TRINIDAD AND TOBAGO
GENDER, HEALTH AND DEVELOPMENT
TRINIDAD AND TOBAGO
Gender, Ethnicity and Health Unit
Population The total population of Trinidad and Tobago is estimated at 1,305,000 in 2005, of which 76.2% live in urban areas. 1 Women represent 50.7% of the total population. 2 In the year 2004, 381,000 women were 15 to 49 years old, that is, around 58% of the total number of women. 3 The average annual rate of growth of the population had ups and downs during the period 1970 to date, but overall it followed a downward trend and is currently approaching zero growth (Figure 1). Figure 1. TRINIDAD & TOBAGO: Average annual rate of population growth (%), 19701975 to 20052010
4.0
3.0
2.0
1.0
0.0
1970 1975 1980 1985 1990 1995 2000 2005 1975 1980 1985 1990 1995 2000 2005 2010
Population grow th 0.83 1.34 1.71 0.62 0.71 0.40 0.32 0.28 (%)
Source: United Nations. World Population Prospects: The 2004 Revision. New York, 2005.
The latest year for which detailed mortality data from Trinidad and Tobago are available in the PAHO mortality database is 1997. During the period 19951997 the estimated (crude) death rate increased slightly among women as well as men (Figure 2).
1
PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005. Based on data from: PAHO/AIS. Technical Information System. Table Generator. http://www.paho.org, 26 January 2006. 3 PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, 2005. 2
1
Figure 2. TRINIDAD & TOBAGO: Estimated (crude) death rates, 1995 1997 10,0
Rate per 1.000
9,0
8,0
7,0 6,0
5,0
1995
1996
1997
Women
6,5
6,6
6,6
Men
8,0
8,1
8,3
Source: PAHO/AIS. Technical Information System. Table Generator. (December 2005) http://www.paho.org
Socioeconomic context The gross national income per capita (PPP value) was US$10,390 in 2003. 4 Data are not available as to the ratio between the income of the population with the 20% highest and the population with the 20% lowest income. Health expenditure Public expenditure on health was 2.1% of gross domestic product in 20002001, and private expenditure was 2.8% (excluding health insurance) in 2004. 5 Environmental health The entire population has access to sanitation services; access to improved water sources is quite high but has not yet reached 100%, and remains better in urban than in rural areas (Figure 3).
4 5
PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005. Ibid.
2
Figure 3. TRINIDAD & TOBAGO: Access to improved water sources and sanitation services, 2002 100
% population
100
92
100
88
75 50 25 0
Water
Sanitation Urban
Rural
Source: PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005.
Education Among the population aged 15 years and over, literacy was 98.8% in 2005; male literacy was 99.2% and female literacy, 98.3%. 6 The gross enrollment rate for the primary level is estimated to be roughly 100% for both sexes, but secondary enrollment has not yet reached that level for either sex and is better among women than men (Figure 4). Figure 4. TRINIDAD & TOBAGO: Gross enrollment rate (%), primary and secondary levels, 20022003 125 99
101
Percent
100
86
79
75 50 25 0 Prim ary
Secondary Wom en
Men
Source: UNESCO. http://www.uis.unesco.org, 24 January 2006.
6
PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005.
3
Political participation Percent of women 7 : in Parliament in ministerial posts (2001)
25% 9%
Resources that facilitate initiatives leading to gender equality Commitment to gender equality The facultative protocol for the Convention on the Elimination of Discrimination Against Women (CEDAW) 8 : Was signed Was ratified by the legislature
Yes No X X
Abortion policy 9 Does the penal code prohibit abortion? Are there exceptions: To save the life of the mother To preserve the physical and mental health of the mother In cases of rape or incest Other exceptions
Yes No X X X X X X
Health Situation In 2005, life expectancy at birth was 72.7 years for women and 67.4 years for men. 10 Recent demographic estimates found that, during the period since 1970, the gap between male and female life expectancy was as high as 6.6 years greater life expectancy for women; for the 2005 2010 quinquennium this gap will be 4.8 years (Figure 5).
7
PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, DC, 2005. 8 United Nations. Division for the Advancement of Women, Department of Economic and Social Affairs. http://www.un.org/womenwatch/daw, 27 March 2006. 9 United Nations. Population Policy Data Bank, Population Division, Department of Economic and Social Affairs. http://www.un.org/esa/population/publications/abortion/doc , 27 March 2006. 10 PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005.
