Executive summary

Annex 3.1: Assessing Social Protection in Panama: A Framework

A Social Risks and Groups-At-Risk

This section discusses the main risks facing the different age groups in Panama as well as the risks facing households. This review is not comprehensive but focuses on the major “microeconomic” risks that can contribute, if not addressed, to perpetuating the intergenerational transmission of income poverty. The main finding is that risks occur population wide, but are particularly prevalent among indigenous peoples. The exposure to key risks in childhood fuels the intergenerational transmission of poverty, as malnutrition and lack of sufficient schooling combine to limit income generating potential across the lifecycle.

Children between 0 and 5 years of age

Poor children 0-5 years of age, and particularly the indigenous, suffer from inadequate diet and lack of early stimulation, both of which will impair their development and may maintain them as poor adults.

Malnutrition in children. Low birth-weight due to inadequate maternal food intake may cause poor development in the early years of life and lead to premature death. A recent study commissioned by SENEPAN shows that 20 percent of pregnant women have low weight in the Provinces, with this proportion increasing to 50 percent in the Kuna Yala Comarca.⁴⁶ Ten percent of newborns nationwide have low birth weight, but this percentage is higher in indigenous areas.

Low food intake in infants is a critical risk because it can lead to stunting, illness and early death. In 2003, about 21 percent of children under 5 years of age (62,300) suffered from chronic malnutrition (height for age) (Table A.3.1.1). The prevalence is twice as high for indigenous children, with near 57 percent of children affected. Chronic malnutrition has increased for all groups since 1997, but particularly among indigenous and urban children.

Table A.3.1.1: Chronic Malnutrition Among Children Under 5 Years, 1997, 2003 a/

	Total	Extreme Poor	All Poor	Non-Poor	Urban Areas	Rural (non indigenous)	Indigenous
1977 (%)	14.4	34.5	24.4	4.3	5.6	13.7	48.7
2003 (%)	20.6	39.4	29.9	9.8	13.8	18.6	56.7
2003 (no.)	68,272	37,923	53,566	14,922	25,037	19,597	25,303

Source: LSMS 1997 and 2003.

a/ Height for age. Children whose height is at least two standard deviations below the reference value.

Low coverage of preschool. There is ample evidence that good child care and preschool increase children's school preparedness. Children who have attended preschool have lower repetition rates in primary school and their overall educational attainment is higher. MEDUCA data indicate that the increase in preschool enrollment between 2000 and 2004, from 36 to 52 percent, was accompanied by a 22 percent reduction in the first grade repetition rate (from 10.9 to 8.6 percent) during the same period. MEDUCA preschool enrollment estimates for 4 and 5-year-olds is 57 percent in 2005 (Table A.3.1.2). This implies that 58,000 children do not access preschool and therefore are at risk.

Table A.3.1.2: Preschool Enrollment Estimates, 2005

	No. of Children
	Age 4	Age 5	Ages 4-5
Children Ages 4 and 5 years	67667	67567	135234
Total Enrolled	21466	55937	77403
Public schools	16605	47078	63683
Private schools	4861	8859	13720
Not Enrolled	46201	11630	57831
Memo: % Enrolled, Total	31.7	82.8	57.2
Panama Province	26.2	82.7	54.4
Kuna Yala Comarca	57.0	75.5	66.3

Source: MEDUCA’s Planning Department