Honduras - Women in Development

Document of The World Bank FOR OFFICIAL USE ONLY CONFIDENTIAL Report No. 11035-HO HONDURAS WOMEN IN DEVELOPMENT January 21, 1993 FILE COPY CONFIDENTIAL: Report No.:11035-HO Type: (SEC) Title: WOMEN'S COUNTRY ASSESSMENT PAP Author: VINH NGUYEN Ext. :39251 Room:1 7076 Dept. :LA2HR Country Department II Human Resources Operations Division Latin America and the Caribbean Regional Office This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization. CURRENCY & EQUIVALENT UNITS US$1 = 5.40 Lempiras (July 1992) SDR1.0 = US$1.4045 (October 1992) WEIGHTS & MEASURES 1 Hectare (ha) = 10,000 m2 1 Metric ton (mt) = 1,000 kg 1 Kilometer = 1,000 m FISCAL YEAR January 1 - December 31 ACRONYMS ASHONPLAFA Honduran Family Planning Association (La Asociaci6n Hondurefna de Planificaci6n Familiar) BMI Maternal Child Coupon Program BMJF Woman-Headed Household Food Coupon Program (Bono Mujer Jefe de Familia) CESAR Rural Health Center (Centro de Salud Rural) CESAMO Health Center with Physician (Centro de Salud Rural con Midico) CHMP Honduran Committee of Women for Peace (Comiti Hondureflo de Mujeres por La Paz, Vsitaci6n Padilla) CODIMCA Council for Integrated Development of Rural Women (Consejo para el Desarrollo Integral de la Mujer Campesina) EAP Economically Active Population ENESF National Epidemiological and Health Survey (Encuesta Nacional de Epidemiologla y Salud Familiar) EPHPM Permanent Household Survey (Encuesta Permanente de Hogares) FAFH Federation of Women's Associations of Honduras (Federaci6n de Asociaciones Femeninas de Honduras) FHIS Honduran Social Investment Fund GOH Government of Honduras IDA International Development Association IHSS Honduran Institute of Social Security MCH Maternal and Child Health Care MOE Ministry of Education MOH/MSP Ministry of Health (Ministerio de Salud Piblica) NGO Non-Government Organization PAHO Pan-American Health Organization PCWA Permanent Congressional Committee on Women's Affairs (Comisi6n Permanente para Asuntos de la Mujer) PRAF Family Assistance Program (Programa de Asignacid6n Familiar) SECPLAN National Planning Secretariat (Secretarla de Planificaci6n, Coordinaci6n y Presupuesto) UNAH National University of Honduras (Universidad Nacional Aut6noma de Honduras) UNICEF United Nations International Children's Emergency Fund USAID United States Agency for International Development -i- HONDURAS WOMEN IN DEVELOPMENT TABLE OF CONTENTS EXECUTIVE SUMMARY ............................ v I. INTRODUCTION ................................ 1 II. POVERTY AND THE ECONOMIC CHARACTERISTICS OF HOUSEEOLDS ............................... 2 M. EDUCATION AND TRAINING ...................... 4 A. FORMAL EDUCATION ...................... 4 B. EDUCATION AND TRAINING OUTSIDE THE CLASSROOM ........................... 8 IV. WOMEN'S LABOR FORCE PARTICIPATION ............ 8 V. LEGISLATION AND WOMEN'S EMPLOYMENT AND PAY ... 12 VI. ACCESS TO CHILDCARE ........................ 14 VII. WOMEN'S HEALTH STATUS ...................... 17 A. PATTERNS OF MORTALITY AND MORBIDITY ...... 17 B. WOMEN'S REPRODUCTIVE HEALTH ............ 20 C. FERTILITY AND FAMILY PLANNING ............ 21 VIII. INSTITUTIONALASPECTS ....................... 23 A. PUBLIC PROGRAMS PROVIDING ASSISTANCE TO W OM EN .............................. 23 B. PRIVATE PROGRAMS PROVIDING ASSISTANCE TO W OM EN .............................. 24 IX. CONCLUSIONS AND RECOMMENDATIONS FOR DEVELOPING AN ASSISTANCE STRATEGY FOR WOMENS'DEVELOPMENT...................... 25 A. CONCLUSIONS ........................... 25 B. PRIORITY AREAS OF CONCERN ................ 26 C. SECONDARY AREAS OF CONCERN ............. 27 This report was prepared by Carolyn Winter (PHRWD). Eduardo Velez (LATHR) participated in the mission and assisted in the collection of data and information. Document processing was done by Adala Bruce-Konuah and V. Nguyen. - ii - SELECTED BIBLIOGRAPHY .......................... 29 TEXT TABLES 1. The Economic Characteristics of Households ............ 3 2. School Enrollment Rates by Department and Sex, 1974 and 1988 (Ages 5-29) ................ 5 3. Enrollment, Grade Completion, Repetition, Drop-Out and Failure Rates by Sex at Primary and Secondary Schools,1989 ....................... 6 4. Changes in the Gender Composition of University Graduates, 1979-1987 .................. 7 5. Average Wages by Employment Sector and Gender (Lempiras perWeek) ........................ 10 6. Labor Force Participation Rates and Average Earnings by Education Level and Gender ............. 11 7. Causes of Mortality Among Women Aged 12-50, 1989/90 ......................... 19 APPENDIX TABLES 1. Women's Educational Attainment by Urban/Rural Area and Departament (percent), 1988 ............... 31 2. Female Graduates as a Percent of Total Graduates by Course of Study .................... 32 3. Workers: Means (and Standard Deviations) of Variables by Gender and Economic Sector ............ 33 4. Distribution and Average Earnings by Industry Group and Economic Sector ................ 34 5. Mortality Rates Among Women of Reproductive Age by Department, 1989-1990 ................... 35 6. Maternal Mortality Rates by Department, 1989-90 ......... 36 7. Use of Birth Control Among Women in Union by Education Level,1987....................... 37 -m- FACT SHEET PROFILE OF HONDURAN WOMEN Unit Year Female Population Female Population as a percentage of the total 49.9 % 1991 Women less than 25 years of age 64.2 % 1991 Women of fertile age (15-50 years) 46.0 % 1991 Women in urban areas 41.2 % 1988 Female-headed households 22.0 % 1990 Health Female life expectancy 63.7 years 1991 General mortality rate per 1,000 (ages 12-50) 6.8 deaths 1991 National fertility rate (women aged 15-50) 5.2 births 1990 Urban fertility rate (women aged 15-50) 3.9 births 1990 Rural fertilty rate (women aged 15-50) 6.5 births 1990 Child deliveries attended by health staff 47.0 % 1991 Women of fertile age (ages 12-50) using birth control 29.7 % 1991 Maternal mortality rate (per 100,000 live births) 221.0 deaths 1990 Education Illiteracy rate of the female population (aged 10 and older) 32.0 % 1988 Illiteracy rate among rural women 42.2 % 1988 Initial primary school female enrollment 49.5 % 1989 Initial secondary school female enrollment 53.5 % 1989 Initial university female enrollment 43.6 % 1989 University female graduates 50.8 % 1989 Employment Women in the labor market (EAP/aged 15-65) 30.4 % 1990 Women in urban areas participating in the labor market 24.0 % 1990 Formal sector (female EAP) 46.1 % 1989 Self-employment (female EAP) 54.0 % 1989 Ratio of male/female earnings - formal sector 0.95 ratio 1989 Ratio of male/female earnings - self-employment 1.61 ratio 1989 Female-headed Households Percentage of households headed by women 21.7 % 1990 Ratio of mean per capita incomes in male/female-headed households 1.31 ratio 1990 Percentage of female-headed households in poverty 36.8 % 1990 Sources: SECPLAN, UNAH, ENESF, EPHPM. - iv - [This page left blank] EXECUTIVE SUMMARY 1. This reports reviews the status of women in Honduras with the intention of identifying factors which constrain their ability to make an optimal contribution to the development of the country. This special focus on women is warranted given that females in Honduras, as in many Latin American countries, have traditionally received less education, are much less likely than men to participate in the labor market or to hold higher-paying, higher-productivity jobs, have sometimes been subject to discrimination under the law, and suffer particular health risks because of their childbearing role. 2. This review indicates that Honduras has made substantial progress in addressing women's issues over the past decade. The Government of Honduras has achieved significant increases in girls' school attendance rates, has improved women's access to pre-natal care and revised some legislation which directly discriminated against women. 3. However, much remains to be done. Women's health status continues to be low because of their reproductive function and the rate of maternal mortality remains unacceptably high. A significant proportion of births are high risk because institutional delivery rates are low, pre- and post-natal care limited and of poor quality, use of family planning methods low, and because a high percentage of births occurs among very young and older women. Girls' access to education has increased rapidly over the past decade and their enrollment rates now equal boys'. The principal concerns in the education sector are the low quality of education provided (for both sexes) and women's propensity to pursue courses of study that lead to lower-paying occupations. Women's labor market participation rates are still relatively low and a substantial male/female wage differential exists. Labor-related legislation includes several laws intended to protect women during and immediately after childbearing periods. The effect of these laws, however, is frequently to raise the relative cost of women's labor, so providing incentives for employers to recruit male, rather than female, labor. The report recommends that an extensive review of labor legislation be undertaken to evaluate the impact of specific laws on women's participation and pay. 4. The report points out that, in all of these sectors, major rurallurban differences are evident. Women in rural areas have much more limited access to education, health, and child care services which are also of much lower quality. 5. The report also examines, within the constraints of the limited data available, the relative position of female-headed households. It is clear that female-headed households have a greater propensity to be poor and should therefore be targeted in any poverty alleviation efforts. - vi - 6. The policy recommendations emerging from the analysis in the report stress the need for priority to be given to improving women's access to better quality reproductive health care and to improving the quality of basic education. In both sectors, it is recommended that special attention be paid to these needs in rural areas and that priority be given to the improvement of: (a) women's access to reproductive health care; (b) women's access to family planning services; and (c) school retention rates, with priority to educational investments at the primary and secondary levels. Investments in these two sectors are likely to yield the greatest social returns and be most effective in reducing existing inequities. These efforts will improve women's living conditions and environment and increase their ability to contribute to the country's development. HONDURAS WOMEN IN DEVELOPMENT I. INTRODUCTION 1. This report reviews the major issues affecting women and their role in Honduras' economic and social development. It is prepared as an input to the Bank's efforts to promote the role of women in development. The Government of Honduras (GOH) has made considerable progress over the past decade in improving the position of women: girls' access to schooling has been greatly improved, more attention and resources have been focused on women's reproductive health, some important barriers to women's participation in the formal labor market have been identified and steps taken to reduce their effects, and resources are being targeted more effectively to groups of women in need. However, a considerable amount remains to be done. 2. This report analyzes the present situation of women in Honduras and identifies areas which should be given special attention and resources in future public programs. While the report identifies several areas of concern, there are two that should clearly be given the highest priority. The first is women's reproductive health. Maternal mortality rates remain very high, especially in rural areas where the quality of health services provided is low and where only a small proportion of women plan their families. The second is education. Girls' and women's access to higher quality education at all levels is important, especially in rural areas. The benefits to women of even a few years of additional education are very evident in Honduras. Better- educated women are more likely to seek pre- and post-natal care, delay childbearing until their twenties and plan their families, and find higher- paying, higher-productivity jobs in the formal sector. Efforts to improve the allocation and use of resources in these two areas clearly have potential to yield high social rates of return for the country at large. 