Indicadores de la calidad de vida de las poblaciones en torno a los Esteros del Iberá en la Provincia de Corrientes. (2001)

10-Reflexions and preliminary conclusions

Summary: of the study of objective indicators of quality of life important differences are verified among the studied departments, however a worsening of negative situations is verified in the departments of San Roque, San Miguel and Concepción and in the rural areas, as well as a high population percentages with UBN. In spite of the inconveniences found by the lack of up-to-date and specific data we present, as preliminary conclusions, relationships and dynamics among those indicators considered important for the model of quality of life. As for the problems linked with health we have approached the following topics: water supply and treatment, accumulation, inconvenient housing, mothers' age and education and their relationship with the infantile and maternal mortality, stressing the high percentages population without health insurance. The indicators of education have been related with: characteristics of urban and rural areas, unsatisfied basic needs, conditions of educational infrastructure and socio-economic vulnerability.

Of the study of the objective indicators of quality of life important differences are verified among the studied departments that show the socioeconomic heterogeneity of the area, however it is verified in all the approached problems the concentration and worsening of negative situations in the departments of San Roque, Concepción and San Miguel. Are also prominent, in all the departments, the high percentages of population with Unsatisfied Basic Needs¹ (UBN) that could mean a threat especially for the life of the residents in the most sensitive groups, since the accumulation, the conditions of the housing, the education and jobs are some of the vital elements for the human being. Of the analysis of the education indicators and housing they also arise wide differences among the urban and rural populations, being observed a worse situation in rural areas.

Regrettably, the lack of up-to-date and specific data as likewise the access difficulties to departmental information have not allowed us to deepen the relationships among the different indicators developed along this report, neither to check them quantitatively. Based on the objetive and subjetive information available will be able to simulate, through the built model, the quality of life systems to determine causality and to obtain projections.

In spite of the inconveniences mentioned before, subsequently we present relationships and dynamics among those adequate indicators for the model of quality of life, also we propose possible issues to be deepened with new official statistical information or with the data gathered in other investigation areas. In this last stage of the analysis, problems linked with health and education have been prioritized and contrasted, through cartography, with the information about unsatisfied basic needs and rural / urban population’s percentages, arriving to the preliminary conclusions that are presented next.

As for the problems linked with health, we have approached the following topics: water supply and treatment, accumulation, inconvenient housing, mothers' age and education and their relationship with the infantile and maternal mortality, stressing the high population percentages without health insurance:

  As it is indicated in the section Family and Homes, in the studied departments, population's percentage with services of drinkable water reached in 1991 in Concepción to 22,4% continued by San Miguel with 34,5%, San Roque with 40,4%, San Martin with 45,7%, Santo Tome with 53,6%, Mercedes 57,2% and Ituzaingó with 60,3%. As for population's percentages with services of drainage cloacal or public net in none of the studied cases overcame to 34%, reaching the lowest values in the departments of Concepción (0,1%), San Miguel (0,3%) and San Roque (0,8%), (See Map 3.3). The safe supply and residual treatment of water are very important factors to reduce the infectious diseases. The shortage or inaccessibility of the water makes difficult the personal hygiene, and this could be one of the causes of the increasing of the diarrheas and cutaneous diseases and ocular infections. Water can also be the habitat where insects, vectors of various deseases, develop. Among the infectious diseases, the group of water transferable diseases is one of the most outstanding causes in infantile mortality (see section 5-Health). Due to the nonexistence of departmental data about infantile mortality causes, it has not been possible to correlate these variables.

  The supply of water and foods in appropriate quantities and with acceptable quality and the interruption of the fecal-oral chain are essential to reduce the digestive diseases, one of the causes of infantile mortality in the province. The fourth cause of deaths of children younger than one year and the fifth among the women of one to four years, according to the percentage of death, are the intestinal infectious diseases (see section 5-Health). According to different international studies the safe and enough supply of water and an appropriate sanitation would reduce children mortality more than 50% and would avoid 25 % of the episodes of diarrhea.

  High infantile mortality for infectious diseases of the respiratory system is in part for childbirth problems that does not arrive to term, accumulation conditions, inconvenient housing and bad nutrition, but many deaths could be avoided with vaccination, reproductive education for mothers, medical attendance in the pregnancies and special cares. In the map 10.A.1, we can see that generally high levels of infantile mortality coincide with a high percentage of inconvenient housings. The acute respiratory infections are the fourth cause of mortality among the children from one to four years old and the fifth cause among those younger than one year old, according to the percentage of deaths (see section 5 - Health).

  Some consequences of the accumulation are: domestic accidents, air transmitted infections, acute illnesses of the respiratory system, pneumonia and tuberculosis. The risks for health are increased when they are linked with low revenues because of the lack of resources to improve the inhabited places achieving space, security and enough service.

  It is important to emphasize that between 70 and 75% of the infantile deaths of the Province of Corrientes could be "avoidable", according to the information of the Department of Vital Statistics of the Sub Area of Health Statistics of Corrientes, the classification of "avoidable" includes those causes "reductible" and "partially reductible", that is to say, the first ones are those that could be avoided with simple actions and a low cost and the second are those that could decrease with certain actions of health, although there are not categorical evidences in this respect.

  The variables "mothers' age" and "infantile mortality", achieve a direct correlation with a coefficient of 0,80 in the first test. This correlation could not be verified due to the necessity of up-to-date and detailed data and a confirmation in situ. For this reason we can only say that the drop age of the mothers could be one of the influential factors in the infantile mortality, in the Province of Corrientes 25% of them is smaller than 19 years. The difficulties presented in the pregnancy, the childbirth and the puerpera are related with mothers health, maturity and nutritional state, being reflected in children and their development.

