This imposes a bias in the data since, as shown by numerous studies, those who leave school and those who are absent on any given day (e.g. the day the survey was done) are at higher risk that their peers for nearly every negative outcome. Thus, what is presented by the data is the most positive picture - it is based on school going youth. Approximately one-fifth (21.4 percent) were 16 to 18 years of age, 47.2 percent were 13 to 15, and nearly a third (31.4 percent) were aged 10-12. The difference in age distribution for males and femrales, although statistically significant, is not large enough to be of practical importance (<3 percent in each age category). 1 A draft questionnaire was reviewed by maternal and child health representatives from 19 Caribbean nations then pilot tested on 105 young people. The instrument was revised, again piloted and critiqued by more than 50 school-going young people. Surveys with more than one-third of the items left blank were deleted from the sample. A total of 13 percent of the weighted sample was deleted for incompleteness. Surveys were also checked for invalid responses; only 2 percent of the sample were deleted for these reasons. Page 3 of 6 Annex 1: Methodological Description for Chapter 4 Table A1.1: Population Estimates and Sample Size from Participating Caribbean Countries Country Population Final % of Sample Weighted % Estimate* Sample of Sample Antigua 64,000 2,158 13.7 1.5 Bahamas 279,000 1,787 11.4 5.6 Barbados 265,000 1,819 11.6 6.5 British Virgin Islands 19,000 400 2.5 0.4 Dominica 75,000 2,719 17.3 1.9 Grenada 99,000 1,255 8.0 2.4 Guyana 724,000 1,396 8.9 17.6 Jamaica 2,500,000 2,635 16.8 60.7 St. Lucia 145,000 1,526 9.7 3.5 Total 4,i 70,000 15,695 100 100 * population estimate from Department of Commerce websites for each country. Descriptive analyses were conducted for all variables of interest. Data on prevalence rates for each outcome are described as the proportion of students affected. Prevalence is reported by age group and by gender in order to better understand who is most affected within the sample. Rates are presented as proportions. Demographic subgroups were compared using standard bivariate tests such as chi-square statistics. Weighting was used in the analyses so that the results reflect the proportion of the population in each country. Although this approach gives more weight to some countries than others, it allows us to better describe the region as a whole. There were only four out of more than 200 possible responses for which weighted results were more than 5 percent different than unweighted results, suggesting that it is reasonable to present weighted results as representing the region and not solely the voice of larger countries. Table A2.2 shows that regression results by country are also very similar across countries, thus allowing us to generalize across the set of countries. (ii) Data Analysis Two methodologies are used to test the correlation between risk and protective factors and observed negative youth outcomes. First, logistic regression are used to estimate the correlation between having a risk or protective characteristic and the probability of engaging in risky behavior. A parameter estimate greater than one suggests a positive correlation between the behavior and the risk/protective factor while a parameter estmate less than one suggests a negative correlation. We would expected protective factors to carry coefficient estimates less than one, which would indicate that they are negatively correlated with the negative behavi6r, and risk factors with a coefficient estimate greater than one. Due to the high correlation among the protective and risk factors, each regression only includes a single risk or protective factor and controls for gender and age group. The coefficient estimates presented in Chapter 4 are significantly different from zero at the one percent level. Five outcome (dependent) variables were used: * Perception of general health, Page 4 of 6 Annex 1: Methodological Description for Chapter 4 * Ever had sexual intercourse, * Ever attempted suicide, * Violent behavior (a composite of four items, including if the respondent had carried a weapon to school in the past month and if he/she had been injured in a fight with a weapon), and * Problems due to alcohol and drugs (a composite of 10 questions, including the quantity of alcohol or drugs consumed in the previous week, whether ever had social problems due to substance use, whether ever engaged in risky behavior due to substance use, etc.) Nine predictor (independent) variables were used: * How hard the person tries at schoolwork * Attendance at religious service * Thinks about hurting or killing someone * Parents' problems with violence * Parents with mental health problems * Friend or family who has committed suicide * Parental and family connectedness (a composite variable of feel that parents care, can tell parents about problems, feel that other family members care, feel that people in the family understand, family pays attention to the young person) * Victim of physical or sexual abuse * Parental substance abuse (alcohol or drugs) The coefficient estimates show how well having a particular risk or protective factor explains the variance of the dependent variable, i.e. how closely correlated they are. It does not show the magnitude of the effect. The second methodology uses non-parametric methods to identify the powerful effects of the presence of multiple protective or risk factors. The top three protective (or risk) factors were taken for each outcome. Selecting protective factorp,, the likelihood of engaging in the risky behavior for youth with a high amount ofp,, but a low amount of characteristics P2 and p3, was measured. A similar exercise was done forp2 andp3. This exercise showed the marginal effects by protective factor. Next, the proportion of youth with various combination of two of the three protective factors was calculated. Finally, the proportion of youth with all three protective factors and who engage in the risky behavior is calculated. A similar exercise was carried out for the risk factors. Page 5 of 6 Annex 1: Methodological Description for Chapter 4 Table A1.2: Factors Associated with Risk Behaviors, by Risk Behavior and Country Country Risk Risk or Protective Factor 1 2 3 4 5 6 7 8 9 Behavior Ever Had Sex Tries hard in school 1.01 0.64 0.68 0.84 0.81 0.91 0.78 0.82 0.93 Connectedness to parent/family 0.67 0.50 0.92 0.43 0.54 0.61 0.57 0.54 0.38 Attends religious services 0.91 0.90 0.93 0.81 0.85 0.87 0.83 0.87 0.79 Sexual abuse 1.75 5.70 1.73 3.39 4.23 2.07 4.46 3.36 3.30 Evcr Tries hard in school 0.68 0.68 0.74 0.74 0.73 0.71 0.85 0.66 1.00 Attempted Connectedness to parent/family 0.27 0.31 0.32 