4
Figure 5. TRINIDAD & TOBAGO: Life ex pectancy at birth (years), 19701975 to 20052010 90 80 70 60 50
1970 1975 1980 1985 1990 1995 2000 2005 1975 1980 1985 1990 1995 2000 2005 2010
Women 68.3
70.9
72.6
74.2
74.5
74.4
73.0
72.5
63.6
65.9
67.4
68.9
68.6
67.8
66.9
67.7
Men
Women
Men
Source: United Nations. World Population Prospects: The 2004 Revision. New York, 2005.
In 2002, the estimated incidence rates of malignant neoplasms of breast and cervix were quite high among women (see table). TRINIDAD & TOBAGO: Estimated incidence of malignant neoplasms, adjusted (per 100.000), 2002 Site Women Men lung 4.6 14.3 stomach 9.2 11.3 female breast 51.1 n.a. cervix 27.1 n.a. PAHO/AIS. Technical Information System. Table Generator. (December 2005) http://www.paho.org
n.a.= not applicable Risk factors 11 The prevalence of tobacco consumption in the population 1315 years of age was 12% among women and 20% among men (2000). Prevalence data on obesity in the population 15 to 49 years old are available for Mount Hope only (urban): 7% among women and 9% among men (2001). Mortality Agespecific death rates, in 1997, were higher among men than women in all age groups (Figure 6).
11
PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, 2005.
5
Figure 6. TRINIDAD & TOBAGO: Estimated agespecific death rates (per 100.000), 1997 0
2000
6000
8000
1525 1900
Under 1 year 14 years
75 91
514 years
31 39
1544 years
4000
158 276 964 1387
4564 years
5727
65 years & over
7275 Women
Men
Source: PAHO/AIS. Technical Information System. Table Generator. (December 2005) http://www.paho.org
The infant mortality rate was 18.5 per 1,000 live births in 2001. 12 Mortality due to broad groups of causes When broad groups of causes of death were considered it was found that, in 1997, communicable diseases and external causes were the main causes of mortality among children 1 to 4 years old (Figure 7). External causes were also a major concern regarding mortality among children 5 to 14 years of age, although considerably more so among males than females (Figure 7). Figure 7. TRINIDAD & TOBAGO: Estimated death rates (per 100.000) by cause group, 1 to 4 years of age, 1997 0
10
20
30
40
50
TRINIDAD & TOBAGO: Estimated death rates (per 100.000) by cause group, 5 to 14 years of age, 1997 0
18
Communicable diseases
Communicable diseases Diseases of circulatory system
Neoplasms
7,4 5,1
Diseases of circulatory system
10
20
30
40
4,6 4,1 3,3 3,2
13
Neoplasms External causes
10
15
5,3 4,4
10 18
External causes
8,5 15
31
All other causes
40
All other causes
9,4 12
Women Men
Source: Based on data from: PAHO/AIS. Technical Information System. Table Generator. (December 2005) http://www.paho.org 12
Women Men
Source: Idem.
PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005.
6
50
Figure 8. TRINIDAD & TOBAGO: Estimated death rates (per 100.000) by cause group, 45 to 64 years, 1997
TRINIDAD & TOBAGO: Estimated death rates (per 100.000) by cause group, 15 to 44 years of age, 1997 0
100
200
300
400
500
0
600
Communicable diseases
17 35
Communicable diseases
Diseases of circulatory system
24 36
Diseases of circulatory system
Neoplasms
30 18
Neoplasms
External causes
All other causes
22
External causes
92 64
100
200
300
Women Men
Source: Idem.
500
600
34 80 375 549 201 170 22 105 333
All other causes
95
400
482
Women Men
Source: Idem.
Among the population 15 to 44 years of age, as well as those at ages 45 to 64 years, the male death rate due to external causes was over 4 times the female rate (Figure 8). However, at ages 45 to 64, male and female death rates due to diseases of the circulatory system greatly exceeded the rates due to communicable diseases, neoplasms, and external causes. Malignant neoplasms of the digestive organs and peritoneum are an important element within total mortality due to neoplasms, among both men and women. At ages 45 to 64 years, the male death rate in 1997 due to malignant neoplasms of this site was 58 per 100,000 and the female rate, 42. Together with uterus (41 per 100,000 women) and breast (50), these three sites of malignant neoplasms contributed twothirds of the total mortality from neoplasms among women in this age group. 13 Selected causes of death Ischemic heart disease, as well as cerebrovascular diseases and diabetes mellitus, are major causes of death among adults 45 years and over of either sex, and especially adults 65 years and over. Among women at ages 45 to 64 years, the magnitude of mortality due to malignant neoplasms of uterus and breast, jointly, was similar to that from cerebrovascular diseases; however, diabetes and ischemic heart disease were far greater problems at these ages (Figures 9 and 10).