3. While a considerable body of information is available on the situation of women in Honduras, there are several important areas where access to more detailed and reliable information would greatly facilitate policy development. The information on female-headed households and on poorer households in general is inadequate. Available data provides little information about these households' income sources, their allocation of scarce resources within the household, or their coping strategies. This information would be valuable in designing on-going and possible future interventions to target poor groups. -2- II. POVERTY AND THE ECONOMIC CHARACTERISTICS OF HOUSEHOLDS 4. Honduras is one of Latin America's poorest countries with a per capita GNP of US$570 in 1991. Over 50 percent of the total population, and nearly 80 percent of the rural population, are estimated to be living below the poverty line. There is an urgent need to identify and target social programs to poor groups including those adversely affected in the short-run most affected by the adjustment process that has been in progress since 1990. However, little empirical work has been undertaken to identify the most needy groups and obtain more information about their living conditions. GOH programs to mitigate the social impact of adjustment, such as the Family Assistance Program (Programa de Asignaci6n Familiar, PRAF), have relied, in part, on female headship as a proxy for poverty in the absence of more accurate information. 5. The annual household survey data,1' however, provide some basic information about the earnings, household conditions and location of poorer households. Using these data to examine characteristics of the poorest one- third of households,2' poverty conditions in 1990 can be described as follows: (a) Nearly 22 percent of all households are headed by women. These households are more likely to be poor than male-headed households; nearly 37 percent of all female-headed households are poor compared to only 24 percent of male-headed households. As Table 1 shows, average per capita incomes in female-headed households are well below those in male-headed households. This suggests that female-headed households should be targeted in any poverty reduction effort; (b) Poverty, measured in terms of household per capita income, appears to be more acute in urban areas. The average per capita income reported by poor urban households (11.57 Lempiras per month) is only two-thirds of that reported by poor rural households (17.48 Lempiras per month). This is the case even though poor urban households are smaller and their heads more educated. This rural/urban difference is even more pronounced among the poorest 10 percent of households where per capita household income in urban areas (1.55 Lempiras) is only one-quarter the level of that in rural Encuesta Permanemte de Hogares (EPHPM) conducted by the National Planning Secretariat (SECPLAN). 2' For the purposes of this discussion, households are considered to be poor if they fall in the lowest three deciles in terms of average per capita income. Table 1 THE ECONOMIC CHARACTERISTICS OF HOUSEHOLDS Pooret 10% Poorest 20% Poorest 30% Non-poor* Total Population Female Male Total Female Male Total Female Male Total Female Male Total Female Male Total ENTIRE COUNTRY % Households in Category 22.80 7.00 ... 29.90 15.10 ... 36.80 24.10 ... 63.20 75.90 ... 22.00 78.00 ... URBAN AREAS % Households in Category 18.30 5.30 21.30 6.50 25.90 8.90 ... 74.10 91.10 ... 26.00 74.00 ... Household Size 3.70 4.10 3.90 3.90 4.50 4.20 4.20 5.20 4.70 4.80 5.20 5.10 4.60 5.20 5.10 Age of Household Head 49.20 47.90 48.60 48.50 48.30 48.40 48.10 47.30 48.70 45.20 40.30 41.40 46.10 40.90 42.20 Schooling of Head (years) 4.60 6.10 5.30 4.40 5.40 4.80 3.90 4.70 4.40 5.90 7.10 6.70 5.50 6.80 6.40 Per Capita Income (monthly) 1.45 1.68 1.55 4.35 5.62 4.97 9.41 13.23 11.51 154.94 197.57 185.67 122.07 181.20 165.52 Total Household Income (monthly) 5.35 6.89 6.05 16.97 25.31 20.87 39.53 68.82 54.11 743.72 1,027. 964.93 561.51 942.24 844.16 38 Average Number of Workers 0.14 0.23 0.18 0.26 0.37 0.31 0.42 0.61 0.51 1.77 1.73 1.74 1.42 1.63 1.58 RURAL AREAS % Households in Category 13.80 11.70 ... 31.20 28.50 ... 47.40 43.90 ... 52.60 56.10 ... 19.00 81.00 Household Size 3.70 6.50 5.30 4.20 6.70 5.90 4.50 6.60 6.10 4.90 5.30 5.20 4.60 5.70 5.60 Age of Household Head 54.80 47.90 50.90 52.80 44.10 46.70 51.60 43.70 45.60 50.10 42.90 44.10 50.80 43.30 44.70 Schooling of Head (years) 1.80 1.80 1.80 1.70 1.70 1.70 1.70 1.70 1.70 2.40 3.10 2.80 2.10 2.50 2.40 Per Capita Income (monthly) 2.12 7.40 6.08 8.47 13.51 12.62 12.47 18.52 17.48 80.70 84.52 82.31 47.40 60.04 57.00 Total Household Income (monthly) 11.56 48.09 32.23 35.59 90.55 74.43 56.13 122.20 106.60 395.42 447.97 428.61 218.02 342.24 319.21 Average Number of Workers 0.29 0.88 0.63 0.54 1.05 0.91 0.70 1.13 1.03 1.58 1.49 1.50 1.12 1.35 1.31 Notes: ... means not applicable * Households are classified as non-poor if they are not in the poorest 30% of households in terms of average per capita income. Source: Encuesta Permanente de Hogares, 1990. -4- households (6.08 Lempiras). The reasons for this are not clear and are worthy of further study. However, given that the average poor urban household does not even have one household member engaged in regular paid employment, it is possible that unemployment in urban areas in 1990 was higher than in rural areas; and (c) In urban areas, female-headed households are significantly more likely to be poor than male-headed households; 26 percent of female-headed households are poor compared to only 9 percent of male-headed households. Per capita incomes in female-headed households are 71 percent of those in male- headed households. 6. While the data on household earnings provide some information about the relative incidence of poverty, it is clear that households could not survive on the reported income alone. Clearly, the household information on income is incomplete. Supplementary income, possibly earned in short work episodes, is probably not captured in the household surveys. The surveys also fail to record alternative sources of income such as payments in-kind (common among informal sector workers) and transfers from family members working in other areas. More detailed and accurate information on income and income sources would greatly improve knowledge about the nature and extent of poverty and facilitate the design of targeted programs. A community-level survey designed to capture information on poor households differing sources of income would provide more complete information and be valuable in the design of targeted programs. III. EDUCATION AND TRAINING A. FORMAL EDUCATION 7. Although the GOH allocates approximately 4% of Honduras' Gross Domestic Product to public education, these resources are often used inefficiently with the result that education quality is low and education productivity more limited than needs be.Y The bulk of educational services are provided by the public sector and, although significant progress has been made over the past decade, serious problems of access and quality persist. Relatively few Hondurans complete primary school and almost one-third of the adult population was illiterate in 1988. The continuing high level of illiteracy among women (32 percent in 1988), should not, however, mask the progress the GOH has made in improving women's educational opportunities. This progress is more adequately reflected in the fact that, in the 10 to 19 11 In 1990, Honduras allocated 4.1% of GDP to the education sector, comparable to Costa Rica (4.8%) and more than Argentina (3.3%). -5- year old age group, girls' illiteracy rate (18 percent) is now considerably below that of boys' (25 percent). 8. The declining illiteracy rate among women reflects the serious efforts that have been made over the past decade to increase school enrollment, especially the enrollment of girls. Enrollment rates among girls increased by 9 percentage points between 1974 and 1988 (from 33 percent to 42 percent), compared to only a 6 percentage point increase in enrollments among boys (from 36 percent to 42 percent) (see Table 2). Increases in girls' enrollments have not, however, been achieved uniformly across the country and sharp differences in access rates persist between urban and rural areas; 74 percent of women who have never attended school are in rural areas; only 15 percent of secondary school enrollees were from rural areas; and women with higher education are almost exclusively (97 percent) from urban areas (see Appendix Table 1). Table 2 SCHOOL ENROLLMENT RATES BY DEPARTMENT AND SEX 1974 AND 1988 (Ages 5-29) 1974 1988 Department Females Males Females Males Atlantida 40.0 43.0 48.0 48.0 Colon 36.0 39.0 44.0 43.0 Comayagua 33.0 34.0 44.0 43.0 Copan 22.0 21.0 32.0 31.0 Cortes 40.0 44.0 47.0 48.0 Choluteca 29.0 31.0 40.0 39.0 El Paraisa 27.0 28.0 38.0 36.0 Francisco Morazan 42.0 48.0 51.0 53.0 Gracias a Dios 42.0 50.0 42.0 46.0 Intibuca 22.0 27.0 31.0 33.0 lelas de la Bahia 37.0 41.0 47.0 48.0 La Paz 22.0 26.0 34.0 35.0 Lempira 19.0 21.0 25.0 26.0 Ocotepeque 25.0 27.0 34.0 32.0 Olancho 28.0 29.0 36.0 35.0 Santa Barbara 26.0 29.0 37.0 35.0 Valle 34.0 37.0 44.0 45.0 Yoro 37.0 40.0 44.0 43.0 All Departments 33.0 36.0 42.0 42.0 Source: Irma Cano. (Jan. 1991). Diferencias Geogrdficas de la Escolaridad Hondurefna. Universidad Naconal Autdnoma de Honduras, Facultad de Clencias Econdmicas. (Censos Nacionales de Poblacd6n 1974 y 1988). 