0.26 0.31 0.32 0.36 0.36 0.26 Suicide Attends religious services 1.01 0.96 1.04 0.98 0.88 0.99 0.90 1.07 1.06 Ever experienced any abuse 3.20 2.22 3.39 3.38 2.15 2.54 2.36 2.27 4.60 Family/friend attempted suicide 2.62 2.48 1.84 2.48 2.06 2.42 2.29 2.24 2.92 Ever Involved Tries hard in school 0.72 0.76 0.70 0.78 0.88 0.62 0.84 0.78 0.99 in Weapon Connectedness to parent/family 0.51 0.63 0.49 0.49 0.59 0.58 0.59 0.47 0.60 Related Attends religious services 0.97 0.95 0.82 0.76 0.85 0.86 0.88 0.87 0.81 Violence Ever experienced any abuse 1.51 1.90 1.90 1.61 2.22 1.89 1.52 1.66 2.30 Think about hurting/killing someone 2.45 3.02 3.67 4.35 3.42 2.83 2.63 3.31 5.45 Parents have a problem with violence 2.64 1.51 2.39 2.62 3.50 3.57 1.98 1.65 2.60 Ever Hlad T'ries hard in school 1.26 0.92 0.78 0.82 1.07 0.98 0.92 0.80 0.99 Problems Due Connectedness to parent/family 0.74 0.64 0.55 0.45 0.66 0.43 0.54 0.69 0.72 to Alcohol or Attends religious services 0.84 0.86 0.85 0.80 0.78 0.88 0.81 0.81 0.69 Drugs Parent(s) have mental health problem 2.93 2.84 3.01 3.60 3.29 3.15 3.96 2.37 3.94 Worried about substance abuse at home 2.67 1.98 3.31 3.58 4.42 4.24 2.94 3.64 2.19 Parents have a problem with violence 2.19 2.79 3.66 4.57 2.41 3.61 3.03 3.34 5.66 Source: PAHO Adolescent Health Survey Odds Ratios: >1 = risk <1 = protective Page 6 of 6 ANNEX 2. Annex 2. Lifetime Earnings from an Additional Level of Education for Select Countries by Sex 1200 - 1200- 000 - 1000 s8SO - Cy 80 CO 6m - v I 200 - = - 40 U,~ ~ ,I 40 7 I 1s 20 2s 30 3s 40 4s 50 5 60065 1520 25 30 3s 40 45 5 55 6065 Age Age Dominican Republic: Boys Dominican Republic: Girls 60000 60000 50000 50000 E 40000 - & 40000- co Ii 30000- 40000 0000 0000 10000 - 10000 0 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _0 _ _ _ _ _ _ _ _ _ _ _ _ _ _ 10 1$ 20 25 30 35 40 45 50 55 60 65 10 15 20 25 30 35 40 45 50 55 60 65 Age Age Guyana: Boys Guyana: Girls *Ear nmigs are given in local currency in the year of the survey. Mean earnings from a post-secondary education Mean earnings from a secondary education Mean earnings from a primary education Page I of 2 Annex 2. Lifetime Earnings from an Additional Level of Education for Select Countries by Sex 300- 3~~~~~~~~~~~~~~~~~3 300] 250 cD 200 200 -0 Eu ISO w 50- 0 . 130 - 3 25~~~~~~~~~~~~~~~~~~~~~~~s - 5 50~ ~ ~~~~~~~~~5 ______ 50 __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1- 20 2 33 3 46 45 0o 15 20 25 X 0 ' 4 4 45 5o0 65 Age Age Jamaica: Boys Jamaica: Girls 3D 30 20 -P20 CCC - 15 --L is 10 C 1s 20' 25' 36 35 154 S 0 6 20 25 30 3S 40 45 50 55 60 65 Age Age St. Lucia: Boys St. Lucia: Girls *Earn~inigs are given in local currency in the year of the survey. Mean earnings from a post-secondary education Mean eamnings from a secondary education Mean earnings from a primary education Page 2 of 2 ANNEX 3. Annex 3. Methodology for Cost Calculations, Chapter 5 Due to the scarcity of data in the Caribbean, the methodology to estimate the costs in Chapter 5, uses the country specific-numbers that can be obtained, but also makes bold assumptions that cost structures in certain areas are similar across the Caribbean. These estimates can be further refined as additional data becomes available. Unemployment The unemployment section estimates the increase in GDP if youth unemployment were set equal to zero, equal to adult unemployment, or equal to youth unemployment in the United States. The assumptions in this exercise are: * The wage elasticity of supply is set equal to 0 in the first column but equal to 2 in the second to estimates. The e=2 is derived from Arango and Maloney (2001) who generate wage elasticities for the manufacturing sector in Mexico and Argentina. The elasticities for youth in the Caribbean are likely to be higher - since they are primarily employed in services. * The unemployment rate is a random walk with a mean of 0. The year represented in the calculation for each country is assumed to be an average year. Since the years differ (based on the available of unemployment data), world economic conditions will also differ * Real wages are constant. The wages are adjusted by the rate of inflation (CPI) to bring them to the year for which unemployment is measured. * Youth wages are 80% of adult wages due to less experience but higher levels of completed education * Boys and girls earn the same real wages * Women earn 80% of men's wages. * Unemployment rates from the following years are used: Country Survey Year Antigua and Barbuda 1991 Barbados 1999 Dominican Republic 1996 Guyana 1992 Jamaica 1999 St. Lucia 1998 Suriname 1998 T&T 1999 Source: ILO * Only those countries for which wages and unemployment rates were available are included in the sample. Wages were missing for Grenada, Dorninica, Belize, St. Vincent and the Grenadines, and St. Kitts and Nevis. * Higher youth employment does not crowd out adult employment Page I of 8 Annex 3. Methodology for Cost Calculations, Chapter 5 To calculate the value in each cell, the following equation was used: Cell value = { [(youth unemployment rate - target youth unemployment rate)*number of youth labor force participants]*[adult wage*O.8]}/GDP Where the term in square brackets is the increased number of youth due to higher youth employment and the second term is square brackets is the youth wage. Multiplying these terms together is the total additional output due to productively employing more of the youth labor force. Finally, the total product is divided by GDP to estimate the increase in GDP due to higher youth employment. The exercise is repeated three times for girls and boys, where the "target youth unemployment rate" is set equal to: * Zero. This would be an ideal situation, though highly unrealistic. Thus, it should be interpreted as the upper bound of lost productivity. * The adult unemployment rate. This may be a feasible target if the productivity of the more educated young labor force rises to the level of the productivity associated with higher productivity of adults. The wage elasticity is set equal to 2. * The youth unemployment rate in the United States. Given the high degree of migration to the United States, the two labor markets may move toward convergence. With perfect convergence, the youth unemployment rates should be equal. The wage elasticity is set equal to 2. The data are drawn from the following sources: * Wages - ILO adult wages * Unemployment rate - ILO youth and adult unemployment rates * Number of youth in the labor force - ILO * GDP - IMF International Financial Statistics reported in local currency * Inflation rate - IMF International Financial Statistics based on the CPI School leaving The measurement of net and total productivity loss due to early school leaving is a two-step process. First, an age earnings