13
The data in this paragraph are from: PAHO/AIS. Technical Information System. Table Generator, http://www.paho.org (December 2005).
7
Figure 9. TRINIDAD & TOBAGO: Estimated death rates (per 100,000) due to cerebrovascular diseases, 1997
TRINIDAD & TOBAGO: Estimated death rates (per 100,000) due to ischemic heart disease, 1997 0
400
800
1200
0
1600
400
1200
1600
88
122 All ages
800
All ages
150
81
188 4564 years
99 4564 years
315
121
1289
979 65 years & over
65 years & over
984
1576
Women Men
Women Men
Source: Idem.
Source: Idem.
Figure 10. TRINIDAD & TOBAGO: Estimated death rates (per 100,000) due to diabetes mellitus, 1997 0
400
800
1200
TRINIDAD & TOBAGO: Estimated agespecific death rates due to malignant neoplasms of uterus and breast (per 100.000 women), 1997 1600
0
70
140
210
280
99 All ages
90
3544 years 15 21
205 4564 years
231
4564 years
41
50
896 65 years & over
852
Women Men
Source: Idem.
65 years and over
133
124
Uterus Breast
Source: Idem.
Accidents, suicide and homicide are all included in the grouping external causes of death. In 1997, the male death rates in Trinidad and Tobago due to each of these causes were far greater than those for females (Figure 11).
8
Figure 11. TRINIDAD & TOBAGO: Mortality due to accidents, suicide and homicide, 1997
Estimated (crude) death rate per 100.000
80
60
40
20
0
Wom en
Men
Hom icide
4.3
17
Suicide
5.2
20
Trans port accidents
5.4
18
Accidents , exce pt transport
6.6
19
Source: Idem.
Sexual and reproductive health In 2004 the total fertility rate in Trinidad and Tobago was 1.6 children per woman. 14 Adolescent pregnancy is one of several reproductive risk categories; 15 it constitutes a barrier that can prevent women from developing capabilities to help them achieve the resources necessary for their wellbeing. In Trinidad and Tobago, in 2004, 4% of adolescents 15 to 19 years old gave birth; among women 35 to 49 years, 1% gave birth to a child. 16 There were 7 maternal deaths in 2001. 17 There has been an increasing trend in the number of AIDS cases reported annually since the beginning of the epidemic in Trinidad and Tobago, among women as well as men (Figure 12). A total of 16 cases were reported for which the sex is unknown (2 in 1996, 2 in 1998, 9 in 2001, 3 in 2002); they are not included in the figure. 18 In September 2005 there were 1,498 people under
14
PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, DC, 2005. 15 Reproductive risk factors: mother’s age less than 20 years and over 34 years; birth interval less than 24 months; birth order greater than 3. 16 PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, DC, 2005. 17 PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005. 18 PAHO AI and National Aids Program.
9
treatment with antiretroviral drugs; 19 an estimated 4,700 people 15 to 49 years old needed such treatment in 2004. 20 Figure 12. TRINIDAD & TOBAGO: Reported cases of AIDS, 19832003
Cases
300
200
100
Men
20 03
20 01
19 99
19 97
19 95
19 93
19 91
19 89
19 87
19 85
19 83
0
Wom en
Source: PAHO/AI and National AIDS Program.
Access to health services Family planning services Among women aged 15 to 49 years who are currently married or currently partnered, 33% use modern methods of family planning and another 5% use other methods. 21 Prenatal care and care at childbirth In 2001, 99.5% of all births were attended by trained personnel and 90.4% of pregnant women received at least one consultation for prenatal care, provided by a trained health worker. 22 Health personnel Although this subject is an essential element in analyzing genderbased inequalities related to the participation of women and men in the health sector, the statistics that would allow such analyses are not currently available.