9. School retention rates and achievement levels, measured by grade completion, however, are higher for girls than boys at both primary and -6- secondary school (see Table 3). While girls account for almost 50 percent of enrollments at primary school, they comprise over 52 percent of primary graduates. Repetition rates are also lower among girls; in 1989, 45 percent of girls in primary school repeated a grade compared to almost 55 percent of boys. Secondary school completion rates are also significantly higher for girls than boys (58 percent versus 42 percent). The reasons for these differences in achievement levels are not clear. One possibility is that the opportunity cost of boys' time is high in rural areas where they are incorporated into agricultural activity at an early age. This explanation does not fully explain the difference, however, since girls typically also have responsibility for tasks in the home. While this an interesting issue, the fact that only around 12 percent of primary school entrants of either sex graduate from this level is of much greater importance. It points to the need for efforts to be focused on improving the quality of teachers and instructional methods used in the primary education system at large. Table 3 ENROLLMENT, GRADE COMPLETION, REPETITION, DROP-OUT AND FAILURE RATES BY SEX AT PRIMARY AND SECONDARY SCHOOLS, 1989 Girls Boys No. Students Percentage No. Students Percentg PRIMARY SCHOOL Total Enrollment 437,573 49.5 446,031 50.5 Completion of Grade 361,053 50.5 352,629 49.5 Primary School 39,455 52.2 35,625 47.5 Graduates Grade Repeaters 50,508 46.3 58,477 53.7 Failed the Grade 55,715 45.3 67,163 54.7 School Drop-Outs 16,602 43.7 21,315 56.3 SECONDARY SCHOOL Total Enrollment 105,415 53.4 91,647 46.6 Completion of Grade 87,066 56.1 67,923 53.9 Secondary School 10,523 58.2 7,544 41.8 Graduates Source: Anuario Estadistico, 1989. Secretarfa de EducaciOn Pdblica, Direccidn General de Planificacidn Educativa, Departamento de Estadtica. 10. As girls' access to secondary school has increased, so has their participation at the most prestigious tertiary level institution, the National University of Honduras (Universidad Nacional Autonoma de Honduras, UNAH). As Table 4 shows, women constituted 50.7 percent of enrollments in 1989, a substantial increase from 1979 when they made up only 32 percent of enrollments. -7- Table 4 CHANGES IN THE GENDER COMPOSITION OF UNIVERSITY GRADUATES, 1979-1987 Year Women Men Women as a% of Total Graduates 1979 203 439 31.6 1980 260 461 36.0 1981 344 518 39.9 1982 369 452 44.9 1983 478 505 48.6 1984 413 473 46.6 1985 540 535 50.2 1986 692 703 49.6 1987 681 649 51.2 1988 630 612 50.7 1989 573 556 50.7 Sources: Projecto PNUD/UNFEM/SECPL4N. Pothica Nacional Para La Mujer. Tegucigalpa, 1988; and UNAH, Etadsicas (No. 21), 1989. 11. Women's organizations have focused their concerns in the educational sector on gender stereotyping in school textbooks and the curriculum, which they believe reinforces cultural norms about "appropriate" subjects and occupations for women to pursue. They have been successful in attracting donor funding from the United Nations Children's Emergency Fund (UNICEF) and the United States Agency for International Development (USAID) to finance the revision of school textbooks to reduce sex stereotyping. Some preliminary work has already begun on this project. 12. Interestingly, the data available on women's chosen course of study at UNAH indicates that women are already moving into courses traditionally dominated by men. Although women still account for a high proportion of students in the traditionally "female" courses of study -- teaching, social work and nursing -- their enrollment in business and science courses has been increasing. In 1979 the four courses with the highest female enrollment were law, teaching, nursing and social work. Men were predominantly enrolled in law, agricultural engineering, civil engineering and economics. By 1989 this pattern had changed so that the most popular courses for women were law, medicine, and business administration, closely following men's preference for law, engineering, medicine, and business administration. Women also accounted for 69 percent of enrollments in dentistry in 1989 (see Appendix Table 2). 13. Women's enrollment in other higher education institutions, many of which provide more vocationally oriented courses, is much lower. Women -8- are still not permitted to enroll at the Escuela Nacional de Agricultura and have only had access to the Escuela Agfcola Panamericana de Zamora since 1983, where they make up a very small proportion of the student population. Women are, however, increasingly studying technical subjects at the Universidad Tecnologica Centroameficana where they now make up 40 percent of the student body. 14. Honduras has clearly made great strides in reducing illiteracy among women and increasing girls' access to education at all levels. Given the especially high social returns to investments in girls' education this should continue to be given priority.!' The sharp urban/rural differences in educational access and quality are a serious concern, however, and warrant further attention. These differences affect the educational opportunities of students of both sexes. B. EDUCATION AND TRAINING OUTSIDE THE CLASSROOM 15. The GOH and a variety of Non-Governmental Organizations (NGOs) provide informal education and training opportunities for women. Although some courses (such as those provided by the publicly-funded Instituto Nacional Agrario and the Instituto Nacional de Formaci6n Profesional) offer training in basic entrepreneurial skills, women predominantly enroll in courses dealing with domestic activities such as household administration, sewing, food and nutrition, and confectionery. While no follow-up studies have been done to determine how course participants use their training, womens' typical choices of study suggest that they do not intend to use these skills to find employment or to become entrepreneurs. The reasons why women do not seek training as a means to future income-generating activities should be explored. Ttheir current choices may reflect hidden barriers of entry for women in work-oriented training programs. 16. Approximately 35 NGOs work with rural and urban women and offer courses in literacy, community health, women's legal rights and small enterprise activities. The majority of these NGOs operate on small budgets and have very limited institutional capacity. They generally do not maintain records on enrollment numbers or course completion rates, but the information that is available suggests that the programs reach relatively few women and that the quality is low. IV. WOMEN'S LABOR FORCE PARTICIPATION 17. Female labor force participation rates in Honduras are comparable to those in most other Latin American countries; in 1990, just over 30 percent of women aged 15 to 65 years were working in the labor market. 11 The returns to girls' education are discussed more fully in L.H. Summers, "Investing in All the People - Educating Women in Developing Countries", Mimeograph. The World Bank. 1990. -9- Interestingly, though, the male/female earnings differential in Honduras is among the lowest in Latin America, with women earning over 81 percent of men's average weekly earnings' The wage gap is considerably smaller among workers in the formal sector than among those self-employed. Self- employed women earn only 62 percent of self-employed mens' earnings. The wage gap is very small among public sector workers and women in the private sector actually have a small pay advantage over men. Two factors may partially explain these unusual findings. First, a large proportion of working men (over 40 percent) are in agricultural employment where average wages are extremely low (less than half the average wage in other sectors),9' while women are concentrated in the social services and commerce sectors where average wages are low but above those in the agricultural sector. Second, working women have a human capital advantage since they have on average one-and-a-half years more education than working men. Indeed, in the private and public sectors, women's educational advantage increases to 2.2 years and 2.9 years, respectively (see Table 5). 18. The effects of increased educational attainment on female labor force participation rates and earnings relative to men are very strong, as Table 6 shows. Female participation rates are low (21 percent) among women with no education, but increase markedly (to almost 33 percent) when women have completed even primary education. With completed secondary education, women's participation rate increases to 60 percent. Women's participation rate, like men's, levels off among those with university education. This may reflect the high rate of unemployment among university graduates of both sexes. 19. It is also clear that the male/female earnings differential is substantially smaller among workers with higher education levels. Women with primary education, for example, earn only 61 percent of similarly educated male workers' earnings, while female tertiary level graduates earn approximately the same as men. This information provides strong support for government policies directed towards increasing girls' school enrollment levels and retention rates given the clear link between increased educational attainment and higher participation and earnings. This differential is low not only relative to other Latin American countries, but also to many industrialized countries. In Bolivia and Jamaica, for instance, women earn 63 percent and 58 percent of men's earnings, respectively. In industrialized countries such as Britain, Australia and the United States, women earn close to three-quarters of men's earnings. 9 The proportion of men engaged in agricultural production is high relative to most other Latin American countries. This distribution of male labor largely accounts for the unusual male/female earnings pattern. Similar earnings patterns are found in Guatemala where males are also predominantly engaged in agriculture. - 10 - Table 5 AVERAGE WAGES BY EMPLOYMENT SECTOR AND GENDER (Lempiras per week) Females Males Sector Average Education Distrib. of Average Education Distrib. of Ratio Earnings (Years) Workers Earnings (Years) Workers Female/Male (%) (%) Earnings TOTAL COUNTRY Self- 37.68 3.81 54 60.59 3.09 35 62 Employment Public Sector 156.09 11.12 17 164.02 8.85 13 95 Private Sector 91.27 8.20 28 89.82 5.24 51 101 Formal Sector* 120.57 9.25 46 113.96 6.01 65 106 URBAN AREAS Self- 44.32 4.38 46.1 108.95 5.12 17.7 41 Employment Public Sector 165.79 11.50 18.2 182.37 9.53 61.0 91 Private Sector 98.25 8.77 34.2 118.35 6.77 17.7 83 RURAL AREAS Self- 27.51 2.94 71.6 43.78 2.39 49.1 63 Employment Public Sector 125.37 9.91 12.0 112.15 6.95 38.1 118 Private Sector 43.94 4.36 13.7 46.13 2.89 6.0 95 Note: * Formal sector is comprised of the public and private sectors. Source: Encuesta Permanente de Hogares (EPHPM), September, 1989. 