Estudio de la asistencia social domiciliada

For much of the 20th century, the social protection debate was linked to contributory social protection and a ‘labour-based society’ (ECLAC 2006). It was an approach of ‘protection based on formal employment’, which, as mentioned earlier, was a first attempt to devise mechanisms for protecting workers from unforeseen circumstances (unemployment,

8 _{A distinction needs to be made between authors who focus on the role of labour market} regulation (Barrientos and Hulme, 2008) and strengthening labour institutions (Weller, 2008) for social protection (see chapter IV.E.3) and those who emphasize the role of labour policies and improving worker employability (Ribe, Robalino and Walker, 2010). According to the social protection approach presented in this book, the latter would be better described as social promotion policies (see chapter IV.A), which, while they have much in common with social protection policies, are implemented by different means.

illness or occupational accidents), as well as at certain stages in their lives (mainly by means of retirement and other pensions and survivors’ insurance for workers’ relatives).

This approach led to instruments and mechanisms such as social insurance and mutual funds, as well as labour legislation developed by States to meet demands for better working conditions for formal-sector

workers organized into unions and associations.9 _{In practice, these}

instruments were stratified in terms of coverage, as they were available only to people linked with the world of formal employment (Filgueira and Filgueira, 2002). Major social sectors were left out, particularly rural workers and the self-employed urban poor, a situation exacerbated by recent labour market trends. In such a context, ECLAC (2006) has referred to the unfulfilled promise of full employment, as it has failed to consolidate the rights pertaining to social citizenship in Latin America (Marshall, 1950). While this social protection approach has been maintained over the years, the region’s governments, as well as a number of international institutions, have been focusing more attention on creating mechanisms to provide a basic level of protection for those who, for various reasons, remain outside the formal labour market.

2. Emergency protection

These considerations, as well as the changes taking place in social policy paradigms, have led to calls for more comprehensive and coordinated approaches for overcoming poverty. Interest intensified following the diagnosis of the impact of the recurrent economic crises that have struck the region. Price volatility, job insecurity and numerous restrictions on access to public and private insurance mechanisms are hitting the poor and vulnerable hardest, reducing the means available to them to smooth consumption and protect their basic welfare in the wake of critical events, leaving them more likely to suffer present and future losses in accumulated capital (Cook and Kabeer, 2009). It was then that the talk turned to ‘safety

nets’10_{. Safety nets are part of a broader set of poverty-reduction policies and}

programmes that had existed hitherto (including cash or in-kind transfers, cash subsidies for food and energy, workfare and social investment funds), coupled with fee waivers for more traditional social services (health, education, transport and, in some cases, housing) (Grosh and others, 2008). Safety nets are compensatory interventions that increase income and other assets by means of targeted transfers, designed specifically to sustain

9 _{Such as Uruguay’s pioneering labour reforms in the 1920s or Mexico’s 1943 social} insurance act.

10 _{The authors of this document opt for the term “safety nets”, as opposed to social} protection systems, which could be used to refer to coverage that is more comprehensive at a conceptual or operational level.

or enhance the welfare of poor or vulnerable groups during periods of economic transition or crisis (Graham, 1994, in Cohen and Franco, 2006a),

which is why it has been called the ‘emergency protection’ approach.11

Safety nets are non-contributory policies targeted at the poor and extremely poor and do not include contributory social protection policies (Grosh and others, 2008). The measures provided by safety nets are implemented for as long as people are seeking new economic opportunities, which, in theory, will enable them to improve their situation rapidly (Barrientos and Hulme, 2008). They are novel in that they coordinate public provision by offering safeguards to mitigate the impact of critical events. The idea is to incorporate into this temporary safety net people who are outside the reach of social policies and do not have the ability to cope with risks on their own. Even though they are residual interventions designed to offset sudden drops in income affecting the poorest households by means of mitigating and compensatory short-term measures (Deveraux, 2002a; Conway and Norton, 2002), safety nets are a direct predecessor of the latest debates on social protection.