19
Ibid. UNAIDS/WHO. 21 PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, DC, 2005. 22 PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005. 20
10
TRINIDAD AND TOBAGO
Gender, Ethnicity and Health Unit
Population The total population of Trinidad and Tobago is estimated at 1,305,000 in 2005, of which 76.2% live in urban areas. 1 Women represent 50.7% of the total population. 2 In the year 2004, 381,000 women were 15 to 49 years old, that is, around 58% of the total number of women. 3 The average annual rate of growth of the population had ups and downs during the period 1970 to date, but overall it followed a downward trend and is currently approaching zero growth (Figure 1). Figure 1. TRINIDAD & TOBAGO: Average annual rate of population growth (%), 19701975 to 20052010
4.0
3.0
2.0
1.0
0.0
1970 1975 1980 1985 1990 1995 2000 2005 1975 1980 1985 1990 1995 2000 2005 2010
Population grow th 0.83 1.34 1.71 0.62 0.71 0.40 0.32 0.28 (%)
Source: United Nations. World Population Prospects: The 2004 Revision. New York, 2005.
The latest year for which detailed mortality data from Trinidad and Tobago are available in the PAHO mortality database is 1997. During the period 19951997 the estimated (crude) death rate increased slightly among women as well as men (Figure 2).
1
PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005. Based on data from: PAHO/AIS. Technical Information System. Table Generator. http://www.paho.org, 26 January 2006. 3 PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, 2005. 2
1
Figure 2. TRINIDAD & TOBAGO: Estimated (crude) death rates, 1995 1997 10,0
Rate per 1.000
9,0
8,0
7,0 6,0
5,0
1995
1996
1997
Women
6,5
6,6
6,6
Men
8,0
8,1
8,3
Source: PAHO/AIS. Technical Information System. Table Generator. (December 2005) http://www.paho.org
Socioeconomic context The gross national income per capita (PPP value) was US$10,390 in 2003. 4 Data are not available as to the ratio between the income of the population with the 20% highest and the population with the 20% lowest income. Health expenditure Public expenditure on health was 2.1% of gross domestic product in 20002001, and private expenditure was 2.8% (excluding health insurance) in 2004. 5 Environmental health The entire population has access to sanitation services; access to improved water sources is quite high but has not yet reached 100%, and remains better in urban than in rural areas (Figure 3).
4 5
PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005. Ibid.
2
Figure 3. TRINIDAD & TOBAGO: Access to improved water sources and sanitation services, 2002 100
% population
100
92
100
88
75 50 25 0
Water
Sanitation Urban
Rural
Source: PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005.
Education Among the population aged 15 years and over, literacy was 98.8% in 2005; male literacy was 99.2% and female literacy, 98.3%. 6 The gross enrollment rate for the primary level is estimated to be roughly 100% for both sexes, but secondary enrollment has not yet reached that level for either sex and is better among women than men (Figure 4). Figure 4. TRINIDAD & TOBAGO: Gross enrollment rate (%), primary and secondary levels, 20022003 125 99
101
Percent
100
86
79
75 50 25 0 Prim ary
Secondary Wom en
Men
Source: UNESCO. http://www.uis.unesco.org, 24 January 2006.
6
PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005.
3
Political participation Percent of women 7 : in Parliament in ministerial posts (2001)
25% 9%
Resources that facilitate initiatives leading to gender equality Commitment to gender equality The facultative protocol for the Convention on the Elimination of Discrimination Against Women (CEDAW) 8 : Was signed Was ratified by the legislature
Yes No X X
Abortion policy 9 Does the penal code prohibit abortion? Are there exceptions: To save the life of the mother To preserve the physical and mental health of the mother In cases of rape or incest Other exceptions
Yes No X X X X X X
Health Situation In 2005, life expectancy at birth was 72.7 years for women and 67.4 years for men. 10 Recent demographic estimates found that, during the period since 1970, the gap between male and female life expectancy was as high as 6.6 years greater life expectancy for women; for the 2005 2010 quinquennium this gap will be 4.8 years (Figure 5).
7
PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, DC, 2005. 8 United Nations. Division for the Advancement of Women, Department of Economic and Social Affairs. http://www.un.org/womenwatch/daw, 27 March 2006. 9 United Nations. Population Policy Data Bank, Population Division, Department of Economic and Social Affairs. http://www.un.org/esa/population/publications/abortion/doc , 27 March 2006. 10 PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005.