profile is constructed to measure the foregone earnings attributable to not completing an additional year of education. Using household and labor force surveys from Jamaica (1997), the Dominican Republic (1998), St. Lucia (1995) and Guyana (1999), average non-zero income by age group (in five year intervals) and education group (by education level) are generated. The wages are multiplied by the probability of working at each age and education level to find an. average wage per age/education group. These are used to construct "age earnings profiles", which are the graphs of total earnings based on education level given in Annex 2. Five year intervals are used since the sample sizes are too small to robustly generate mean earnings per age group and the education group is used since the surveys do not report grade level. The following assumptions are made: Page 2 of 8 Annex 3. Methodology for Cost Calculations, Chapter 5 * Earnings of a 60 year old today is a proxv for real earnings of a 20 year old today when he/she is 60 years old * Reported monthly wages are multiplied by 12 to estimate annual wages Jamaica and Guyana) and weekly wages are multiplied by 4.3 and by 12 (St. Lucia). * Wage earnings begin at age 16 for primary and secondary school dropouts since the legal work age is 16 in most countries and work younger than age 16 is usually unpaid in small businesses. Wage earnings begin at age 22 for post-secondary educated individuals. * Individual are in the labor market until age 45-55, depending on the country. The upper age is determined by data availability * The number of boys and girls who do not finish each grade level is equal. This is a bold assumption as girls have higher education rates than boys, especially in urban areas. * The social rate of return is 6% This method is used rather than estimating a Mincer earnings equation and using the estimates to plot the earnings path since that would constrain the returns to each level of education to be linear, which it clearly is not. Second, the foregone earnings from not completing the higher level of education is generated by summing the total lifetime earnings from education level E+ 1 and subtracting from it the total lifetime earnings from leaving school with education level E. The exercise is carried out for primary versus secondary education level and for secondary versus tertiary education and separately for men and women. These values are converted to US$. Finally, to calculate the lost productivity of all youth who were not in school in the observation year, the marginal rates are multiplied by the number of youth who were not in each level of school. Thus, the marginal gain to secondary relative to primary is multiplied by the percentage of students who did not enter secondary school and the marginal gain to post-secondary relative to secondary is multiplied by the number of secondary students who did not go on to post-secondary school. The number of students who did not enter each respective level of school is given in Table A. Table A. Number of students who did not finish the respective grade level DR Guyana Jamaica Primary 54,824 3,550 5,460 Secondary 267,453 21,007 22,526 Abovesec 3,028,507 .377,609 1,174,156 Source: World Development Indicators (World Bank, 1998- 1999) The data are drawn from the following sources: * Wages by age and education level -Jamanica Survey of Living Conditions (1997), Guyana Survey of Living Conditions (1999), National Survey of Income and Expenditure (Central Bank, Dominican Republic 1998), Living Standards Measurement Study for St Lucia, 1995 Page 3 of 8 Annex 3. Methodology for Cost Calculations, Chapter 5 * Number of students who did not finish each grade level - World Development Indicators (World Bank, 1998- 1999) * Proportion of the employed labor force - household and labor market surveys Crime and Violence The costs of crime are difficult to estimate due to the scarcity of data on criminal activity and arrest, judicial, and incarceration rates and costs. However, enough data were available for two exercises that measure (i) the cost of youth criminal activity in terms of public expenditure and indirect costs and (ii) the increase in tourist receipts from a 1 percent decrease in youth crime. The first set of calculations are carried out for Jamaica and St. Lucia while the second set are for Jamaica and Barbados. These countries were selected based on data availability. (i) Cost of youth criminal activity in terms of direct and indirect costs. To measure the direct cost of crime, per criminal costs of arrest, judicial processing, and incarceration for are needed. Additionally, the value of the property damage should also be included. A 1995 UNICEF study (cited in World Bank 1996) estimated that the cost of arrest, judicial process, and six-month incarceration in Trinidad and Tobago were US$5000. This value is applied to Jamaica and St. Lucia, the two countries for which costs are estimated. The direct cost of life and property loss is not measured for two reasons. First, it is difficult to put a value on a lost life. Second, data that measures the value of lost property are not available. Indirect costs are measured by the foregone earnings of the criminal while he/she is in prison. The cost of foregone earnings is assumed to be equal to the youth annual wage (equal to 80 percent of the adult wage), discounted for the level of youth unemployment and multiplied by the average number of years of incarceration. In Trinidad and Tobago, the average prison stay was six months, so it is assumed the same for St. Lucia and Jamaica. The cost of private security measures ranges from US$5036 to US$34,000peryear, of which US$3969 are fixed costs and the remaining are annual recurrent costs. The fixed costs include installing security cameras, barriers to the house, or improving the safety of one's car while the recurrent costs are primarily due to hiring a 24-hour guard. The total value of the security industry in the countries of study cannot be estimated, so we can only note that the figures that are generated are omitting this category, which could increase costs substantially. The sum of the direct and indirect costs give the cost to society of a single youth who commits a crime and is sentenced to prison. However, youth commit over half of the crimes in these countries (Moser 1996, CEPAL 2001) so the cost per criminal is multiplied by the number of prosecuted youth criminals in each country. This data are given for Jamaica (see Table 3.6 in Chapter 3), but not for St. Lucia. However, inJamaica, approximately 1/10 of all crimes are prosecuted and 55 percent of all crimes are committed Page 4 of 8 Annex 3. Methodology for Cost Calculations, Chapter 5 by youth so (# cnrmes)*(1/10)*(0.55) gives the total number of prosecuted youth criminals in St. Lucia. The data sources used in these calculations are: * Direct cost of crime in terms of arrest, prosecution, and incarceration is $5000 per arrest (World Bank 1996) * The number of youth and adults crimes convicted in Jamaica is from Pantin (1998) * Mean wages were generated using the Jamaica labor force survey and the St. Lucia Living Standards Survey. * The total number of crimes by country is given by the UN * The youth unemployment rate is from the ILO (ii) the increase in tourist receipts from a 1 percent decrease in youth crime To estimate the gain in tourist dollars due to a decrease in youth crime, we use the elasticities found in Levantis (1998), 1994 tourist flows and expenditures as reported bv the Caribbean Tourism Organization, and 1994 crime rates as reported by the UN. A one percent decrease in youth crime was estimated to decrease the total crime rate by 6 percent. Applying the elasticity to this measure, total tourist flows were estimated to increase and, assuming that demand for tourist goods and services is perfectly elastic, the corresponding increase in tourist expenditures was generated. This was presented as a proportion of current tourist flows. HIV/AIDS The cost to society of youth AIDS deaths and the deaths of those who contract HIV while youth is measured as foregone earnings in this report. These would be the cost to society of not spending any money on AZT or HAART treatments, instead relegating the individual to home care for the period of a year until death occurs (World Bank 2001). Two measures are presented in Chapter 5: (i) the cost to the country of AIDS deaths in the year 2000, the most recent year for which data on AIDS is available (PAHO), and (ii) the total output that is foregone in the year 2000 due to allindividuals who have died of AIDS since 1982, the first year for which PAHO provides data. The following equation is used to generate the cost of foregone earnings of AIDS deaths in the year 2000: (# AIDS deaths age 16-24*mean annual wage*0.8*youth unemployment rate) + (#AIDS deaths age 25-39*mean annual wage*adult unemployment rate) where the number of deaths for each age group is given by PAHO statistics on newly reported HIV/AIDS cases in 2000. The mean annual wage and youth and adult unemployment rates are derived from ILO statistics. The assumptions in this calculation are: (i) The period between contraction of HIV and AIDS is 10 years (ii) An individual with untreated AIDS dies within one year Page 5 of 8 Annex 3. Methodology for Cost Calculations, Chapter 5 (iii) The opportunity cost of the AIDS-related death is the total value of foregone income, which includes taxes paid. It underestimates the true cost, since it does not consider AIDS orphans, psychic costs, or other related negative externalities of the early death. (iv) The number of reported cases of HrV/AIDS is a proxy for the number of AIDS cases that develop per year. The number of HIV cases is unknown. (v) A person with HIV is as productive as a healthy person; once HIV evolves into AIDS, the person's productivity falls to 0 (vi) no treatment (vii) Youth earn 80 percent of adult mean wages (viii) The wage elasticity of demand is zero. To estimate the total losses in year 2000 from all AIDS deaths of youth or of individuals who contracted HIV during their youth, the following is estimated: (#AIDS deaths age 16-24 in 2000*mean annual wage*0.8 *youth unemployment rate) + (#AIDS deaths age 16-24 for 1982-1999*mean annual wage*adult unemployment rate) + (#AIDS deaths age 25-39 for 1982-2000 *mean annual wage*adult unemployment rate) where the first term is the foregone earnings of youth who died of AIDS in the year 2000, the second term is the foregone adult earnings of youth AIDS deaths of previous years who are not contributing to productivity in the year 2000, and the third termn is the value of foregone earnings of all adult AIDS deaths since 1982 that are not contributing to GDP in the year 2000. Pregnancy The cost of adolescent pregnancy reaches far beyond the hospital cost of a young woman giving birth. Instead, they include all the additional costs over the lifetime of the adolescent mother and her child that are born privately or by society at large that would not have occurred had the childbirth been postponed until the woman was 18 years old. The costs may be broken into six general areas: Mother's foregone annual earnings. To measure the net loss to the mother's lifetime earnings that result from early school dropout and entry into less competitive or less lucrative jobs (in order to care for her child), the annual value of foregone earnings is given by (mean adult earnings * adult unemployment rate - mean youth earnings* youth unemployment rate)*(80/100) where the first term is the net loss to the adolescent mother's earnings since she earns only a portion of the wage that she would have earned has she finished her education. This is multiplied by 0.8 to account for the gender wage gap that makes the net adult earnings rate an over-estimate for women. Page 6 of 8 Annex 3. Methodology for Cost Calculations, Chapter 5 Annual child support. Adolescent mothers are shown to collect 32 percent less in child support than are non-adolescent mothers. The value of child support is approximately 18 percent of wages (Maynard 1996).1 These private costs are born by society where annual foregone child support= (annual wage * 0.18)- (annual wage * 0.18*0.32) Government income transfers, rent subsidies, food stamps. Since young mothers wiill have lower earnings and less support from their fathers, they will have a higher demand for public transfers than would other mothers. For several countries, the cost of these government benefits could not be measured. Given the scarcity of wide-reaching public assistance programs and the even rarer targeting of the programs toward young mothers, instead often targeting the elderly, an estimate of the value of government transfers that may be received by young mothers is derived from World Bank (1996). The following assumptions were made: for Jamaica, the weekly value of food stamps was assumed to be equal to '/2 of the basic food basket adjusted for 11 percent of the population as recipients; for St. Lucia, no benefits were accrued to adolescent mothers since most benefits seem to reach one person households (namely the elderly); and for Trinidad and Tobago, the social benefits were assumed to accrue with equal probability to the whole population. Medical care. Adolescent mothers and their children require more health care than do children born to older mothers. The net additional cost is estimated to be 28.8 percent higher for the adolescent mother and