3. Protection as assistance and access to promotion

Between the late 20th century and the early part of this century, a clear need has arisen to develop strategies that transcend critical events and their immediate effects of recurrently undermining the living standards of individuals and families. The aim is to address the longer-term effects of intergenerational transmission of poverty and aggregate losses in the welfare of families and their members, as a result of adopting risk

strategies that jeopardize essential assets.12 _{Thus, poverty is starting to}

be seen as a dynamic process, with multiple entries and exits over time, requiring more complex and lasting interventions to overcome it. Social protection should therefore assume both short- and long-term roles in reducing poverty (World Bank, 2001b) and address the most urgent needs arising from risks and crises. It should also support asset preservation and accumulation —including, for example, non-contributory pensions— by means of prevention policies, as well as helping to change the socio- economic conditions at the root of poverty (Acosta and Ramírez, 2004;

Barrientos and Hulme, 2005).13 _{This broader version of social protection}

has been called ‘protection as assistance and access to promotion’.

11 _{This approach was present, implicitly or explicitly, in the very first social investment} funds (for example, those of the Plurinational State of Bolivia) and safety nets, from the late 1980s to the 1990s.

12 _{Wood (2003) describes the situation facing those in poverty as “staying secure, staying} poor” (see Barrientos and Hulme 2005).

13 _{Acosta and Ramírez (2004) point to the need to combine comprehensive social protection} systems with mechanisms for mitigating the risks associated with economic crises and counter-cyclical measures, in times of greater stability. The hope is that these mechanisms will maintain the funding and operational “functioning” of social protection.

This new approach is reflected in the title of the World Bank’s first sector strategy paper (Social protection sector strategy: from safety net to

springboard), which shows how the notion of social protection has changed

from one of ‘safety net’ to ‘springboard’ (World Bank, 2001b; Cook and

Kabeer, 2009), going beyond responses focused solely on ‘emergencies’.14

Gradually, other measures that had been set aside during the structural adjustment period, are being incorporated. They include labour market regulation, non-contributory transfers to older people not covered by contributory social protection mechanisms and the incorporation of unemployment insurance benefits (Cook and Kabeer, 2009; Acosta and Ramírez, 2004).

Even though, in practice, the two approaches —emergency protection and protection as assistance and access to promotion— are closely linked and both focus on poverty as their main line of action, they differ not only in terms of their time span but, more importantly, in terms of their policies. Emergency protection entails ad hoc responses to a crisis scenario, while protection as assistance and access to promotion is consolidating a longer term view, with more coordinated interventions intended to meet the protection needs of families and households throughout life. Policies designed as part of a social emergency protection approach were not always able to reach those living in extreme poverty, as in the case of social investment funds (Britto, 2004; Deveraux, 2002a), whereas the approach of protection as assistance and access to promotion is designed to be more attentive to the needs of the poor, extremely poor and vulnerable.

The approach of protection as assistance and access to promotion is also making an increasing distinction between promotion and protection actions: whereas protection actions are associated with the concepts of risk and vulnerability (see box  I.3), promotion actions are linked more closely with strategies to build human capital and improve the coverage

and quality of related services.15 _{In particular, social promotion policies}

consist of a set of specific efforts to enhance the assets available to families. Promotion policies include sectoral policies of health and education (and others such as housing), together with programmes to increase family

14 _{A recent World Bank report (Ferreira and Robalino, 2010) proposes the term ‘opportunity} ropes’ (as opposed to ‘safety nets’) to emphasize the concept of sustainable self-reliance. 15 _{Between 1999 and 2001, the World Bank published a series of conceptual documents}

acknowledging the limitations of economic growth and macroeconomic policies alone for eliminating poverty (World Bank, 2001a and 2001b; Holzmann and Jorgensen, 1999). The

World Development Report 2000/2001: Attacking Poverty addresses this concern and proposes a new strategy for attacking poverty in three ways: opportunity creation; empowerment of poor people; and social protection (World Bank, 2001a). At the same time, many studies have demonstrated the decisive role that education plays in poverty measured by income (Fiszbein and Psacharopoulos, 1995 and ECLAC, 2002 in Britto, 2004).

incomes (such as microcredit) and to improve the employability of poor and vulnerable families and individuals (training programmes) (Deveraux, 2002a; Dreze and Sen, 1989).