20. Despite the relatively small male/female pay differential in Honduras, significant differences in employment patterns and earnings between men and women persist. One of the most marked differences is in terms of the sexes' distribution across the informal and self-employed sectors. As Appendix Table 3 shows, the majority of working women (54 percent) are in self- employment (typically working as domestic servants, small-scale food sellers and handicraft producers) where average earnings are well below those in the public and private sectors, and where the male/female earnings differential is largest. Although more than one-third of men are self-employed, the majority (51 percent) of working men are in the higher-paying private sector. Two issues are important in considering women's propensity for self- employment. First, it is women with limited education who enter self- employment; they have, on average, less than 4 years of education while their counterparts in the private and public sectors have 8.2 years and 11.1 years of schooling, respectively. Second, information from the household surveys refutes the widely held belief that women enter self-employment because of the flexibility it gives them in terms of caring for young children. A probit analysis of work sector choice issues (formal versus self- employment) reveals that, while mothers of young children are more likely to be self-employed than in the public or private sectors, limited educational attainment (primary school education or less) is a much more powerful - 11 - predictor of self-employment.2' This finding again suggests that the most effective means of increasing women's formal labor market participation rate (thereby increasing their productivity and earnings) will be to focus on increasing girls' enrollment and retention rates at school. Table 6 LABOR FORCE PARTICIPATION RATES AND AVERAGE EARNINGS BY EDUCATION LEVEL AND GENDER Women Men Ratio of Education Female/Male Level Participation Average Participation Average Average Rate (%) Earnings Rate (%) Earnings Earnings I ~ (weely) (weekly)I No Education 21.2 28.06 80.4 43.89 64 Primary 32.8 51.59 72.3 84.12 61 Education Secondary 59.6 134.85 79.7 186.38 72 Education Tertiary 58.5 298.22 74.6 311.52 96 Education Source: Encuesta Permanente de Hogares (EPHPM), September, 1989. 21. In Honduras, as in many other Latin American countries, women tend to be concentrated in a number of industries where average wages are low. Women work predominantly in three industry groups. Nearly 42 percent work in social services, over 30 percent in commerce, and 21 percent in manufacturing (see Appendix Table 4). Of the women working in social services, approximately half are self-employed, largely as low-paying domestic servants. The women in commerce are similarly concentrated in low-paying self-employment. Furthermore, women's average earnings are low relative to men's in these sectors. Self-employed women in the commercial sector, for example, earn only 49 percent of self-employed men's earnings. 22. The reasons why such a small proportion of women work in the labor market and why they are concentrated in lower paying sectors are not fully understood. More needs to be known about the effects of labor-related legislation on women's employment prospects and about wage and occupational discrimination in the labor market. Further study of the links between wider access to child care and women's labor force participation rates would also be desirable. In the meantime, it is clear that continued efforts to increase girls' educational attainments will narrow the male/female wage gap and increase women's labor force participation rates. 2' For a fuller discussion of this analysis see C. Winter and T.H. Gindling, "Women's Labor Force Participation and Earnings in Honduras" in Psacharopoulos and Zannatos (Eds.) Women's Employment and Pay in Latin America, World Bank, 1991. - 12 - V. LEGISLATION AND WOMEN'S EMPLOYMENT AND PAY 23. Honduras has, like many other Latin American countries, enacted legislation intended to reduce sex discrimination in the labor market and has sought to revoke legislative provisions which directly discriminated against women. 24. Perhaps the most significant legal change was the repeal of the Land Reform Law (together with Decree 1972 and its rulings) in March, 1992. This law, which provided for a system of land tenure and ownership in rural areas, directly discriminated against female ownership. The law specifically forbade women from holding title to agricultural land except if widowed with dependent children under 16 years of age. Women relinquished even this limited title when their eldest son reached 16 years. This and other harmful and discriminatory provisions not only excluded women from independent agricultural production but also prevented them from holding the collateral necessary to obtain credit for this or other productive ventures. 25. The rights of working women are specified in both the Constitution of 1982 (the preeminent legal document) and the Labor Code. Article 127 of the Constitution specifically promotes equality of opportunity among all workers, stating that "...every person has the right to work, to freely chose their occupation, to resign from a position, and to expect equitable working conditions". This Article also establishes the principle of equal pay for equal work, although the very restrictive definition of "equal work" severely limits the application of this principle. It is important to note that while the Labor Code prohibits discrimination on the grounds of race, religion, or political belief, it does not specifically prohibit sex discrimination. This has the effect of severely restricting women's ability to challenge discriminatory practices in the workplace, since it means that women cannot file complaints of discrimination with administrative tribunals. Rather, such cases must be presented as human rights violations under the general equality provisions contained in the Constitution and filed with higher-level courts. This is a complex and costly proceeding beyond the means of the average worker. 26. The Labor Code includes a number of provisions regulating women's working conditions. These are intended to be protective of women, stressing the need to ensure their physical and moral safety and focusing particularly on women's childbearing role. The practical effect of these provisions, however, is generally quite different from their intent. They either discriminate against women by limiting their employment opportunities, or they have the effect of increasing the cost of women's labor relative to men's, thereby providing incentives for employers to recruit male, rather than female, labor. F For work to be considered "equal" it is necessary that the job position, length of the working day, productive efficiency and service time of the respective workers all be equal. - 13 - 27. Among the provisions which discriminate against women are laws prohibiting women's employment in the mining industry, in jobs requiring "great strength" or in night shift work for periods longer than 5 hours.2' 28. The provisions which increase the relative cost of female labor are more numerous, but two are of special interest. The first concerns the established maternity benefit system. The Work Code now provides for 18 weeks of maternity leave which is comparable to that provided in many other Latin American countries.,-L' During maternity leave, the law provides for a stipend to be paid to the worker, which is set at the level of the worker's average salary in the 180 working days prior to the commencement of maternity leave. In departments where the social security scheme is operative, the Honduran Institute of Social Security (IHSS) contributes 66 percent of the stipend and employers are required to contribute the remaining 34 percent. In those departments not covered by the IHSS, employers are required to pay the full stipend' The second provision which effectively raises the cost of female labor to employers is that which grants women two paid 30-minute breaks per day in which to nurse infants under 6 months of age. The law requires employers to pay women their full salary during these breaks. 29. While it is clearly very important that the law establish conditions which enable women to retain their jobs during childbearing and nursing and which ensure that they have financial support during these periods, it is important that the effects of the laws be carefully evaluated. As they currently stand, Honduran laws require employers to bear much of the cost of providing these benefits. Employers' rational response is to either avoid the costs (by hiring men rather than women, when possible) or pass them on (possibly by paying women lower wages). Either of these actions penalize women. It is clear that the revision of these laws is important if sex discrimination in the labor market is to be reduced. In any such revision, it is important to ensure that employers are not required to bear undue costs of providing these benefits. Other countries have typically done this by ensuring that the maternity stipend is funded by the Social Security Institute or the Ministry of Health (MOH). In some cases the stipend is composed of 2' The law specifies that "the work of women and minors should be in accordance with their age, physical state and condition, and intellectual and moral development". This broad-based provision results in the exclusion of women from any position considered to meet these criteria. L1 To qualify for maternity benefits the woman must: (i) have been employed and contributed to the social security system (in regions covered by the system) for at least 75 days during the 10 months prior to commencing maternity leave; and (ii) provide the employer with a medical certificate confirming her pregnancy. L' Social security coverage has been introduced slowly in Honduras to cover various types of risks and different geographical areas. It currently covers the following urban areas: Tegucigalpa, San Pedro de Sula, Puerto Cortes, Choloma, Tela, La Ceiba, Choluteca and Jamastran. - 14 - basic foodstuffs (powdered milk, etc.) and a cash payment equal to some proportion (typically two-thirds) of the worker's usual salary. VI. ACCESS TO CHILD CARE 30. The Ministry of Education (MOE) has expended considerable effort over the past decade in increasing the number of pre-school facilities serving children aged 4 to 6 years. Public facilities increased from 386 in 1982 to 669 in 1989, and enrollments increased from 40,573 to 56,615 over the same period.' The average number of children per facility declined from 105 to 85, reflecting the MOE policy to build a larger number of smaller facilities in more decentralized locations. These facilities continue, however, to be very unevenly distributed across the country, with over two-thirds being in urban areas. 31. The Ministry of Labor has also supported a limited number of pre- school facilities (11 in 1989), but has not expanded or upgraded these facilities in recent years. 32. Information on day care services for children under 4 years of age is not available, but their provision is apparently very limited and women appear to rely on relatives or paid child-minders. 33. Private sector provision of pre-school and day care services is very limited. In 1989 there were 233 private pre-school facilities serving 10,433 children aged 4 to 6 years. These were almost exclusively in urban areas. No data exist on the number of private day care centers serving children under 4 years but these are known to be very few in number. The reasons why there are not more private sector facilities - whether it is a supply or demand constraint - are not clear. One possible explanation would be that private pre-school and day care centers may be affordable only to a limited number of families. However, religious institutions providing low-cost day care services do not report excess demand for places and the expansion of public pre-school facilities has not been matched by parallel increases in child enrollments. Thus, this issue needs to be studied more carefully with regard to costs per child and accessibility of existing facilities before any conclusions are drawn. One success story regarding affordable day care services which the GOH may wish to analyze is the Colombia model of providing child care services in poor neighborhoods.