4
Figure 5. TRINIDAD & TOBAGO: Life ex pectancy at birth (years), 19701975 to 20052010 90 80 70 60 50
1970 1975 1980 1985 1990 1995 2000 2005 1975 1980 1985 1990 1995 2000 2005 2010
Women 68.3
70.9
72.6
74.2
74.5
74.4
73.0
72.5
63.6
65.9
67.4
68.9
68.6
67.8
66.9
67.7
Men
Women
Men
Source: United Nations. World Population Prospects: The 2004 Revision. New York, 2005.
In 2002, the estimated incidence rates of malignant neoplasms of breast and cervix were quite high among women (see table). TRINIDAD & TOBAGO: Estimated incidence of malignant neoplasms, adjusted (per 100.000), 2002 Site Women Men lung 4.6 14.3 stomach 9.2 11.3 female breast 51.1 n.a. cervix 27.1 n.a. PAHO/AIS. Technical Information System. Table Generator. (December 2005) http://www.paho.org
n.a.= not applicable Risk factors 11 The prevalence of tobacco consumption in the population 1315 years of age was 12% among women and 20% among men (2000). Prevalence data on obesity in the population 15 to 49 years old are available for Mount Hope only (urban): 7% among women and 9% among men (2001). Mortality Agespecific death rates, in 1997, were higher among men than women in all age groups (Figure 6).
11
PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, 2005.
5
Figure 6. TRINIDAD & TOBAGO: Estimated agespecific death rates (per 100.000), 1997 0
2000
6000
8000
1525 1900
Under 1 year 14 years
75 91
514 years
31 39
1544 years
4000
158 276 964 1387
4564 years
5727
65 years & over
7275 Women
Men
Source: PAHO/AIS. Technical Information System. Table Generator. (December 2005) http://www.paho.org
The infant mortality rate was 18.5 per 1,000 live births in 2001. 12 Mortality due to broad groups of causes When broad groups of causes of death were considered it was found that, in 1997, communicable diseases and external causes were the main causes of mortality among children 1 to 4 years old (Figure 7). External causes were also a major concern regarding mortality among children 5 to 14 years of age, although considerably more so among males than females (Figure 7). Figure 7. TRINIDAD & TOBAGO: Estimated death rates (per 100.000) by cause group, 1 to 4 years of age, 1997 0
10
20
30
40
50
TRINIDAD & TOBAGO: Estimated death rates (per 100.000) by cause group, 5 to 14 years of age, 1997 0
18
Communicable diseases
Communicable diseases Diseases of circulatory system
Neoplasms
7,4 5,1
Diseases of circulatory system
10
20
30
40
4,6 4,1 3,3 3,2
13
Neoplasms External causes
10
15
5,3 4,4
10 18
External causes
8,5 15
31
All other causes
40
All other causes
9,4 12
Women Men
Source: Based on data from: PAHO/AIS. Technical Information System. Table Generator. (December 2005) http://www.paho.org 12
Women Men
Source: Idem.
PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005.
6
50
Figure 8. TRINIDAD & TOBAGO: Estimated death rates (per 100.000) by cause group, 45 to 64 years, 1997
TRINIDAD & TOBAGO: Estimated death rates (per 100.000) by cause group, 15 to 44 years of age, 1997 0
100
200
300
400
500
0
600
Communicable diseases
17 35
Communicable diseases
Diseases of circulatory system
24 36
Diseases of circulatory system
Neoplasms
30 18
Neoplasms
External causes
All other causes
22
External causes
92 64
100
200
300
Women Men
Source: Idem.
500
600
34 80 375 549 201 170 22 105 333
All other causes
95
400
482
Women Men
Source: Idem.
Among the population 15 to 44 years of age, as well as those at ages 45 to 64 years, the male death rate due to external causes was over 4 times the female rate (Figure 8). However, at ages 45 to 64, male and female death rates due to diseases of the circulatory system greatly exceeded the rates due to communicable diseases, neoplasms, and external causes. Malignant neoplasms of the digestive organs and peritoneum are an important element within total mortality due to neoplasms, among both men and women. At ages 45 to 64 years, the male death rate in 1997 due to malignant neoplasms of this site was 58 per 100,000 and the female rate, 42. Together with uterus (41 per 100,000 women) and breast (50), these three sites of malignant neoplasms contributed twothirds of the total mortality from neoplasms among women in this age group. 13 Selected causes of death Ischemic heart disease, as well as cerebrovascular diseases and diabetes mellitus, are major causes of death among adults 45 years and over of either sex, and especially adults 65 years and over. Among women at ages 45 to 64 years, the magnitude of mortality due to malignant neoplasms of uterus and breast, jointly, was similar to that from cerebrovascular diseases; however, diabetes and ischemic heart disease were far greater problems at these ages (Figures 9 and 10).