Owing to their potential to enhance the assets available to households, protect them from risks and help them to overcome poverty, human capital formation policies are linked closely with social protection policies. The latter safeguard the conditions that ensure individuals and families gain access to and remain in human capital formation systems, preventing child labour, for instance, from being used as a means for coping with certain critical events. In addition, human capital is an asset and building it can provide significant long-term protection against certain risks. As discussed below, this complementarity between protection and promotion underpins co-responsibility transfer programmes, which require greater coordination between the income-transfer component of programmes and sectoral public provision in the areas of human capital formation (health and education).

Box I.3

RISK AND VULNERABILITY AS KEY SOCIAL PROTECTION CONCEPTS At the heart of the latest definitions of social protection are the ideas of risk and vulnerability. Events or conditions in the environment that pose a ‘risk’ are those that could undermine well-being and whose occurrence is uncertain (Sojo, 2007). While risk and critical events affect everyone in society, they hit particularly hard people living in poverty and extreme poverty and those who, while not actually poor, are vulnerable to poverty. In this context, ‘vulnerability’ means the probability of being poor in the future or of being harmed by a specific risk or threat (Barrientos and Hulme, 2008).

The World Food Programme (WFP) defines vulnerability to food insecurity as “the probability of an acute decline in ‘food access’ or ‘consumption’” in relation to a minimum critical level of human well-being (WFP, 2002 in Martínez and Fernández, 2006). This definition can be expressed as:

Vulnerability = exposure to risk - ability to cope

The definition appears to apply not only to food security and malnutrition, but also to low incomes and poverty, as well as to other areas of social protection. In fact, according to this definition, a key aspect for identifying vulnerable individuals or groups is the ability of individuals and families to cope with various types of risk. It follows that the most vulnerable will be those with the least ability to cope.

The ability to cope can be based on the assets available to households, families and individuals, together with the social and institutional capacity to cope with risk situations and the existing opportunity structure within society.

Assets are a set of resources that a household can mobilize at a given time to seek improvements in its welfare or to prevent its welfare from declining (Kaztman et al, 1999, p. 9). These assets include: human capital (health, education and knowledge); social capital (support networks, contacts and access to information); physical or financial capital (food, land and other items); income and work (Kaztman et al, 1999; Moser, 1996 in Escobar and González de la Rocha, 2002). In each type of asset there are individual or family attributes that can be controlled and mobilized for asset accumulation, consumption or productive investment (Kaztman et al, 1999).

Social capital enables mechanisms outside the home to be activated to provide protection in situations of social, economic or environmental risk that cause a sudden drop in income or loss of assets. The informal expression of social capital mechanisms is provided independently by the community itself, typical examples of which are consumer associations, barter markets, work paid in kind (minga) and community soup kitchens. The more formal expression is that provided by State institutions through their non-contributory social protection instruments, the distribution of resources, goods and services, or workfare.

The opportunity structure comprises both market and State mechanisms and refers to a set of asset renewal and accumulation sources enabling households to use their own resources or providing them with others that they can use to become integrated into society (Kaztman and Filgueira, F. 2006). Opportunity structures can provide new assets or regenerate depleted assets (for example, through health services and free education). They can also facilitate more efficient use of a household’s resources (for example, by opening a crèche to release human resources that can then be invested in producing income) (Kaztman and Filgueira, F. 2006). Opportunity structures therefore incorporate both social advocacy and protection policies and strategies.

Source: A. Escobar and M. González de la Rocha, “Evaluación cualitativa del programa de desarrollo humano Oportunidades. Seguimiento de impacto 2001-2002, comunidades de 2.500 a 50.000 habitantes”, evaluación de resultados de impacto del programa de desarrollo humano Oportunidades, Mexico City, Centre for Research and Higher Learning in Social Anthropology (CIESAS), 2002; R. Kaztman and others, “Vulnerabilidad, activos y exclusión social en Argentina y Uruguay”, Documento de trabajo, No. 107, Santiago, Chile, International Labour Organization (ILO), 1999; R Kaztman and F. Filgueira, “Las normas como bien público y como bien privado: reflexiones en las fronteras del enfoque AVEO”, Colección aportes conceptuales, No. 4, Montevideo, Catholic University of Uruguay, 2006; R. Martínez and A. Fernández, “Modelo de análisis del impacto social y económico de la desnutrición infantil en América Latina”, Manuales series, No. 52 (LC/L.2650-P), Santiago, Economic Commission for Latin America and the Caribbean (ECLAC), 2006. United Nations publication, Sales No. S.06.11.G.175.