child than for the average citizen. Thus, the value used for the annual additional cost of medical care for the young mother and her child is 28.8 percent of the mean health care expenditure per person in each country. Foster care, incarceration of young men, productivity of young adults. Foster care programs are not well developed in the Caribbean, so this was given a cost of zero. An absence of crime data did not permit calculation of the second term. Productivity of the child when he/she grows to adulthood is not included either due to the difficult of putting a price on a life. Social exclusion, mental health, poverty. Adolescent mothers and their children are more socially excluded and face higher mental health problems as a result (from interviews in the Dominican Republic with adolescent mothers) than do adult women, especially those who are married. Measurement of these psychic costs is not possible. Additionally, the longer run costs of poverty, resulting from social exclusion, lower income, and less child support, reach beyond income to include lower levels of health, less volunteerism, higher prone to engage in drug and violent activities, and a slew of other externalities that impose high costs on society. 'Child support is estimated to equal 18 percent of the average wage Page 7 of 8 Annex 3. Methodology for Cost Calculations, Chapter 5 To generate the table in Chapter 5, the following definitions were used for each column: cost per year total cost of lifetime marginal total all Marginal cost per year = foregone earmings + net child support lost + social programs + medical costs The total costs per year is the marginal cost multiplied by the number of new adolescent mothers are born each year, given by US Census Bureau and PAHO adult and teen pregnancy rates. Total cost of lifetime is given by [(marginal cost per year*18 ) + (mother's lifetime income * (65-1 8-15))]*number of adolescent births in 2000. Where the first term in parentheses is the value of foregone earnings, net child support, social programs, and medical costs in the 18 years that the child is living at home. The next term in parentheses is the net loss to mother's lifetime earnings once her child leaves home but she still suffers the labor market consequences of having spent her fornative productive years in childcare as well. The sum of these two terms is multiplied by the number of adolescent births in 2000. Page 8 of 8 ANNEX 4. Annex 4. Caribbean Youth Policies and Programs Table 4.1: Overview of National Youth Programs, Policies and Laws Related to Youth in Select Caribbean Countries Couttry Responsible Separate Thicnatic Thrtust Services Programnies/ Links Comlmlelnts Governmeint Agency Youthl to Other Polic, Programimes Antigua and Youth Department, No Drugs, study skills, VJunior achievement Barbuda Ministry of Education, AIDS, career VPeer-counselling Youth, Sports and development, teen VNational summer camps Community pregnancy, family and vDrug busters Development school relations, school /Continuing education leavers The Bahamas Youth Department, Yes Youth leadership, safe vNational youth research Ministry of Youth and physical spaces, labor and resource center Culture market preparation, /National media citizenship, culture and campaign history, literacy -/Youth leadership training and organization, strengthieninitg famiily "'Job readiness and enterprise scheme ,/Personal development seminar /Health, sports anid recreation programme Barbados Youth Affairs Division, No Citizenship, culture, /Youth Service Considered highly Ministry of Education, employment, nation -Youth effective due to: Youth Affairs and building Development political will and Culture Programme support; V'Youth Enitrepreneur autonomous nature Programme of the division; and effective information and rescarch system. Bchze Mvinistry of Human Yes Disaffected youth, gang /National Youth Resources, Women's violence and street crime Council Affairs and Youth Dcvclopmcnt Domiica MNinistry of Education, In draft Drug prevention Effective processes Page 1 of 13 Annex 4. Caribbean Youth Policies and Programs Country Responsible Scparate Theimiatic Thrtust Services Programcnles/ Links Commiienlts Governinleit Agenicy Youtlh to Othre Poli c Programmiliies Sports and Youth Affairs education to identify youth needs and tailor programs through cadre of youth officers working at the local and municipal levels. Dominican Secretariat of State for Yes Republic Youth Grenada Ministry of Youth, Sports In draft 'National Youth Interest has not yet and Community Council of Grenada translated into Development effective programming. GYP currently advising on improving the organizational structure of the ._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ y o u th un it. Guyana Youth Department, Yes Leadership, anti sex VNational Youth Hindered by size of Ministry of Labour, discrimination, Council the country and I-luman Services and citizenship -/Youth Service large geographical Social Security Scheme distribution of the V"Youth Employment population; weak Scheme public service struicture affects overall effectiveness of public scrvicc ______________ _______________________ ____________ _____________________ (including youth ). Haiti Ministry of Education, ? Youth and Sports Jamaica Youth llnit, Mitistry of Yes Education and training, 'Special Training and Effective at the Education and Culture (currently employment and Empowerment national level due to under empowerment strategies, Programme (STEP) the success of the revision) health (including ln'uman National Center for Page 2 of 13 Annex 4. Caribbean Youth Policies and Programs Coutntry Responsible Separate Tlcinatic Thrtst Services Prograiniies/ Links Commellnlts Governmcnt Agency Youthl to Other Policy Programmes responsible parenting), Employment and Youth drug abuse, recreation Resource Training Development; weak and leisure, values, (HEART) at the field level; attitudes and anti-social -National Youth active NGO sector. behavior, youth in Service Programme community and nation VNational Youth building Council St. Lucia Department of Youth Draft Youth economic National Youth Considered to be and Sports, Ministry of (approved participation, youth Council highly effective due Education, Human by Cabinet) education and training, to long history of Resource Development, crime prevention, voluntary youth Youth and Sports substance abuse organizations religious values, sports (under the National and recreation, culture, Youth Council). teen pregnancy, participation, health St. Vincent and Department of Youth, Draft Group development and Development education VNational Youth Continues to Grenadines Ministry of Housing, dynamics, leadership and training, outreach, Commission maintain