-' 1 Source: Ministry of Education, Anuario Estadfstico for 1982 and 1989. The MOE plans to build over two thousand more pre-school centers, serving an additional 42,000 children children during the 1993-1995 period. 1 The Colombia Child Care and Nutrition Program provides loans and training to women in low-income neighborhoods to upgrade their homes to provide day care services for pre- school children. Day care providers are trained to monitor health indicators of children and provide basic educational stimulation. - 15 - 34. It has been widely assumed that improved access to child care services is key to increasing women's labor force participation rates. The fact that a woman's probability of participation in the labor market declines if she has young children has supported this assertion (see Box) and encouraged the GOH to enact legislation requiring employers of more than 20 workers to fund and maintain child care facilities at places of employment.A' Two factors, however, suggest that access to day care facilities may not be a key factor influencing womens' participation decision in Honduras. First, if women's participation is graphed by age group, there is no evidence of a dip in participation rates during the peak childbearing years (see Figure 1).L5' In Honduras, the average working woman does not appear to withdraw from the labor market when her children are young. Rather, women's participation rates continue to increase through the childbearing years and peak at around age 35. Second, in those firms where employers provide day care facilities, the use of these facilities is frequently very low. Female employees, even those with lower paying jobs, report that they prefer to leave their children in the care of relatives or paid child-minders at home. 35. These two pieces of information suggest that the average Honduran woman is currently able to make satisfactory child care arrangements and that child care is not a key determinant of her decision to work in the labor market. The participation curve in Figure 1 suggests that the average working woman makes a decision to enter the labor market and continues there through much of her working years. L' W' The enforcement of this law is lax, however, and compliance by firms is low. Typically only the larger firms and multinational organizations comply. L51 In many countries women's participation rates drop sharply during the peak childbearing years and then resume an upward trend after age 35. Such is the case in Japan, the United Kingdom and Australia, for example. This trend is not, however, evident in most Latin American countries or in Scandinavian countries (where there is very wide access to public child care facilities). M' An important question, then, is what factors keep other women from entering the labor market at all. Possible factors which may be interconnected are early childbearing, limited knowledge about family planning, large family size and limited education. Considerably more research on the interrelationship between these factors and women's participation decisions are necessary, however, before conclusions can be drawn. - 16 - FACTORS AFFECTING FEMALE LABOR FORCE PARTICIPATION RATES IN HONDURAS Econometric analysis enables us to assess the effects of different factors on women's labor force participation rate such as educational attainment, motherhood, and urban/rural residence. A probit analysis can be used to predict the probability of women's labor force participation given certain conditions. In this case, the probit equation was run using probability of labor force participation as the dependent variable and level of schooling, presence of young children, women's age and area of residence as the independent variables. The table below presents the probability of labor force participation for each condition while holding the effects of other variables constant at their mean value. Women's Predicted Probability of Labor Force Participation Characteristic Predicted Probability Education No Education 21.32 Primary 27.41 Secondary 46.61 Tertiary 39.81 Motherhood No children 30.98 One child (under 6 yrs.) 27.68 Two or more children (under 6 yrs.) 25.55 Residence Urban 35.84 Rural 20.47 It is clear that a woman's probability of participating increases significantly as she completes higher levels of education. A woman with completed primary education has a 28% greater probability of participating than a woman with no education (the estimated probabilities are 27.41% with completed primary education versus 21.3% with no education). Women with completed secondary education are much more likely to participate than those with only primary education (the probabilities are 46.6% versus 27.4%). This pattern changes, however, among women (and men) with completed higher education; women with tertiary level education are less likely to participate than women with completed secondary education. This probably reflects the country-wide high unemployment level among tertiary level graduates who appear to be willing to accept a long period of unemployment while searching for a "suitable" job. The probability that a woman will participate is substantially reduced if she is the mother of young children under six years of age. Having one child reduces a woman's probability of participating by 11% (the probability of participation is 27.6% with one child and 30.9% with no children). The probability is greatly reduced if she has more than one child. Women in urban areas have a participation probability 15 percentage points higher than rural women, reflecting the better employment opportunities for women in urban areas. Much of this employment is in the social services sectors, but the expansion of the free trade zone near San Pedro de Sula is providing alternative employment for women. Knowledge of the effects of education, motherhood, and area of residence on women's labor force participation decisions is important in guiding policy formulation. It is clear, for example, that efforts to improve girls' access to secondary education are likely to increase women's participation rates and, ultimately, their economic well-being. Improving women's ability to plan their families will also likely to increase their participation rates. 36. The fact that child care is probably not a key factor affecting women's work decision at the present time should not, however, be taken to mean that child care provision is unimportant. A well-established child care system, - 17 - whether publicly or privately Figure I funded, can yield Faml Paiosaion bY Age COhWt important social 70 welfare benefits for both mother So I and child. Better s0 cared-for children, so who receive early stimulation and so basic health care 2o monitoring, grow 10 up to be healthier, a_ more productive 5-19 20-24 25-35 3s-44 4-44 65. adults. Improving Am access to adequate -198 a -- 1986 -*- 1989 - s990 quality child care ',a .*m. m... s.we.. " facilities should thus be given priority by the GOH. VII. WOMEN'S HEALTH STATUS A. PATTERNS OF MORTALITY AND MORBIDITY 37. Despite significant progress over the past decade, women's health status in Honduras continues to be poor and improvements in basic and preventive health care services are urgently needed. The MOH has worked to improve access to Maternal and Child Health Care (MCH), but women's morbidity and mortality rates continue to be especially high due to inadequate natal care. Although 80 percent of all women now receive some form of pre-natal care, and efforts are being made to identify and treat women with high risk pregnancies, the quality of health services differs sharply between departments and especially between urban and rural areas. This is evident from the differences in women's mortality rates reported in 1989/90 for the different departments.-L' They ranged from 31 to 322 deaths per 100,000 live births (see Appendix Table 5). The highest female mortality rates are recorded in the departments of Intibuca, la Paz, and Copan in the southwest, where the rates are 322, 239 and 224 deaths per 100,000 live births, respectively, and in the northeastern department of Gracias a Dios where the rate is 253 per 100,000 live births. A relatively small percentage (59 percent) of females whose deaths were registered in 1989/90 received medical care from a physician prior to their death, and those who did 1W' Much of the data in this section is drawn from a UNAH survey which covered women aged between 12 and 50. UNAH, Investipaci6n Sobre Mortalidad de Muieres en Edad Reproductva Con Enfasts en Mortalidad Materna. Tegucigalpa, 1990. - 18 - generally lived close to the larger urban areas where public hospitals are located. 38. The principal causes of death among women of childbearing age are complications resulting from childbirth, infections and parasitic diseases. The fact that these disorders can generally be effectively prevented and treated through basic and preventive health care is indicative of the limited and poor quality of care available in many areas. Mortality rates attributed to these causes are especially high in rural areas, as Table 7 shows. Maternal mortality, principally resulting from hemorrhaging and infection, accounts for 46 percent of deaths in the rural area of Mosquitia, but only 13 percent of female deaths in the major metropolitan area of Tegucigalpa. Although data on the incidence of cervical cancer is scanty, it does appear that this is an important cause of death among women. This suggests that more attention needs to be given to developing screening programs to aid in the early detection of this disorder. 39. Morbidity concerns are increasingly focusing on the unusually high incidence of AIDs and other sexually transmitted diseases among women in Honduras. Although efforts are being made to collect nationwide data on the incidence of AIDs, the information currently available continues to be limited. However, available data shows that, through 1990, almost 35 percent of the AIDs cases detected were in women. Incomplete information prevents the drawing of conclusions about this but it is clear that public education programs have an important role to play in increasing awareness of the disease and its means of transmission. 40. Under-nutrition is widespread in Honduras with 49 percent of Honduran households consuming less than 80 percent of the required daily calorie requirements in 1987. Under-nutrition is especially prevalent among pregnant and nursing women, and programs to provide nutritional supplements reach only 64,200, or 12 percent, of mothers at risk of malnutrition. The reportedly high incidence of iodine deficiency among women and children in the southern and western regions is an issue requiring special attention since severe deficiencies are associated with an increased incidence of cretinism among newborns. Nutritional deficiencies are aggravated in many rural areasby the traditional belief that pregnant and nursing women should avoid eating certain foodstuffs which can be naturally rich in protein and minerals (avocados, mangoes, squash, papaya, beets and lemon). Improved nutrition counseling provided through MCH services could clearly play an important role in educating women about better nutritional practices. Table 7 CAUSES OF MORTALITY AMONG WOMEN AGED 12-50, 1989-90 Matern. Mortality 46% rau ma Infection/Parasites 15% Cr tr Circulatory 10% 4% Infection/Parasites Endoc./Nut.IMeta. 