4. Protection as a citizen guarantee

The need to instil a more inclusive and sustainable vision of social protection has led to a fourth approach to social protection, which goes beyond people living in poverty by seeking to guarantee minimum levels of protection for all citizens: ‘protection as a citizen guarantee’, which

provides basic guidelines for achieving comprehensive and inclusive social protection. While this vision is based on the 1948 Universal Declaration of Human Rights, the 1966 International Covenant on Economic, Social and Cultural Rights and other international human rights instruments (see annex  1), it is only in the past decade that its message has begun to resound more clearly and to gain a larger following in Latin America, among both analysts and staff responsible for designing and implementing social protection.

Social protection as a citizen guarantee focuses primarily on the realization of economic, social and cultural rights and on the four principles that should be incorporated into social protection systems at the conceptual and operational level: (i) equality and non-discrimination; (ii)  participation and empowerment; (iii)  accountability; and (iv) transparency. These principles create for States mandatory, universal and progressive obligations towards their citizens that cannot be waived (Abramovich, 2006). States have an obligation to respect, protect, fulfil and promote rights, which are complementary and indivisible (Abramovich, 2006). Thus, rights become a citizen guarantee and the basis of citizenship (ECLAC, 2006).

According to Abramovich and Pautassi, applying these rights to development strategies leads to the establishment of guidelines and criteria for designing and implementing sustainable development strategies and inclusive social policies. These guidelines culminate in legal standards (such as the obligation to guarantee the minimum content of rights; the obligation for States to apply progressive, not regressive, policies; and the obligation to guarantee citizen participation). They also culminate in principles (equality and non-discrimination; universality; access to justice; and access to public information). In turn, these standards and principles can be used to develop a matrix enabling States, social partners and development cooperation agencies to define intervention policies and strategies, as well as to devise means for monitoring and evaluating public policies (Abramovich and Pautassi, 2009).

In complying with their obligations under the mandates enshrined in constitutional charters and international covenants and treaties, States develop positive public policy measures, which facilitate the implementation of mechanisms to monitor these public policies (Abramovich and Pautassi, 2009). It is increasingly common in the region to find social programmes, sectoral policies and reforms that have been designed using a rights-based approach. Examples are Chile’s System of Universal Access with Explicit Guarantees (the AUGE Plan, see box II.5) and its social protection system and Colombia’s health system reform. Some co-responsibility transfer programmes, such as Mexico’s Oportunidades or

Brazil’s Bolsa Família, make direct reference to rights standards, although not all their interventions result from this matrix and neither are they always effective.

Placing the concept of social protection in a normative framework of rights entails setting and implementing specific and egalitarian standards for all citizens. The guarantees therefore cover a set of standards that transpose economic, social and cultural rights in specific policy areas —such as access, quality, financial protection, revision and participation and redress— that are subject to legislation requiring the State to implement and monitor them (Gacitúa-Marió and Norton, 2009). According to the rights-based approach, the aims of social protection should therefore be: (i)  the definition and widespread communication of rights, entitlements and standards that citizens can demand; (ii) a commitment to the equitable delivery of the specified rights, entitlements and standards; and (iii)  the availability of mechanisms of redress that citizens may use if they are unable to enjoy specified entitlements (Norton, Gacitúa-Marió and Georgieva, 2009).

The approach of protection as a citizen guarantee has emerged from a series of discussions, analyses and concrete proposals on rights- based social protection by various academic circles in the region and by international organizations, rather than from a single source (cf. ECLAC, 2006; Filgueira and others, 2006; Gacitúa-Marió, Norton and Georgieva, 2009; Molina, 2006; ILO, 2008a and 2008b; United Nations, 2009a and 2000). Despite their diversity, these proposals converge to some extent as they all seek to extend protection mechanisms to those not yet covered and to achieve social citizenship. Most share the following aspirations:

(i) Social protection based on the concept of social citizenship and economic, social and cultural rights, where the State plays a key role as guarantor of standards defining minimum social protection levels and establishing a common basis for quality and access (coverage) to the services and benefits arising from social protection policies, irrespective of whether they are provided by the State, the private sector or a combination of the two.