Article by Leticia Benedet [1], Master in Gender and Public Policy, expert for the Gender Equality Area at EUROsociAL+ and Alejandra López [2], PhD in Social Sciences and Psychologist, Coordinator of the Institute’s Gender, Sexuality and Reproductive Health Programme of Health Psychology, Faculty of Psychology of the University of the Republic of Uruguay.
© Federika Odriozola - Performance de "El Cuento de la Criada" del 28 de mayo de 2020, organización Mujer y Salud Uruguay (MYSU)
Uruguay is prominent in the Latin American and Caribbean region for its notable advances in the recognition of gender equality as a relevant issue for sustainable development, well-being and the exercise of citizenship rights. With the recovery of democracy, after a long period of civic-military dictatorship between 1973-1985, a process of increasing visibility and social recognition of the various forms of discrimination and violence against women in different areas began. The role of the feminist and women’s movements was a vital part of this process. At its impulse, other social, academic and political actors joined forces to advance in the construction of public policies that effectively respond to these needs and demands.
The genesis of a public policy entails the assumption of a social problem [3] [4] . In the last 15 years, Uruguay has made significant progress in strengthening its public policies with a focus on human rights and gender, placing at its centre the physical autonomy of women and people with dissident gender identities.
In these years, a rights agenda was built, embodied in a set of regulatory frameworks and programmatic lines in different sectors. Among them we can mention the laws on: sexual rights and reproductive rights (2008), voluntary interruption of pregnancy (2012), equal marriage (2013), right to care (2015), trans identities (2019) and gender violence ( 2019). The robust articulation between diverse actors has been and remains one of the key issues in ensuring that these conquests are maintained and expanded.
October 2020 marked eight years since the approval of the law of voluntary interruption of pregnancy (IVE), which enshrined the right of women to decide for themselves on whether or not to continue a pregnancy up until 12 weeks of gestation, ensuring abortion services within the framework of the national health system. The law places Uruguay among the few countries in the region that recognise this right of women. In January 2013, IVE services began throughout the national territory, and although various studies have detected barriers in their implementation[5] [6], the law is considered an achievement that encourages other countries to recognise this right.
This commemoration is also an opportunity to make visible the virtues and potential of articulating the design, preparation and implementation of public policies with academic knowledge and international cooperation, in this case through the EUROsociAL+ Programme of the European Union.
In recent decades, the relationship between knowledge production and public policy has become a matter of the utmost interest. There is a growing consensus in considering the importance of public policies being nurtured by the systematic knowledge provided by scientific knowledge[7] [8]. In the relationship between knowledge and public policy, actors with different logics and interests intervene[9]. International cooperation plays an important role in building bridges between these actors, in order to promote trust, transcend sectoral languages and stimulate the transfer of knowledge. That is, promoting cross fertilisation through a virtuous link between the actors involved.
A virtuous experience of liaison between public policy, knowledge and international cooperation. The role of EUROsociAL+
An outstanding experience of coordinating actors has been the process of creation and implementation of the “National and intersectoral strategy for the prevention of unintentional pregnancy in adolescents” that took place between 2016 and 2020[10]. This public policy arose as a response to the resistance to the decline of adolescent fertility and its high contribution to the global fertility rate in Uruguay. By 2014, the rate was 59 x 1000 adolescents, very close to the Latin American average. However, it was not viewed as a relevant social problem. In the construction of the public problem, the contributions of the Interdisciplinary Nucleus in Adolescence, Health and Sexual and Reproductive Rights of the University of the Republic[11] were highly significant, offering a corpus of solid evidence that helped guide this policy.
The Strategy was built with the participation of different public bodies at the central level of the State, technical assistance from the University of the Republic and the support of international cooperation organisations. The relationship between political, academic and international cooperation actors strengthened their advocacy capacities, their social acceptability and the development of comprehensive policies[12].
Within this framework, Uruguay demanded cooperation from EUROsociAL+ to strengthen the Strategy, specifically for the review of its design, implementation, monitoring and evaluation. Based on this demand, the country, together with the EUROsociAL+ Gender Equality Area, agreed on cooperation actions focused on specialised technical assistance from Europe and Latin America, workshops and seminars, and the exchange of experiences and learning between pairs of institutions from both regions.
In Latin America, with the support of EUROsociAL+, the Strategy could be shared with a delegation from Panama (represented by the National Council for Pregnant Minors – CONAMA), which visited Uruguay to learn first-hand about the inter-institutional policy in all its phases, the actors involved, and identify strengths, weaknesses, and challenges in order to gather inputs for the regulation and implementation of the Panamanian law on pregnancy in girls and adolescents.