27% Endoc./Nut./Meta. Matern. Mortality Others 10% Vau12% 13% 11% 8% Metropolitan Region Mosquitia Region (Rural Area) Source: UNAH, Mortalidad de Mujeres en Edad Reproductiva y Mortalidad Materna, 1990. - 20 - B. WOMEN'S REPRODUCTIVE HEALTH 41. A major health risk for Honduran women derives from their pattern of childbearing. The total fertility rate in 1990 was estimated at 5.2 children per women, one of the highest in Latin America. Given this fertility rate and the very high maternal mortality rate of 221 per 100,000 live births, 15 of each 1,000 women entering reproductive age are expected to die of complications associated with childbirth. High fertility, poverty and deficient health care services contribute significantly to high-risk pregnancies and births. Honduran women often experience more than one risk factor associated with childbirth, which contributes significantly to the high maternal mortality rate. The principal risk factors are the following: (a) Age. The maternal mortality rate for older women (aged 35 and over) is 67 percent higher than average (4.0 per 1,000 pregnant women compared to 2.4 per 1,000 for women aged 15 and over), reflecting high incidence of post-natal hemorrhages among older women who have had more than one pregnancy;L (b) Number of pregnancies. In most countries, maternal mortality risk increases significantly after the first two pregnancies. In the case of Honduras, the highest risk is observed among women who have had more than 4 pregnancies, peaking at 4.4 deaths per 1,000 at the sixth pregnancy;'L' (c) Civil status. The risk of maternal mortality increases significantly among single women, reaching 29.9 per 1,000 compared to 1.7 per 1,000 among married women. This extremely high rate observed among unmarried women seems to indicate not so much the importance of marital status but rather the reluctance among single women to admit they are pregnant and seek pre-natal care and their higher propensity to terminate the pregnancy through an unsafe abortion;LO' (d) Level of education. Women's education level is one of the most significant variables in estimating the risk of maternal mortality. Among women of reproductive age, those without formal education register a 5.3 per 1,000 mortality rate, compared to 1.2 per 1,000 among women with completed primary education and 0.6 per 1,000 among women with completed secondary education; W UNAH. Mortalidad de Mujeres en Edad Reproductiva y Morwlidad Materna. Tegucigalpa, 1990, page 60. L91 Ibid, page 61. 2' Ibid, pages 35-36 and 61-62. - 21 - (e) Pre-natal care. Women receive only limited pre-natal care, particularly in rural areas. In general, the probability of women dying of childbirth complications increases significantly in the absence of pre-natal care. Among women who received some pre-natal care, those who died of childbirth complications tend to have received less than average pre-natal care: 3.5 visits compared to 4.9 visits, which was the reported average nationwide in 1987; (f) Delivery care. The rate of institutional child delivery in Honduras is low and a high proportion of births occurs in the home. In 1990, only 34 percent of births were assisted by health professionals and this type of care was concentrated in urban areas. Whereas only 11 percent of births in urban areas occurred in the home, 79 percent occurred in the home in rural areas. Rural women are also much more likely to have received care only from a traditional midwife; and (g) General health status. Women are frequently in poor physical condition due to under-nutrition and short spacing between births. 42. While these various risk factors contribute to the observed high mortality rate in all regions of Honduras, mortality rates are significantly higher in rural areas. In Gracias a Dios, for example, the estimated mortality rate is 878 deaths per 100,000 live births, approximately four times the national average. Similar figures are reported for other preponderantly rural departments, such as Intibuca (534 per 100,000) and La Paz (460 per 100,000), compared to 145 per 100,000 in Francisco Morazan, which is mostly urban (see Appendix Table 6). C. FERTILITY AND FAMILY PLANNING 43. The high total fertility rate in Honduras of 3.9 births per woman estimated in 1991 is surprising given the widespread knowledge of contraceptive methods. A survey conducted in 1987 reported that, while 97 percent of women knew about oral contraceptive methods, only 41 percent of women in union nationwide, and 27 percent in rural areas, used contraceptionXI' More recent data from 1991 shows some increase in usage rates among these groups; among women aged 15-45 years in union, W National Epidemiological and Health Survey (Encuesta Nacional de Epidemiologta y Salud Familiar), conducted by the MOH in 1986/87. - 22 - 47 percent in urban areas and almost 30 percent in rural areas now report using some method of contraception.22' 44. Responses to a survey seeking information about women's low contraception usage revealed that women worry about possible side effects and have insufficient knowledge about the methods. This, plus the fact that illegal abortion rates are reportedly very high, strongly suggests the need for strengthening family planning education efforts in Honduras. 45. Family planning services are currently provided under the MCH program of the MOH and by a private NGO, the Honduran Family Planning Association (La Asociaci6n Hondurefna de Plamficaci6n Familiar, ASHONPLAFA). The MOH's program is designed to target women who are poor, pregnant, or who have recently given birth or had an abortion, and is provided by area and regional hospitals and by health centers with physician (CESAMO) and rural health centers (CESAR). This program, however, has not achieved a very broad coverage of its target population because of the limited regional distribution of contraceptives and lack of educational outreach programs, particularly to women not attending clinics and hospitals. The lack of educational outreach programs is a serious problem given that: (i) young women under 20 years of age account for a very high proportion (16.4 percent) of total births in the country;2' and (ii) mortalities resulting from illegal abortions are very high among women living in poorer areas who are less likely to have attended MCH or basic health care clinics. 46. A more pro-active approach is followed by ASHONPLAFA, which has broadbased community distribution schemes for contraceptives and which also promotes voluntary sterilization in public and private hospitals throughout the country. ASHONPLAFA is reportedly the most effective agency in promoting birth control practices. The agency's network of 1,712 family planning clinics is two-and-a-half times larger than the MOH network, covers 263 of the country's 290 municipalities and provides temporary or permanent contraceptive services to approximately 100,000 women in urban and rural areas. ASHONPLAFA is presently expanding its educational and contraceptive distribution programs to the most remote rural areas through mobile units. -' These rates of contraceptive prevalence in Honduras are significantly higher than estimated rates for Nicaragua (27% in 1981) and Guatemala (23% in 1987). See Ross, J.A., Maldin, W.P., Green, S.R. and Cooke, E. R., Family Planning and Child Survival Programs as Assessed in 1991. The Population Council, New York, 1992. 2' This rate of 16.4 percent is high even relative to countries with higher fertility rates. In Bolivia, for example, where total fertility rate is estimated at 4.9, this age group accounts for 10.6 percent of births and in Paraguay and Peru, where total fertility rates are 4.7 and 4.0, respectively, teenage mothers account for 11.5 percent of births. - 23 - 47. In Honduras, as in most developing countries, there is a strong link between educational attainment, use of contraceptives, and fertility. Contraceptive use among women with even a little secondary education is almost three times that of women with no education (see Appendix Table 7). Even women with only three years of primary education are significantly more likely to use some form of birth control than women with no education. It is also notable that use of the more reliable forms of birth control (oral contraception, sterilization) increases with level of education. VIII. INSTITUTIONAL ASPECTS A. PUBLIC PROGRAMS PROVIDING ASSISTANCE TO WOMEN 48. The GOH has initiated a number of programs designed to alleviate poverty among poorer groups and particularly among poorer women. Among these programs is the Honduran Social Investment Fund (FHIS) which directly benefits women in several ways. The FHIS portfolio includes, for example, an informal sector credit scheme which funds a variety of subprojects such as community banks providing financial services to women, which are implemented by NGOs. These NGOs target more than half of the loan funds to. women and charge interest at market rates. Moreover, women represent 90 percent of the beneficiaries of social services subprojects funded by FHIS which include training, nutrition and child care programs organized at the community level. These social services subprojects also include infant feeding programs (lactafios) and pre-school education that directly benefit children while freeing women's time for participation in the labor market. 49. The Programa de Asignacid6n Familiar (PRAF) administers food coupon programs designed to transfer income to women for the purchase of food for themselves and their families, complemented by a training program to improve women's employment potential. Under the PRAF food coupon programs, coupons worth L20.00 (US$3.70) are distributed to poor mothers and young children supplementing the cost of their individual food requirements by about 17 to 20 percent. PRAF targets poor pregnant and lactating women and children under five under the Maternal Child Coupon Program (BMI) and poor mothers of children enrolled in grades 1-3 of primary school under the Women Head of Household Coupon Program (BMJF). The BMJF coupons are distributed three times a year during the school year and the BMI coupons are distributed monthly through public health centers. The PRAF food coupon programs benefitted about 176,000 poor mothers and children in 1991. 50. Other nutrition assistance programs that distributed food in kind also directly benefit women. These programs are implemented by the MOH with funding from USAID and the World Food Program. Food supplements provided under these programs represent about 25 percent of the individual food requirements of participants, benefitting approximately 66,000 women - 24 - and 105,900 children under five years in the poorest municipalities countrywide. 