  Another interesting fact to observe is the rate of maternal mortality for every 10.000 born alive for the Province of Corrientes in 1997 was 4,8. It has been proved by international studies that approximately the 3/4 parts of the maternal deaths in developing countries are cause for hemorrhages and infections. According to studies developed in Argentina more than 50% of the maternal deaths are the result of complications of the childbirth and pregnancy or lack of corresponding cares, consequently, their death is not only caused by biological and medical factors but rather to readiness and quality of the services of health and social and economic conditions. Regrettably the nonexistence of data about departmental maternal mortality has not allowed us to present these relationships through cartography.

  Finally, as an added difficulty, it is necessary to highlight that an important population proportion did not have health insurance in 1991. Of the provincial population, 48,4% was not stuck to a social security service (obligatory for those who work in dependence relationship) neither they were affiliated to a medical insurance (volunteer). See Map 5.3, in the departments of Emperado, Mburucuya, San Roque, Lavalle, Concepción, San Miguel and Gral Paz 60 % of population does not have health insurance.

The education indicators have been related with: urban and rural characteristics, unsatisfied basic needs, conditions of the educational infrastructure and socio-economic vulnerability:

  The net rate of literacy varies if it is in rural or urban areas being inferior in the former, the significance of these differences increases if one has present that is also superior in the rural means the backwardness in the ages in those that you advances in the primary literacy². According to data of the INDEC in the Province of Corrientes primary literacy net rate for urban areas reached 96,1% in front of 91,8% of rural areas. The primary literacy average rate in urban areas reached 51,3%; and for rural areas 13,5%. Observing the rates of university education and / or third level these reached 18,1% in urban areas and only 2,0% in rural ones. The biggest difference among urban and rural areas is given in the secondary level and higher education students, some of the possible causes will be mentioned next (sees maps 10.B.1). Considering the data corresponding to the studied departments we observe that these maintain the provincial tendencies. The biggest difference among the rate of urban and rural literacy average is in San Martin. In the department of Ituzaingó is observed that the rate of university or third level literacy are quite similar in both areas, being the contrary situation in San Miguel.

  The differences among urban and rural areas can also be observed in the qualifying age to jobs, being sensibly earlier in the rural areas. In the Province of Corrientes according to National Census of Population and Housing 1991, the rate of the population's activity between 14 and 19 years old was of 33,1%, the rate of employment 29,7% and the rate of unemployment 10,2%. In the same group of ages we observe that rate of activity is bigger in rural areas 45,2% vs. 28,8 % in urban ones, employment rate in rural areas was of 42,6% and in urban areas of 25,2%; finally unemployment rate was of 5,8% among rural population from 14 to 19 years and of 12,6% in urban population.

  The earliest entrance age to jobs in rural areas results congruent with smaller family income and literacy levels like we have already seen previously it in the data of the Province and the departments studied. Work of the members of poorest homes is the basic resource, children and adolescents work, contributing in the realization of domestic tasks, production for self-consumption and / or to obtain additional revenues, is a very important contribution for these families. Also in many occasions the low family revenues hinder the payments of tranport expenses, gear and materials that the school requires. It is noteworthy to highlight that the distance and difficult accessibility to the schools of rural areas worsen the situation. The previously mentioned ones could be some of the causes for rural population rates of illiteracy, as we observed in the map 10.B.2.

  The school desertion and the illiteracy can be related among other topics with children and adolescent work but also with bad conditions of life (accumulation, poverty, precarious conditions of housing) and with the lack of access to the educational establishments. We can observe in the map 10.B.3 that important percentages of population have incomplete primary level and these percentages coincide especially with the departments with bigger percentage of homes with unsatisfied basic needs. Likewise in the map 10.B.4 the high illiteracy rates are in the departments with bigger percentages of defective housing.

  According to national studies in the marginal urban or rural areas with a low degree of integration this characteristics are observed: smaller quantity of lecture hours, falling quality in the teacher career accompanied by a low salary, infrastructure antiquity and instruments obsolescence, besides a decrease of the educational efficiency. Relationing: academic achievements and school resources (state of the building, bathrooms and classrooms), the results revealed that in schools in good state, the students have better school grades. The same relationship settles down with better didactic resources, as furniture and blackboards. This relationship is still the same between the achievements of students with other variables as good school climate, security in the school and time that the director dedicates to the pedagogic topics. As it has already been described in the section of Education, most of the educational establishments in the studied departments, possess an antiquity between 21 and 30 years except in the departments of Mercedes, where prevail buildings with more than 50 years, few establishments are in a acceptable condition of conservation requiring smaller repairs, most of the educational buildings does not possess public net water and in general high percentages of the buildings do not have electric power, regrettably the correlation between the academic achievements and the school resources has not been able to be proven because the data do not belong to the same years.

  According to the report of Educational Evaluation 2000 (Ministry of Education, 2000) more than half students in Argentinean Northeast region has a condition of socio-economic vulnerability that does not allow a good learning and generates difficulties to stay inside the system. Studies of educational quality show a segmentation of the student performance that puts in disadvantage the students coming from families of low revenues and education levels. To achieve a good education it would be necessary that the population had satisfied basic needs as food, health, housing and employment. Although it depend on them, a good development is also related with the methods and the forms of organizing work in the schools. In connection with the expansion necessities, it is detected as a crucial one the design and implementation of programs that assist the specific characteristics of the infantile populations (children with high populational dispersion, handicapped and children in rural sectors). In this way the educational system could respond appropriately to the demands of the society.

1See definition in section 3 of this work, Family and Homes

2 Net rate of literacy: percentage in each teaching level with pertinent school age with regard to the total of the population of that age group.