13
The data in this paragraph are from: PAHO/AIS. Technical Information System. Table Generator, http://www.paho.org (December 2005).
7
Figure 9. TRINIDAD & TOBAGO: Estimated death rates (per 100,000) due to cerebrovascular diseases, 1997
TRINIDAD & TOBAGO: Estimated death rates (per 100,000) due to ischemic heart disease, 1997 0
400
800
1200
0
1600
400
1200
1600
88
122 All ages
800
All ages
150
81
188 4564 years
99 4564 years
315
121
1289
979 65 years & over
65 years & over
984
1576
Women Men
Women Men
Source: Idem.
Source: Idem.
Figure 10. TRINIDAD & TOBAGO: Estimated death rates (per 100,000) due to diabetes mellitus, 1997 0
400
800
1200
TRINIDAD & TOBAGO: Estimated agespecific death rates due to malignant neoplasms of uterus and breast (per 100.000 women), 1997 1600
0
70
140
210
280
99 All ages
90
3544 years 15 21
205 4564 years
231
4564 years
41
50
896 65 years & over
852
Women Men
Source: Idem.
65 years and over
133
124
Uterus Breast
Source: Idem.
Accidents, suicide and homicide are all included in the grouping external causes of death. In 1997, the male death rates in Trinidad and Tobago due to each of these causes were far greater than those for females (Figure 11).
8
Figure 11. TRINIDAD & TOBAGO: Mortality due to accidents, suicide and homicide, 1997
Estimated (crude) death rate per 100.000
80
60
40
20
0
Wom en
Men
Hom icide
4.3
17
Suicide
5.2
20
Trans port accidents
5.4
18
Accidents , exce pt transport
6.6
19
Source: Idem.
Sexual and reproductive health In 2004 the total fertility rate in Trinidad and Tobago was 1.6 children per woman. 14 Adolescent pregnancy is one of several reproductive risk categories; 15 it constitutes a barrier that can prevent women from developing capabilities to help them achieve the resources necessary for their wellbeing. In Trinidad and Tobago, in 2004, 4% of adolescents 15 to 19 years old gave birth; among women 35 to 49 years, 1% gave birth to a child. 16 There were 7 maternal deaths in 2001. 17 There has been an increasing trend in the number of AIDS cases reported annually since the beginning of the epidemic in Trinidad and Tobago, among women as well as men (Figure 12). A total of 16 cases were reported for which the sex is unknown (2 in 1996, 2 in 1998, 9 in 2001, 3 in 2002); they are not included in the figure. 18 In September 2005 there were 1,498 people under
14
PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, DC, 2005. 15 Reproductive risk factors: mother’s age less than 20 years and over 34 years; birth interval less than 24 months; birth order greater than 3. 16 PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, DC, 2005. 17 PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005. 18 PAHO AI and National Aids Program.
9
treatment with antiretroviral drugs; 19 an estimated 4,700 people 15 to 49 years old needed such treatment in 2004. 20 Figure 12. TRINIDAD & TOBAGO: Reported cases of AIDS, 19832003
Cases
300
200
100
Men
20 03
20 01
19 99
19 97
19 95
19 93
19 91
19 89
19 87
19 85
19 83
0
Wom en
Source: PAHO/AI and National AIDS Program.
Access to health services Family planning services Among women aged 15 to 49 years who are currently married or currently partnered, 33% use modern methods of family planning and another 5% use other methods. 21 Prenatal care and care at childbirth In 2001, 99.5% of all births were attended by trained personnel and 90.4% of pregnant women received at least one consultation for prenatal care, provided by a trained health worker. 22 Health personnel Although this subject is an essential element in analyzing genderbased inequalities related to the participation of women and men in the health sector, the statistics that would allow such analyses are not currently available.
19
Ibid. UNAIDS/WHO. 21 PAHO/GE. Gender, Health and Development in the Americas. Basic Indicators 2005. Washington, DC, 2005. 22 PAHO/AIS. Health Situation in the Americas. Basic Indicators 2005. Washington, DC, 2005. 20
10