51. For the past thirty years, the MOE has administered a school feeding program which also benefits all children at participating primary school. The food supplement provided is small, estimated at US$6 per year per student, but with about 484,200 beneficiaries in 1991, the program now reaches approximately 52 percent of the total population of the primary public school system, covering all departments except Tegucigalpa. B. PRIVATE PROGRAMS PROVIDING ASSISTANCE TO WOMEN 52. A large number of religious and private NGOs work on women's issues in Honduras. These agencies are primarily small-scale and operate on very limited budgets. They tend to have very limited institutional capacity to plan and manage projects and are not adept at attracting donor funding for their projects. Many of the agencies' activities are limited to the publication and dissemination of short papers on women's conditions. Brief summaries of three of the more active NGOs are given below to illustrate the type and scope of activities they are involved in: (a) One of the oldest of the NGOs is the Federation of Women's Associations of Honduras (Federaci6n de Asociaci6nes Femeninas de Honduras, FAFH), which has existed since 1951. Its main stated objective is to raise women's self- knowledge which is pursued through small seminars on legislative, health and education issues affecting women. The FAFH also administers a small project which provides low interest loans to women working in the informal sector to assist them in building or rehabilitating their homes. The loans have a maximum value of L6,000 (US$1,111) and an interest rate below the market value, and they must be paid back within five years. Information on the number of beneficiaries of this project was not available. A related project, managed by FAFH and funded by UNICEF, provides credit to women living in the low-income areas of Tegucigalpa to build latrines for their homes. To date only 13 women have received credit from this fund although it has been operational for over a year. (b) Another well-established NGO is the Council for Integrated Development of Rural Women (Consejo para el Desarrollo Integral de la Mujer Campesina, CODIMCA) which specializes in rural women's issues and aims to train women. It works with small groups of women to increase the cultivation and use of medicinal plants and the production of natural medicines. It also provides basic literacy courses for women. It has been fairly active and graduated 500 women in - 25 - different rural areas from its first literacy course in 1991. It has also worked to assist the Pan-American Health Organization (PAHO) in its vaccination promotion campaigns. (c) Another active NGO is the Honduran Committee of Women for Peace (Comitd Hondurefio de Mujeres por la Paz, Visitacidn Padilla, CHMP), which provides both legal assistance to women and short training courses. There are currently seven women working at CHMP and they receive additional voluntary support from women doctors and lawyers. The agency places special emphasis on aiding women who have suffered domestic violence, offering them legal and psychological counseling. It has also been actively involved in the successful efforts to change the Criminal Code to ensure that harsher penalties are provided for sexual crimes. Their training courses focus on teaching manual skills related to sewing and electronics. They offer two courses per year in Tegucigalpa to approximately 12 women. They do not, however, collect information about whether their trainees manage to find employment subsequent to their training. IX. CONCLUSIONS AND RECOMMENDATIONS FOR DEVELOPING AN ASSISTANCE STRATEGY FOR WOMENS' DEVELOPMENT A. CONCLUSIONS 53. The GOH has already shown its commitment to improving women's circumstances in several substantive ways. It has created the Permanent Congressional Committee on Women's Affairs (Comisidn Permanente para Asuntos de la Mujer Congreso Nacional, PCWA) in the National Congress, has established the PRAF, has revised legislation in the agricultural sector that discriminated against women, and has made considerable progress in improving social services provision over the past decade. 54. Much, however, remains to be done if women are to be given the same capacities and opportunities to contribute to the country's development. The information gathered for this report points to several areas in which the GOH and the International Development Association (IDA) might work together to improve women's conditions. However, given that available resources are limited, it is necessary to target resources to priority areas which are likely to yield the greatest social returns and be most effective in reducing inequities. GOH and IDA efforts to address women's issues should thus focus on the following: - 26 - B. PRIORITY AREAS OF CONCERN 55. The following areas would be of priority concern: (a) Improving women's access to reproductive health care: The maternal mortality rate, at 221 deaths per 100,000 live births, is unacceptably high. The proportion of births occurring in health institutions is low, as is the percentage of women receiving pre- and post-natal care from qualified health officials. There are tremendous inequities between rural and urban areas in terms of access to, and quality of, reproductive health care. The focus of efforts should thus be to increase access to better quality health services, particularly in rural areas. This is likely to require investments both in basic infrastructure and staff upgrading. There is clearly also a need for community education programs to inform women about the necessity of pre- and post-natal care as well as about nutritional counseling and family planning. Where feasible, efforts should be made to introduce routine testing for cervical cancer (see paras. 41-42); (b) Improving women's access to family planning services: The total fertility rate continues to be high in Honduras and the high birth rate among adolescent women is of particular concern. The gap between women's knowledge and use of contraceptives is large, suggesting that more emphasis needs to be given to education about the various contraceptive methods as well as to the more widespread distribution of supplies (see paras. 43-47); and (c) Improving school retention rates and giving priority to educational investments at the primary and secondary levels: For both sexes, the relationship between higher educational attainment, occupational attainment and higher earnings is very evident from the data available. The potentially very high social returns from public investments in primary education are, however, currently affected by the poor quality of education provided in these schools and the exceedingly high drop-out and repetition rates. Significant urban/rural differences also persist in terms of access to school and educational quality for both boys and girls. These factors suggest that policies should focus on improving education quality through improved training and retraining of teachers and better access to textbooks and school supplies. Steps should also be taken to remove obstacles to women's educational participation at tertiary level vocational institutions, especially the prohibition on female enrollments at the Escuela Nacional de Agricultura (see paras. 7-14). - 27 - C. SECONDARY AREAS OF CONCERN 56. The following areas also deserve attention: (a) Improving access to pre-school and day care services: Available data indicates that day care and pre-school facilities are not a major factor influencing women's decision to enter the labor market. However, access to child care may well become increasingly important to women as female labor force participation rates increase. This, plus the high social returns of investments in day care services, suggests that steps should be taken to increase access to pre-school and day care services. Such steps, however, will require that a detailed and careful analysis be undertaken first to determine the range of services currently being offered by public and private providers, the level of fees charged, and the current demand for such services. Such information will be essential in guiding policy decisions about whether to expand public provision, seek ways to encourage private sector providers, and how to integrate public and private efforts in this area (see para. 33); (b) Reviewing Labor and Commercial Legislation: A review of labor legislation and social security affecting women's employment and pay would be important in order to define measures to improve conditions for labor force participation by women. This review could help identify: (i) laws which directly discriminate against women; and (ii) laws which have the effect of raising the cost of female labor to employers, encouraging them to hire male rather than female labor. Social security, pension plans and taxation systems should also be examined to see if, in treating women differently, they distort women's incentives to work. Legislation and insurance schemes which have these effects should be modified so that these disincentives are removed (see paras. 23-29); and (c) Increasing information on women's living conditions and environment: Although a considerable body of information is available on women's conditions, several key issues affecting women are not well known. One area is women's occupational distribution in the labor force and the reasons why they continue to be concentrated in the lower-paying sectors. A second area requiring further study is the socio- economic status of single mothers and female heads of households in poorer areas. A small-scale survey gathering information on income sources and subsistence strategies would provide useful information that could be used for programs targeted to women and other poor groups as well. A third area about which relatively little is known is women's - 28 - access to credit services in urban and rural areas. Better information on these issues would provide a sounder basis on which to develop policies which will benefit women, improve their circumstances, and increase their contribution to the development process (see para) 6). - 29 - SELECTED BIBLIOGRAPHY Alonzo de Quesada, A., N. Melendez and M. A. Martinez. "Revisión de la Legislación igente en Relación con la Mujer en las Areas de Salud - Salud, Salud - Trabajo, Salud - Educación ". Proyecto Subregional Mujer, Salud y Desarrollo. Tegucigalpa. August, 1990. Bidegain, G. G. "Perfil Sociodemográfico de Honduras ". Unidad de Docencia e Investigación en Población: Facultad de Ciencias Económicas. February, 1991. Callejas, C. and M. de la Paz Borjas. "Directorio de Organizaciones que Trabajan para y con la Mujer en Honduras ". Mimeograph. Agencia Canadiense de Desarrollo Internacional. Tegucigalpa. 1990. Cano, I. "Diferencias Geográficas de la Escolaridad Hondureña ". Unidad de Docencia e Investigación en Población: Facultad de Ciencias Económicas. Tegucigalpa. January, 1991. Flores, M. and G. Bidegain. (Eds.). La Mortalidad hifantil en Honduras. Unidad de Docencia e Investigación en Población: Facultad de Ciencias Economicas. Not dated. . Honduras: Población y Desarrollo. Unidad de Docencia e Investigación en Población. Tegucigalpa. September, 1990. Gallardo Lopez, T. "Informe Final del Proyecto "Mujer en Desarrollo" Ejecutado con la "FEHMUC" en Grupos de Base de Choluteca y Valle". Tegucigalpa: UNIFEM. October, 1990. Garcia, A.I. and E. Gomariz. Mueres CentroAmericanas. Universidad para la Paz. San Jose. July, 1989. Kawas, M.C. and Zuniga, M.L. "Women in Honduras. A Profile: 1991". Mimeograph. Tegucigalpa. 