In Europe, based on the virtuous structuring between State institutions, academia and international cooperation, the Uruguayan experience was presented and discussed with actors from the four countries that make up the United Kingdom. At the same time, there was an explanation of the experiences and accumulated knowledge of those countries in the implementation of sexual education policies and the prevention of unintentional pregnancy in adolescents. This exchange was unprecedented for the delegations of the participating countries, allowing mutual knowledge not only of the public policy under study but also of the country context that gave rise to it, allowing them to approach and understand their stories, cultures and idiosyncrasies.
The adolescent pregnancy prevention strategy developed by England, with more than 20 years of implementation, had been identified by EUROsociAL+ as a successful policy and inspirational model for Latin America. It is an example of a public initiative based on evidence, carried out at the national and territorial level, with long-term resources, which achieved a 51% reduction in the pregnancy rate in adolescents under 18 years of age[13].
In turn, the University of the Republic[14] in Uruguay, suggested including Queen’s University of Belfast (QUB) from Northern Ireland to learn about the design and development of the “If I were Jack” project, led by Prof. Maria Lohan[15]. The objective of the project is to offer tools for decision-making, reduce risky sexual behaviours and address gender inequalities in sexual and reproductive health, with a focus on adolescent males, based on scientific evidence by combining a proposal of intervention and research, unprecedented in the Latin American and Caribbean region.
In this way, with the support of EUROsociAL+, the visit of Prof. Lohan to Uruguay took place in August 2019, in which she held working meetings with the Coordinating Committee of the Strategy, with national authorities and with the research team of the University of the Republic. This was rounded out with lectures addressed to professionals and students in the areas of health and education[16].
Subsequently, a Uruguayan delegation made up of the coordination of the National Strategy, the University of the Republic and the Uruguayan Agency for International Cooperation, with the accompaniment and financial support of EUROsociAL+ visited the United Kingdom to learn about the experiences of England (London) and Ireland of the North (Belfast). The visit allowed holding meetings with those responsible for the design and evaluation of English politics and participation in the Symposium “6 Nations” Relationship & Sexuality Education (RSE)[17] organised by the QUB in Belfast. This event was attended by representatives from all the countries of the United Kingdom and Ireland and Uruguay as well as the collaboration of Rutgers International (Netherlands) and the World Health Organization.
The Strategy had the support of other international organisations such as UNFPA and IDB, with which the cooperation of the European Union was structured. This structuring determined, among other aspects, the inclusion in the study visit to Europe of the Dutch experience in Sex Education, through an expert from that country. In this way, prominent international experts contributed significantly to the development of the Uruguayan Strategy and promoted new paths for its amplification and transformative social impact[18].
Learning from experience
The process described becomes a successful practice capable of being replicated because it not only fulfilled the objective of strengthening the design, implementation, monitoring and evaluation of the Strategy, but also because it achieved unexpected objectives that added value to public policy, based on the agreement to advance with the adaptation, validation and development of the If I were Jack project in Latin American countries, taking Uruguay as a starting point[19].
Towards the end of 2019, preparations began to start the project and during 2020, despite the fact that in March a new administration took over the national government in Uruguay (with a different approach and political ideology from the party that led public policies in the last 15 years), the National Public Education Administration (ANEP) introduced it in its 2020-2024 educational plan.
These results were possible due to several factors. For the purposes of this note, the focus will be on two of them related to the role of international cooperation and academia in strengthening public policy:
International Cooperation, through the EUROsociAL+ programme of the European Union, played a key role in strengthening intersectoral and interdisciplinary dialogue; resulting in greater and better knowledge, expanding the scope of the planned action and favouring the joint identification (Inter-region) of shared strengths, weaknesses and critical nodes in the public policy being analysed. It demonstrated the virtues of being a demand-oriented cooperation, flexible in its rules and procedures, which encourages dialogue and breaks the traditional cooperation schemes, demonstrating that it proposes a relationship between Latin America and Europe that is not focused on the North-South transfer of knowledge or in verticality/horizontality rationales but rather in enhancing the system of networks that, through their actions, enhance synergies and strengthen regions.
The Academy, with its participation, managed to nurture politics with national and international scientific knowledge, legitimising and making a government initiative sufficiently plausible to transform itself into a State policy.
Finally, it is necessary to reaffirm that Latin America needs to strengthen its policies for sexual education, sexual and reproductive health, and the reduction of unintended pregnancy in adolescents. This is one of the mandates of the Montevideo Consensus (2013), the most recent instrument of regional agreement to advance the population agenda with a focus on human rights and gender[20]. For this, it needs the participation of diverse actors and innovative experiences. Therein lies one of the main challenges: to build robust links between knowledge, public policy, social participation and international cooperation as an indispensable gear to advance towards the achievement of more just and egalitarian societies in the 21st century.
