Colombia

The only South American country with coastlines on both the North Pacific Ocean and Caribbean Sea, Colombia is a middle income country that is home to some 47.7 million people. About 81 percent of the population lives in urban areas, mostly in the north and west where agricultural opportunities and natural resources are found.

In the midst of a demographic shift caused by steady declines in fertility, mortality, and population growth rates, Colombia’s birth rate has fallen from more than 6 children per woman in the 1960s to just above replacement level today. This shift is a result of increased literacy, family planning services, and urbanization, yet income inequality in the country is among the worst in the world with more than a third of the population living below the poverty line. This disparity is clearly evident in the stark inequities within Colombia’s healthcare system, which provides near-universal healthcare – albeit dramatically inferior for the less affluent.

The latest data from WHO estimates that the country has 1.82 physicians per 1,000 people, most in urban settings. Colombia’s adult HIV prevalence rate is 0.5 percent, with approximately 150,000 people living with the virus. Key public health threats include bacterial diarrhea from food or waterborne diseases, as well as vector-borne diseases, such as dengue fever, malaria, yellow fever, and zika virus. Malnutrition is a major issue in certain regions. Noncommunicable diseases (NCDs) also present a major challenge with 71 percent of all attributed to cardiovascular disease, cancer, diabetes, and other NCDs, according to a recent report from the U.S. Chamber of Commerce’s Global Initiative on Health and the Economy.

Another long-standing challenge to public health is forced displacement due to violence among guerrillas, paramilitary groups, and Colombian security forces despite the Government’s December 2016 peace agreement with the Revolutionary Armed Forces of Colombia (FARC). In fact, between 1985 and September 2017, nearly 7.6 million people have been internally displaced – the highest total in the world, though actual numbers are likely higher due to lack of registration and reporting. Colombia also has one of the world’s highest levels of forced disappearances with some 30,000 cases recorded over the last four decades. 

The armed conflict of more than 50 years, poverty, lack of education, illiteracy, unemployment, lack of resources for parenting and child care and other factors have also led to a high of level of child abuse and are preventing society from fully guaranteeing the rights of children and adolescents. Cases of violence against children and adolescents have increased since 2015. The number of reestablishment of children’s and adolescent’s rights processes increased from 17,500 in 2015 to 24,300 cases in 2017. Sexual abuse accounts for the largest number of administrative processes (e.g. opening a case file), followed by physical and psychological abuse and negligence. The increasing number of cases of violence against children and adolescents in the country is one of ICBF’s most important and complex challenges, as it involves multidimensional and dynamic causes.

Projects

Strengthening Colombia’s Social Welfare Workforce
(2017 – 2021)

From 2017 to 2021, AIHA supported USAID’s HRH2030 program in Colombia as a member of a broad-based consortium led by Chemonics International. Colombia is one of six priority countries in the United States Government Action Plan for Children in Adversity (APCA), an initiative designed to improve the well-being of children around the world, and it is the only country in Latin America to have an HRH2030 project supported via USAID. It was also the only HRH2030 program that directly focused on the quality and effectiveness of child welfare social services. The project responded to the need that arose from Colombia having endured over 50 years of warfare and violence that greatly impacted family life and the wellbeing of children.