a Local Govemment and and communications, communications and -National traditional welfare Community health and family life information, project Commission for approach to youthl Development education, conflict support Juveniles rather than moving resolution, peer /Youth Exchange to youth ?Ministry of Housing, counseling, parent development. Community education, drugs and Development, Youth and alcohol abuse, small Sports business development Surinam Ministry of Social Affairs ? v"Surinam National and Housing Youth Assembly Trinidad & Departmnent of Youth, Draft Training and District youth services, "Youth Training and Active NGO Tobago Ministry of Sport and employment youth centers, youth Employment sector, of which Youth Affairs placemenit service, youth Partnership SERVOL is resource and information Programme exemplary; PuLlic service /Apprenticeship sector hias a large I_Programme staff but tend to be Page 3 of 13 Annex 4. Caribbean Youth Policies and Programs Country Respotisible Scparatc Thliematic Thrtist Scn,ices Prograinmes/ Links Comiliciits Government Agency Youtil to Other Policv Programiimes (Apprcnticeshipcfor de'sk bound. Industrial Mobilization /Socially and Economnically Disadvantaged Areas -'National Youth Source: Danns et al. (1997); Youth of the United Nations; Country Profiles on the Situation of Youth; National Youth Policy (http://esa.un.org/socdev/unyin/comparea.asp) *Sectors: education, labor, health, economy, justice, commerce/industry, culture/national affairs Page 4 of 13 Annex 4. Caribbean Youth Policies and Programs Table 4.2: Human Rights Instruments Ratified or Acceded Related to the Rights of Youth Antigua and Barbuda 3 -Abolition of Slavery, the Slave Trade, and Insirutions and Practices Similar to Slavery (UN/ 1956) /Consent to Marriage, NMinimum Age for Marriage and Registration of Marriages (UN 1962); /Convention on the Minimum Age for Admission to Employment (ILO/1973). Bahamas 1 "Convention on the Abolition of Slavery, the Slave Trade and Institutions and Practices Similar to Slavery (UN/1956) Barbados 6 /Night Work of Young Persons: Industry (ILO/1948) /Abolition of Slavery, the Slave Trade and Institutions and Practices Similar to Slavery (UN/1956) VDiscrimination in Education (UNESCO/1 960) Consent to Marriage, Minimum Age for Marriage and Registration of Marriages (UN/1962) -Civil and Political Rights (UN/1966) V_Economnic, Social and Cultural Rights (UN/1966). Belize 3 -Medical Examination of Young Persons: Sea (ILO/1921) -'Discrimination in Education (UNESCO/1960) _'Civil and Political Rights (UN/1966). Dominica 6 -Medical Examination of Young Persons: Sea (ILO/1021) VAbolition of Slavery, the Slave Trade, and Institutions and Practices Similar to Slavery (UN/1956) VDiscrimination in Education (UNESCO/1960) -Civil and Political Rights (UN/1966); Economic, Social and Cultural Rights (UN/1966) _Minimum Age for Admission to Employment (ILO/I 973). Dominican Republic 9 -Non-Industrial Occupations (ILO/1946) /Night Work of Young Persons: Industry (ILO/1948) -Abolition of Slavery, the Slave Trade and Institutions and Practices Similar to Slavery (UN/1956) /Discrimination in Education (UNESCO/1 960) VConsent to Marriage, Minimum Age for Marriage and Registration of Marriages (UN/1962) /Civil and Political Rights (UN/1966) VEconomic, Social and Cultural Rights (UN/1966) Grenada 3 -/Medical Examination of Young Persons: Sea (ILO/ 1921) 1Civil and Political Rights (UN/1966) vEconomic, Social and Cultural Rights (UN/1966) Guyana 4 vCivil and Political Rights (UN/1966) /Economic, Social and Cultural Rights (UN/1966) ,Minimum Age for Admission to Employment (ILO/1973) /Vocational Guidance and Vocational Training: Human Resources Development (ILO/1975) Haiti 6 Medical Examination of Young Persons: Industry (ILO/ 1946); Medical Examination of Young Persons: Non-Industrial Occupations (ILO/1946); Night Work of Young Persons: Industry (ILO/1948); Suppression of the Traffic in Persons and of the Exploitation of the Prostitution of Others (UN/1949); and Abolition of-Slavery, the Slave Trade and Institutions and Practices Similar to Slavery (UN/1956); and Civil and Political Rights (UN/1966). Page 5 of 13 Annex 4. Caribbean Youth Policies and Programs _~~~~~~ C Jamaica 4 Medical Examination of Young Persons: Sea (ILO/1921); Abolition of Slavery, the Slave Trade and Institutions and Practices Similar to Slavery (UJN/1956); Civil and Political Rights (UN/1966) and Economic, Social and Cultural Rights (UN/1966). St. Lucia 2 Medical Examination of Young Persons: Sea (ILO/1921); and Abolition of Slavery, the Slave Trade and Institutions and Practices Similar to Slavery (IJN/1956). St. Vincent and Grenadines 4 /Abolition of Slavery, the Slave Trade and Institutions and Practices Similar to Slavery (UN/1956) /Discrimination in Education (UNESCO/1960) /Civil and Political Rights (UN/1966) _ _ Economaic, Social and Cultural Rights (UN/1966). Surinam 3 7Abolition of Slavery, the Slave Trade and Institutions and Practices Similar to Slavery (UN/1956); /Civil and Political Rights (UN/1966) _ _ Economic, Social and Cultural Rights (UN/1966) Trinidad & Tobago 5 "Medical Examination of Young Persons: Sea (ILO/1921) /Abolition of Slavery, the Slave Trade and Institutions and Practices Similar to Slavery (UN/1956) vConsent to Marriage, Minimum Age for Marriage and Registration of Marriages (UN/1962) ZCivil and Political Rights (UN/1966) __Economic, Social and Cultural Rights (UN/1966) Source: Youth of the United Nations; Country Profiles on the Situation of Youth; Human Rights Instruments (http://esa.un.org/socdev/unyin/comparea.asp) Page 6 of 13 Annex 4. Caribbean Youth Policies and Programs Table 4.3: Main Organizations Providing Services to Youth-At-Risk, St. Lucia Name of Type of Target Group Description Of Program Organization Organization National Youth NGO Youth Umbrella organization of 162 youth volunteer organizations Council from 18 braches in St. Lucia (17 community-based, one comprising student councils from around the island) St. Lucia Crisis NGO Females (20-39 Hotline, counseling and legal services for abused and battered Centre years) women; public outreach program Archdiocesan NGO Catholic youth Faith-based activities and retreats, retreats for youth Youth Council (nationwide) Centre for NGO Youth without a Five centers in both urban and rural areas; vocational courses Adolescent (Catholic 2nd school as well as like skills, public speaking, rap sessions, and stress Rehabilitation and Church) placement management Education Junior Private Sector School-going Teaches entrepreneurship, economic self-determination, Achievement youth business skills development; school-based program funded bv Hewlett Packard; 1000 students trained in schools of which