1991. Lopez de Mazier, A. "La Mujer Hondurela en C(fras". Universidad Nacional Autónoma de Honduras: Facultad de Cíencias Económicas. May, 1990. . "La Mujer Hondurenia en las Ultimas Tres Decadas'". Unidad de Docencia e Investigación en Población: Facultad de Ciencias Económicas. September, 1990. - 30 - Ministerio de Salud Pública de Honduras et. al. Encuesta de Seguimiento de Mujeres Embarazadas y Mujeres con Niños Menores de Un Año, Honduras. 1988. Tegucigalpa. August, 1990. Ministerio de Salud Pública, Asociación Hondureña de Planificación de Familia et. al. Encuesta Nacional de Epidemiología y Salud Familiar, Honduras, 1987. Tegucigalpa. 1990. SECPLAN/PNUD/UNIFEM. "Política Nacional para la Mujer". Mimeograph. Tegucigalpa. 1989. UNAH/MSP/OPS/UNFPA/MSH. Mortalidad de Mujeres en Edad Reproductiva y Mortalidad Materna. Tegucigalpa. 1990. UNICEF et al. Program "Educación de la Mujer y Supervivencia Infantil en Honduras ". Memoria del Foro "los Esfuerzos de Paz y la Participación de la Mujer en el Desarollo". 1988. World Bank. "Honduras Social Sector Programs". Report No. 9093-HO. Washington D.C.: World Bank. November, 1990. - 31 - Appendix Table 1 WOMEN'S EDUCATIONAL ATTAINMENT BY URBAN/RURAL AREA AND DEPARTMENT, 1988 No Education Primary Secondary Higher (Not Higher Department Univ.) (University) Urban Rural Urban Rural Urban Rural Urban Rural Urban Rural Atlantida 29.4 70.6 51.8 48.2 87.2 12.8 78.4 21.6 96.3 3.7 Colon 19.7 80.3 28.7 71.3 64.9 35.1 82.3 17.7 80.8 19.2 Comayagua 25.5 74.5 39.1 60.9 81.4 18.6 78.7 21.3 94.2 5.8 Copan 14.5 85.5 27.5 72.5 77.6 22.4 72.9 27.1 80.8 19.2 Cortes 57.0 43.0 67.6 32.4 90.0 10.0 91.9 8.1 96.6 3.4 Choluteca 18.6 81.4 25.8 74.2 76.4 23.6 79.6 20.4 92.2 7.8 El Paraiso 13.1 86.9 24.0 76.0 67.9 32.1 76.3 23.7 90.6 9.4 Francisco Morazan 52.6 47.4 73.9 26.1 95.1 4.9 93.0 6.2 98.2 1.8 Gracias a Dios 0.0 100.0 0.0 100.0 0.0 100.0 0.0 100.0 0.0 100.0 Intibuca 6.2 93.0 15.8 84.2 72.4 27.6 8.6 11.4 66.7 33.3 Islas de la Bahia 14.8 85.2 16.2 83.8 28.9 71.1 20.0 80.0 23.5 76.5 La Paz 9.2 90.8 19.8 80.2 72.1 27.9 76.0 24.0 86.8 13.2 Lenpira 1.9 98.1 4.2 95.8 39.8 60.2 47.6 52.4 53.1 46.9 Ocotepeque 9.6 90.4 15.4 84.6 58.5 41.5 68.4 31.6 78.4 21.6 Olancho 13.5 86.5 24.7 75.3 68.8 31.2 79.8 20.2 81.9 18.1 Santa Barbara 17.5 82.5 26.7 73.3 67.9 32.1 68.3 31.7 75.0 25.0 Valle 20.8 79.2 25.8 74.2 63.9 36.1 76.2 23.8 82.9 17.1 Yoro 23.5 76.5 35.4 64.6 72.5 27.5 73.4 26.6 90.1 9.9 TOTAL 25.6 74.4 43.4 56.6 84.7 15.3 88.1 11.9 96.7 3.3 (Includes women aged 10 years or older) Source: Censo Nacional de Pobkci6n, 1988, cited in Mazier, AL. do. (May 1990). La Mujer Hondurefa en Qfras. Appendix Table 2 FEMALE GRADUATES AS A PERCENT OF TOTAL GRADUATES BY COURSE OF STUDY AT UNAH, 1979, 1983, AND 1987 AND BY FIRST-TIME ENROLLMENT, 1989 GRADUATES 1979 GRADUATES 1983 GRADUATES 1987 FIRST-TIME ENROLLMENT 1989 Tt IWomen Women Women Women as Total Women Men as % of Total Women Men as % of Total Women Men as % of Total Women Men % of No. No. No. Graduates No. No. No. Graduates No. No. No. Graduates No. No. No. Enrollees Law 154 60 94 40 87 25 62 29 91 40 51 43 1298 600 698 46 Public Admin. 1 1 0 100 13 8 5 62 8 4 4 50 11 5 6 45 Journalism 6 3 3 50 1 0 1 0 3 2 1 67 279 153 126 55 Economics 49 10 39 20 158 68 90 43 126 63 63 50 172 80 92 47 Business Admin. 25 6 19 24 119 61 58 51 145 63 82 43 711 336 375 47 Accounting 4 1 3 25 37 13 24 35 68 34 34 50 491 217 274 44 Medicine 35 3 32 9 114 33 81 29 209 74 135 35 808 402 406 50 Pharmacy 27 10 17 37 40 38 2 95 78 69 9 88 287 214 73 75 Dentistry 18 10 8 56 33 23 10 70 56 42 14 75 279 193 86 69 Nursing 17 17 0 100 64 62 2 97 67 66 1 99 175 163 12 93 Microbiology 11 9 2 82 10 9 1 90 39 30 9 77 102 80 22 78 Lab.Technician 20 12 8 60 0 0 0 0 0 0 0 0 NA NA NA NA Psychology 2 2 0 100 23 21 2 91 11 8 3 73 111 84 27 76 Civil Engineer 75 10 65 13 92 26 66 28 106 27 79 25 405 87 318 21 Mechanical Engineer 5 0 5 0 11 1 10 9 14 1 13 7 318 17 301 5 Chemical Engineer 4 3 1 75 4 3 1 75 11 6 5 55 94 37 57 39 Electrical Engineer 6 0 6 0 11 3 8 27 9 0 9 0 535 35 500 7 Teaching 35 25 10 71 20 13 7 65 88 59 29 67 221 173 48 78 Mathematics 5 2 3 40 3 1 2 33 14 6 8 43 40 16 24 40 Physics 3 0 3 0 0 0 0 0 1 0 1 0 4 4 0 100 Biology 5 1 4 20 2 0 2 0 19 13 6 68 32 17 15 53 History 2 1 1 50 6 3 3 50 5 2 3 40 15 3 12 20 Literature 0 0 0 0 6 5 1 83 1 1 0 100 22 14 8 64 Chemestry 0 0 0 0 0 0 0 0 0 0 0 0 13 6 7 46 Social Worker 17 14 3 82 64 56 8 88 57 49 8 86 108 95 13 88 Art 0 0 0 0 2 1 1 50 0 0 0 0 NA NA NA NA Philosophy 0 0 0 0 0 0 0 0 0 0 0 0 4 1 3 25 Industrial Engineering 0 0 0 0 0 0 0 0 29 10 19 34 368 113 255 31 Agricultural Engineering 109 2 107 2 53 4 49 8 67 8 59 12 256 64 192 25 Forestry 7 1 6 14 7 0 7 0 11 2 9 18 12 4 8 33 Agricultural Economics 0 0 0 0 0 0 0 0 7 3 4 43 NA NA NA NA Social Sciences 0 0 0 0 3 1 2 33 4 3 1 75 10 6 4 60 Others 0 0 0 0 0 0 0 0 0 0 0 0 1115 474 641 43 Total 642 203 439 0.32 983 478 505 0.49 1344 685 659 0.51 8296 3693 4603 45 Note: NA - Course discontinued Source: Departamento de Planeamiento Universitario, UNAH, cited in SECPLAN et. al. "Politica Nacional Para la Mujer", 1989. - 33 - Appendix Table 3 FEMALE WORKERS MEANS (AND STANDARD DEVIATIONS) OF VARIABLES BY GENDER AND ECONOMIC SECTOR Women Variable Private Public Formal Self- All Non- Sector Sector Sector* Employment Working Working Weekly 91.27 156.09 120.57 37.68 73.54 Earnings (97.19) (100.6) (121.32) (48.15) (88.31) (Lempiras) Hours Worked 45.15 40.09 43.31 44.25 43.75 1.68 (weekly) (12.45) (8.28) (11.69) (20.83) (17.22) Experience 15.51 17.56 16.62 25.27 21.33 (years) (11.25) (10.05) (11.04) (13.97) (13.45) Education 8.20 11.12 9.25 3.81 6.29 4.63 (years) (4.24) (3.83) (4.35) (3.08) (4.61) (3.86) Age (years) 29.72 34.68 31.87 35.09. 33.62 30.67 (9.81) (9.22) (9.99) (12.61) (11.60) (13.47) Married 44 43 45 44 44 57 (percent) Children 0.58 0.58 0.58 0.75 0.67 0.89 (< 6 years) (0.83) (0.83) (0.83) (0.99) (0.92) (1.11) Children 0.79 0.81 0.81 1.16 1.00 1.12 (7-14 years) (1.07) (1.00) (1.05) (1.23) (1.16) (1.27) Household Size 5.72 5.55 5.56 5.91 5.78 6.38 (2.62) (2.29) (2.49) (2.44) (2.47) (2.70) Workers in 2.45 2.20 2.36 2.30 2.33 1.70 Household (1.32) (0.99) (1.20) (1.08) (1.14) (1.09) Urban 87.1 76.0 82.5 60.4 70.4 46.6 Residence (%) N 1,050 642 1,692 2,112 3,804 8,694 Notes: Female labor force participation rate = 30.4% * Formal sector is private and public sectors combined. Source: Encuesta Permanente de Hogares, September 1989. - 34 - Appendix Table 4 DISTRIBUTION AND AVERAGE EARNINGS BY INDUSTRY GROUP AND ECONOMIC SECTOR WOMEN Self-Employment Private Employment Public Employment All Economic Sectors Worker Average Worker Average Worker Average Worker Average Distrib.* Earnings Distrib.* Earnings Distrib.* Earnings Distrib.** Earnings % (weekly) % (weekly) % (weekly) % (weekly) Agriculture 32.0 29.13 68.0 58.16 0.0 0.00 2.8 49.82 Mining 0.0 0.00 0.0 0.00 0.0 0.00 0.0 0.00 Manufacturing 56.9 28.31 42.4 75.24 0.6 129.21 20.9 49.54 Utilities 0.9 0.00 0.0 0.00 100.0 144.47 0.2 144.47 Construction 17.6 90.31 23.5 125.00 58.8 130.12 0.5 140.95 Commerce 69.7 53.74 30.2 79.96 0.0 0.00 30.3 62.36 Transport 0.0 0.00 27.5 126.53 72.5 158.72 1.1 163.23 Financial 5.0 237.21 80.0 170.69 15.0 185.19 2.6 176.19 Social Services 49.0 25.61 15.0 110.21 36.0 156.06 41.5 85.30 Notes: * This column shows the proportion of workers in this sector relative to workers in the other economic sectors (self, private, and public employment). ** This column shows the distribution of workers by industry grouping. Source: Encuesta Permanente de Hogares, September 1989. DISTRIBUTION AND AVERAGE EARNINGS BY INDUSTRY GROUP AND ECONOMIC SECTOR MEN Self-Employment Private Employment Public Employment All Economic Sectors Industry Group Worker Average Worker Average Worker Average Worker Average Distrib.* Earnings Distrib.* Earnings Distrib.* Earnings Distrib.** Earnings % (weekly) % (weekly) % (weekly) % (weekly) Agriculture 58.8 39.70 41.0 45.78 0.2 113.48 42.2 46.57 Mining 40.0 48.34 60.0 169.86 0.0 0.00 0.3 121.25 Manufacturing 9.9 83.24 88.4 111.65 1.3 87.79 12.4 108.46 Utilities 0.0 0.00 4.4 79.07 95.6 187.65 1.4 182.88 Construction 8.9 81.29 75.7 75.75 15.3 110.04 9.4 83.74 Commerce 48.3 108.62 51.0 111.34 0.6 96.28 11.7 115.52 Transport 19.2 145.51 57.4 111.77 23.4 224.89 5.0 129.17 Financial 5.3 253.23 79.4 202.40 15.3 224.89 2.2 209.21 Social Services 15.0 93.06 36.0 120.85 49.0 170.89 15.0 143.08 Notes: * This column shows the proportion of workers in this sector relative to workers in the other economic sectors (self, private, and public employment). ** This column shows the distribution of workers by industry grouping. Source: Encuesta Permanente de Hogares, September 1989. - 35 - Appendix Table 5 MORTALITY RATES AMONG WOMEN OF REPRODUCTIVE AGE BY DEPARTMENT, 1989-1990 Department Female No. of Deaths Mortality Rate* Population Atlantida 65,511 72 110 Colon 38,218 39 102 Comayagua 62,918 88 140 Copan 57,211 128 224 Cortes 197,953 342 173 Choluteca 77,787 61 78 El Paraiso 67,381 50 74 Francisco 253,683 373 147 Morazan Gracias a Dios 9,876 25 253 Intibuca 31,374 101 322 Islas de la Bahia 6,396 2 31 La Paz 28,066 67 239 Lempira 44,991 85 189 Ocotepeque 19,856 20 101 Olancho 72,965 79 108 Santa Barbara 69,751 92 132 Valle 31,575 37 117 Yoro 89,773 96 107 National 1,225,285 1,757 143 Note: * Mortality Rate is estimated per 100,000 women Source: UNAH, MSP et. al. (1990). Mortalidad de Mujeres en Edad Reproductiva y Monalidad Materna. - 36 - Appendix Table 6 MATERNAL MORTALITY RATES BY DEPARTMENT, 1989-90 Department No. Live Births No. of Deaths Maternal Mortality Rate* Atlantida 9284 24 259 Colon 5834 15 257 Comayagua 9339 21 225 Copan 8559 31 362 Cortes 25603 38 148 Choluteca 11520 17 148 El Paraiso 9918 20 202 Francisco Morazan 31724 46 145 Gracias a Dios 1367 12 878 Intibuca 4867 26 534 Islas de la Bahia 861 1 116 La Paz 4133 19 460 Iempira 6919 25 361 Ocotepeque 2899 8 276 Olancho 11071 19 172 Santa Barbara 10875 22 202 Valle 4677 9 192 Yoro 12991 24 185 Total 172422 381 221 Note: * Maternal Mortality Rate is calculated as the number of maternal deaths divided by the number of live births x 100,000. Source: UNAH, MSP et al (1990). Mortalidad de Mujeres en Edad Reproductiva y Mortalidad Materna. - 37 - Appendix Table 7 USE OF BIRTH CONTROL AMONG WOMEN IN UNION BY EDUCATION LEVEL, 1987 Level of Schooling Usage and Method Total None Primary Primary 7+ Years 1-3 Years 4-6 Years USE BIRTH 40.6 23.6 32.2 45.7 65.3 CONTROL Oral Contraception 13.4 7.9 9.9 16.1 21.1 Female Sterilization 12.6 8.3 10.8 14.9 17.1 Vasectomy 0.2 0.2 0.1 0.1 0.4 IUD 4.3 0.8 3.1 4.5 10.3 Withdrawal 3.9 3.9 3.9 4.4 3.1 Rhythm Method 3.5 1.4 3.4 3.1 7.2 Condoms 1.8 0.6 0.8 2.1 4.8 Injection 0.3 0 0.2 0.3 0.9 Other Methods 0.5 0.5 0.2 0.4 0.8 DON'T USE BIRTH 59.4 76.4 67.8 54.3 34.7 CONTROL TOTAL 100 100 100 100 100 Source: Encuesta Nacional de Epidemiolog(a y Salud Familiar, 1987.