[1] Leticia Benedet, Master in Gender and Public Policy. Expert for the Gender Equality Area of the EUROsociAL+ Programme of the European Union.
[2] Alejandra López, PhD in Social Sciences and Psychologist. Coordinator of the Gender, Sexuality and Reproductive Health Programme of the Institute of Health Psychology, Faculty of Psychology, University of the Republic (Uruguay). information on the Programme at www.derechosgeneroysalud.psico.edu.uy
[3] Parsons, W. (2007), Public policies: an introduction to the theory and practice of public policy analysis, Mexico: FLACSO.
[4] Carrizo, L. (2014) Knowledge and construction of policy problems. Available at https://www.academia.edu/13653053/El_conocimiento_y_la_construcci%C3%B3n_de_los_problemas_de_pol%C3%ADtica
[5] López-Gómez, A., Couto, M., Píriz, G., Monza, A., Abracinskas, L., & Ituarte, M. (2017). Legal services of voluntary interruption of pregnancy in Uruguay. Strategies of the public services of the first level of attention. Public Health of Mexico, 59 (5, Sep-Oct), 577-582. doi: http://dx.doi.org/10.21149/7937
[6] MYSU (2017) National Observatory Report on Gender and Sexual and Reproductive Health. Sexual and reproductive health services and legal abortion in Uruguay. Monitoring 2007-2017 Montevideo: MYSU. Available in https://issuu.com/mujerysaludenuruguay/docs/informe_observatorio_2017_10de19_we
[7] Papanagnou, G. (Ed.). (2011) Social Science and Policy Challenges. Democracy, values and capacities. Paris. UNESCO Publishing.
[8] Weiss, C. (2013). Interview with Stephen Dale: “In conversation: Carol Weiss and Evert Lindquist on policy making and research,” IDRC Publications.
[9] Carrizo L. (2011). “The research-policy link. From applied research to implicated research. A perspective from complexity and transdisciplinarity” in Juan Valdés Paz and Mayra Espina (eds) (2011) Latin America and the Caribbean: Social policy in the new context – Approaches and experiences. FLACSO, UNESCO (p.223). Available at https://biblio.flacsoandes.edu.ec/libros/digital/55854.pdf
[10] López, A. & Varela C. (coord.). Maternity in adolescents and social inequality in Uruguay. Montevideo: University of the Republic, UNFPA. Available at: https://uruguay.unfpa.org/sites/default/files/pub-pdf/Maternidad%20en%20adolescentes%20y%20desigualdad%20social%20en%20Uruguay.pdf
[11] See more info at https://www.youtube.com/watch?v=ZMgk_2oo9Gg&feature=youtu.be
[12] MSP (2020) National and intersectoral strategy for the prevention of unintentional pregnancy in adolescents. Montevideo: MSP, UNFPA; AUCI. Available at http://www.derechosgeneroysalud.psico.edu.uy/sites/derechosgeneroysalud.psico.edu.uy/pub_files/estrategia_de_prevencion_del_embarazo_no_intencional_en_adolescentes._uruguay_2016-_2020.pdf.pdf
[13] England had the third highest teenage pregnancy rate in Europe after Romania and Bulgaria. For more details of the English experience see: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/836597/Teenage_Pregnancy_Prevention_Framework.pdf
[14] Specifically, the Gender, Sexuality and Reproductive Health Program of the Health Psychology Institute of the Faculty of Psychology, member of the Interdisciplinary Nucleus Adolescence, sexual and reproductive health and rights. See: http://www.derechosgeneroysalud.psico.edu.uy/
[15] If I were Jack programme. See at: https://www.qub.ac.uk/sites/if-i-were-jack/
[16] See Lecture by Prof. María Lohan at the University of the Republic: https://www.youtube.com/watch?v=H0pM2447mqg&feature=youtu.be
[17] See information on the activity at: https://www.qub.ac.uk/sites/if-i-were-jack/6NationsRSESymposium/
[18] Maria Lohan (Northern Ireland), Alison Hadley (England) and Ineke van der Vlugt (Netherlands).
[19] The project is led by Prof. Alejandra López from the Gender, Sexuality and Reproductive Health Programme of the Faculty of Psychology of the University of the Republic in agreement with Prof. Maria Lohan from QUB (Northern Ireland).
[20] ECLAC (2013) The Montevideo Consensus on Population and Development. Document available at https://www.cepal.org/es/publicaciones/21835-consenso-montevideo-poblacion-desarrollo