only 10-15 percent are male Charterhouse Private Youth who failed Secondary school preparation, self-esteem and self- High School and to get a 2nd employment training; affiliated with Institute of Counselling, College of school place which has a hotline for abused and marginalized youth Continuing Education Uptown Gardens' Public (quasi) Female youth Rehabilitation program for abused, neglected or abandoned Schools Centre (St. Lucia (12-15 years) girls who are on the verge of delinquency; services include Women's counseling, career guidance, computer literacy, creative arts, Council) language and technical skills training, family support and counseling, home management, physical fitness, job placement National Skills Public (in Youth Job training to assist youth make a transition to the working Training Centre cooperation environment; training in agriculture, business, construction, Inc. with private crafts and furniture making, hospitality services and sector) information technology; day care services available In collaboration with the Belfund,' provides access to start up capital for small businesses Boys Training Public Males (12-16 Home for underprivileged, delinquent boys who are referred Center years) through the juvenile court system; boys remain until their 1 8t" birthday; services include training in basic numeracy, literacy skills and vocational subjects as well as social activities Bureau of Health Public Youth Education and sensitization programs to reduce teen age Education (Ninistry of pregnancy and deal with women's health issues. Health) Dept of Youth Public Youth (10-35 year Development of youth sporting facilities and initiatives to deal and Sports olds) directly with youth issues Drug Abuse Public Children and School based extension program to teach drug prevention; Resistance youth (5-12 years) program promotes self-esteem, stress management, peer Education I pressure management, self-motivation Substance Abuse Public Youth -Public awareness programs; formation of drug prevention Secretariat clubs, and support workshops, seminars, and outreach programs I Belfund, formally titled as the James Belgrave Memorial Fund has a focus on community development and youth development. It is an initiative of the Poverty Reduction Fund, which was established on the model of Social Investment funds in Latin America and The Caribbean with a broad holistic approach to poverty alleviation. Page 7 of 13 Annex 4. Caribbean Youth Policies and Programs Table 4.4: Selected Public Agenc /NGOs Providin Services to Youth-At-Risk, Caribbean S.a 3 . s 0; ;. . g ! 0:. National Youth NGO Youth Membership organization of 57 member youth associations Council, St. and clubs founded in 1966, which provides income Vincent and generation, sports, housing support, community the development projects, and vocational training at the Grenadines* community level Supported by dues, fees and some limited governmental and intemational funding Marion House, NGO Youth Parenting education for teen parents; youth assistance for St. Vincent and school drop-outs (vocational training in hairdressing, child the care, sewing, etc); counseling, including substance abuse Grenadines* counseling; adult education; backyard gardening; interpersonal skills Liberty Lodge, NGO Male Residential care, remedial education and vocational training St. Vincent and youth (furniture making) for 25 youth (max. 2 year stay) the (7-15 Grenadines* years) Youth Public Youth Two Youth Guidance Centers (Barroualie and Greggs Guidance (Ministry of Village) provide skills training for youth; Center, St. Health) Family life education in Owia Vincent and the Grenadines* National Skills Public Unemploy Training for self-employment, 350 youth trained per year Training ed vouth (65% female) Programme, St. (15-35 Vincent and years) the Grenadines* Youth Peer NGO Youth (16- Train youth volunteers to be peer educators in sexual and Education, 19 years) reproductive health services for youth (with an emphasis on Dominican STIs and HIV prevention); 150 youth trained annually, 600 Republic currently active; in 2000 peer educators worked with 6,879 direct beneficiaries and reached 48,641 indirect youth beneficiaries through presentations made Youth Public Youth (15- Mentoring, training, technical and financial assistance to Entrepreneur- (Division of 30 years) assist youth to start their own businesses ship Scheme, Youth Affairs) Barbados Barbados Public Youth (16- 12-month training on self esteem, team building, academic Youth Service, (Division of 22 years) training, including a 19 week job attachment program with Barbados Youth Affairs) I private sector firms and public sector agencies *Source: Barker (1995) Page 8 of 13 Annex 4. Caribbean Youth Policies and Programs Table 4.5: Selected NGOs Providin Services to Youth-At-Risk in Jamaica - - .^.3. I M., M. eLm YMCA | Street Children Academic program for street children and other programs Chlrn First Street Children YWCA Unemployed Girls Operates school leavers institutes, skills training, Women's Center Teenage Mothers Implemented through 7 main centers and 11 outreach centers islandwide. Helps girls continue their education and/or referral for services and skills training Rural Family Support Teenage mothers Provides academic and skills training, counseling and support in 3 Organization and young men rural parishes Mel Nathan Institute Youth 16 and over Operates commrunity college with skills training programs Youth Opportunities In-school youth Mentoring program Unlimited (YOU) Kingston Restoration Inner City youth Remedial education, arts and craft, computer studies, counseling and Company -Necessary between 10 and 16 environment awareness and support to students not attending school Education Training for financial reasons. (NET) Kingston Restoration Students in the Seeks to develop leadership qualities through organized activities for Company -Youth South side of high school students of the South Side of Kingston Education Support Kingston System (YESS) St. Patrick's Foundation Skills training, community gym and health clinic, community development workshops, remedial classes, CXC and GCE classes and job placement Operation Friendship Youth 16-23 Employment generation, education and training programs and primary health care, social work, day care services Addiction Alert Youth at-risk Drug education and life skills programs offered in school (including drug One year rehabilitation and training for at-risk youth to become users) youth leaders, trainers and peer educators Friends Hotline Youth Toll free telephone line that provides counseling and referral Ashe Youth Provides training in the performing arts and remedial education to inner city youth. Fathers Incorporated Young men Offers training workshops, conferences, counseling and micro enterprise development to help men develop positive image of fathering and to become better fathers VOUCH Adolescents Health education and social services on behalf of children Source: Blank (2000) Page 9 of 13 Annex 4. Caribbean Youth Policies and Programs Table 4.6: Jamaica Public Programs for Youth, Fiscal Year 1999/2000 Program Responsible Description Number Total Program Ministry/ Served Budget Agency (J$M) HEART Academies HEEART/NTA Skills training to out of school 9,900 643.8 youth Vocational Training Centers HEART/NTA Skills training to out of school 5,700 313.7 youth School Leavers Training HEART/NTA On-the-job training 5,100 67.4 Opportunities/ Apprenticeship Vocational Training HEART/NTA Training for technical 1,900 82.6 Development Institutions vocational instructors Community-Based Training HEART/NTA Community based training 8,500 395.3 Skills 2000 HEART/NTA, Community based training/ 2,200 47.2 MOLSS, SDC entrepreneurial development (1998/99) (1998/99) National Youth Service MOLGYCD Work 1,600 98.4 experience/resocialization LEAP HEART/NTA, SDC Remedial education, training 230 27.0 and shelter for street children Lift-UpJamaica UDC Short term employment 3,700 1,300 Special Training and SDC Training and community 390 Empowerment Progarn enterprise development Micro Enterprise MIDA Microenterprise credit 8,000 70.3 Development Agency (1998/99) Jamaica Association of Adult MOEC Literacy, numeracy training 11,600 Literacy (IAMAL) MICO Care Center MOEC Assessment and remediation 2,000 24.0 for special learning needs MICO Youth Counseling MOEC Counseling for youth with Unavailable Not available Research Development Ctr. behavioral/emotional problems VOUCH Health, education, social Unavailable 0.3 services Sporting Programs MOLSS Sporting programs in schools 215,200 Not available and communities Cultural Programs MOEC/JCDC Visual and performing arts 35,000- 18.71 programs 40,000 Family Services MOH Counseling, care and 4,500 370.71 protection services Abilities Foundation MOLSS Skills training for disabled 27 trainees 4.7 Police Youth Clubs MONSJ Sport, education and camps 22,160 4 H Clubs MOA Education and training 64,300 40.7 Source: Blank (2000) Page 10 of 13 Annex 4. Caribbean Youth Policies and Programs Table 4.7: Trinidad and Tobago Skilis Training and Employment Programs Program Agc Number Training Skills Provided Stipend Beneficiaries/ Expenditure Range of Dturation / ycar Centers [Fees] Youth Training 15-25 over 20 6 months numeracy, None 10,000 TT$30m/year and school- literacy, life Employment based skills, 70 skills approx. Partnership and 5 courses in 14 TT$1,200/ Programme full-time occupational student/cycle (YTEPP) centers areas, preparation for _mcro-enterpnse Service numeracy, [IT$50 approx. Voluneeter for literacy, life skills / TT$4m/year All (SERVOL) and attitudinal month] (1999 data) -'Junior Life 10 _ development, 448 -'Adolescent 16-19 20 14 weeks skills courses, 1,699 Development technical "'Skill-training ' 12 6 months training in 1,672 7Hi-Tech " 3 3 months computers and 384 electronics Youth 14-21 5 (1 in 2 years preparation for $TT45/ 1,325 TT$17m/year Development Tobago; (resident- exams, primary month; (250 girls; and 1 for ial) school leaving housing 750 boys, approx. Apprentice- girls)* several certificate, trades and residential TT$15,000/ ship Centers months training meals program) youth/year (trade (agriculture, 325 centers) construction, (trade centers) domestic and commercial sector), job placement Source: World Bank (2000) Page 11 of 13 Annex 4. Caribbean Youth Policies and Programs Table 4.8: Jamaica Safety Net Programs Benefiting Youths, 1998 Program Ministry Benefits To Youth Annual Beneficiaries Expenditures JS/USS ('000,000) School Ministry Of School lunch for students in 302,000 J$395.2/US$10.8 Feeding Education And selected secondary schools Program Culture School Fee Ministry Of Fee Assistance to students in 38,500 J$145.3/US$4.0 Assistance Education And selected secondary schools (1997/98) Culture Grants to SLB Grant to low income students Unavailable J$62.5/US$1.7 Tertiary enrolled in public universities Students Student Ministry Of Exam Fee Assistance to Unavailable J$2.0/US$0.l Welfare Education And secondary and tertiary students Programs Culture Food Stamps Ministry of Labour Youth receive income support 263,000 J$395.2/US$10.8 and Social Security to extent that they are pregnant, have children under six or are indigent or incapacitated. Outdoor Ministry of Local Youth receive income support 13,700 J$100.0/US$2.5 Poor Relief Govermment, Youth to extent that they live in poor and Community families, have young children, Development and are indigent or incapacitated. Economic Ministry of Labour Youth receive benefits to 23,200 J$121.0/US$3.3 and Social and Social Security degree that they are Assistance incapacitated or have suffered natural or man-man disaster Source: Blank, 2000 Page 12 of 13 Annex 4. Caribbean Youth Policies and Programs Table 4.9: Trinidad and Tobago Safety Net Programs Benefiting Youths Program Responsible Eligibility Criteria for Benefits Beneficiaries/ Annual Government year Expenditure' Bodv Old Age Ministry of * 65 years or older 59,112 (end-1997) TT$ 269m Pension Social and * resident for 20 years (no (PAP) Community more than 5 years total absence) (Obs.: many recipient Development * annual income not households have exceeding TT$ 7,440 children) Self Help and Ministry of * unemployed and no source 6,800 Tf$ 3.5m Rehabilitative Social and of income households/month Efforts Community * not in receipt of other (estimated 30,000 (SHARE)2 Development public assistance persons, including 20,000 children) (end- 1997) Unemployme Ministry of * able-bodied unemployed 60,000 1TI$130 nt Relief Local between 17-65 (Obs.: some youths may Program Government * no household income benefit directly) (URP) constraints Public Ministry of * female-headed household 48,620 (end-1997) TT$ 56m Assistance Social and * partners have deserted/died (28,449 children) (PA) Community or are incarcerated/ Development incapacitated * certified disabled School Ministry of * needy school children, one-third of primary TT$ 80m Feeding Education informal targeting criteria school population, app. Program 63,000 children Civilian Formerly, the * selection system prefers 5,891 (1997) '1T$25m (1997) Conservation Ministry of older candidates with low scores 24,656 (1993-97) Corps (CCC) National on several indices: education, Security, level of employability, Defense Force occupational status of Currently, household, and involvement in YTEPP community activities * age 18-25 1 1 Source: World Bank (2000) ' Public expenditure; 2 NGOs cooperate in program execution Page 13 of 13