Multi-dimensional Review of Paraguay

Chapter 5. A scorecard for monitoring implementation of the policy recommendations

Abstract

This chapter offers a scorecard containing a series of indicators for monitoring progress on the implementation of the proposed reforms on social protection, health, and education and skills. First, it presents the methodology behind the scorecard; then, it presents the targets that Paraguay should achieve for each indicator by 2030.

Paraguay has set the measure of success of its 2030 development agenda at the achievement of the Sustainable Development Goals, with due priority to certain key areas that require extra government intervention, given the specific situation in the country. Paraguay has set itself the goal of being a country that is competitive, has high levels of social development, is connected and open to the world, is environmentally and economically sustainable, has high levels of legal security and public safety, attends to the needs of indigenous peoples, fosters an active role by women, and has democratic and transparent state institutions that promote equal opportunity (Republic of Paraguay, 2014[1]).

Tools to monitor the implementation of public policies can help Paraguay to achieve the goals it has set in terms of inclusive growth and well-being. This chapter offers a series of monitoring indicators to improve the Paraguayan government’s capacity to monitor its progress towards the development goals. The proposed indicators are closely related to the policy recommendations made during all stages of the Multi-dimensional Review of Paraguay, especially Volume 2 (OECD, 2018[2]) and in this report, and have been validated by the Paraguayan administration. The indicators give an overview of progress towards the goals of (i) a social protection system for all, (ii) a health system that encourages healthier lifestyles, and (iii) an education system and skills that promote inclusion and employability.

By setting specific objectives and regularly monitoring achievements, the scorecard contributes to the transparency of the Paraguayan government’s work. Allowing citizens and stakeholders to monitor the progress of the development agenda in this way is essential to ensure there is a balanced social contract. Furthermore, using more and better accountability tools improves the public administration’s capacity and fosters civic participation. To achieve these aims, the scorecard needs recent, high-quality data that are properly disaggregated.

The scorecard offers indicators for achievement of the Sustainable Development Goals for 2030

For each of the thematic areas analysed in the Multi-dimensional Review of Paraguay (social protection; health; and education and skills), the scorecard presents a series of primary and secondary indicators, as well as targets for 2030 for each indicator. The primary indicators measure the overall progress in each of the three policy areas, while the secondary indicators are a more precise measure of the extent to which the expected results of the proposed reforms have been achieved.

For each indicator, the scorecard presents some historical values to show the progress made and specifies at least one of three alternative targets to be achieved by 2030. The scorecard combines data from international sources with local data and surveys. Three criteria were used to set the 2030 targets:

1. Generally, the targets were set using a methodology that compared Paraguay’s performance with that of countries with a similar income per capita. The benchmarking countries used to calculate the targets using regression analysis included lower middle-income, upper middle-income and upper middle-income countries (see Box 5.1).

2. A superscript “n” denotes targets that reflect the national objectives specified in the Paraguay 2030 National Development Plan (Republic of Paraguay, 2014[1]), institutional targets or targets agreed with the government throughout the process of this review.

3. A superscript “a” denotes alternative targets calculated as the average of the figure for the last year available among the group of upper middle-income and high-income countries.

Box 5.1. The standard methodology used to calculate the 2030 targets

The first methodology uses a three-step procedure:

1. First, the target gross domestic product (GDP) per capita for 2030 was calculated using the 2017 GDP per capita (USD 8 827) and the constant annual GDP growth rate (6.8%), as specified in the 2030 National Development Plan (Republic of Paraguay, 2014[1]). The result was a 2030 target GDP per capita of USD 15 995.

2. Next, for each indicator, regression analysis was performed using the GDP per capita of each country in the sample, except for high-income, upper middle-income and lower middle-income countries with an atypical GDP per capita, which were excluded from the analysis. The calculations are based on the value of the indicator in 2017 or the latest available year. In each regression equation, the dependent variable is the indicator in question for country i in 2017 (or the latest available year), and the independent variable is the GDP per capita of country i in 2017 (or the latest available year):

${indicator}_{ii,\mathrm{ }2017}=\mathrm{\alpha }+\mathrm{\beta }\mathrm{*}{GDP\mathrm{ }per\mathrm{ }capita}_{ii,2017}$ (1)

3. For each indicator and the estimated respective coefficients, the 2030 targets for Paraguay are derived. In particular, the estimated intercept (which captures the average characteristics of the group of benchmarking countries) is added to the product of the estimated GDP per capita coefficient (as calculated in step 2) and the long-term target GDP per capita (as calculated in step 1):

${indicator}_{Paraguay,\mathrm{ }2030}=\widehat{\mathrm{\alpha }}+\widehat{\mathrm{\beta }}\mathrm{*}15\mathrm{ }995$ (2)

The targets presented in the scorecard should be interpreted with caution. Specific sampling areas for each of the sources, for instance, could distort the estimates. Furthermore, in the first methodology, the way equations 1 and 2 model the relationship between the indicators and the GDP per capita may fail to capture non-linearity, thus introducing other specification errors. 

The estimates do not take into account possible future shocks and global trends, which could accelerate or slow down changes in certain indicators, further distorting the estimates. Nevertheless, the scorecard gives an overview of the trend that Paraguay needs to follow to achieve inclusive and sustainable growth over the long term. The target values should therefore be interpreted in the light of historical values, rather than based only on changes from one year to the next.

Table 5.1. General indicators for economic performance and statistical capacity

	2010	2011	2012	2013	2014	2015	2016	2017	2030 Target	Source
GDP per capita, PPP (constant 2011 international USD)	7 290	7 505	7 312	8 227	8 502	8 639	8 871	8 827	15 995	World Bank
GDP growth rate	-	-	-1.2	14.0	4.7	3.0	4.0	4.3	6.8 n	Central Bank of Paraguay
Extreme poverty rate	-	-	7.38	5.69	5.47	5.42	5.73	4.41	3 n	DGEEC, EPH 2012-17
Overall statistical capacity (scale: 0–100)	70.0	70.0	70.0	71.1	71.1	72.2	70.0	67.8	85.0 n	World Bank
Online queries and procedures (% of total procedures available)	-	-	-	0	0.9	5	5.2	5.4	100 n	SENATIC

Note: The statistical capacity indicator is a composite score that assesses the capacity of a country’s statistical system. The indicator is based on a diagnostic framework that evaluates the methodology used as well as the source, periodicity and timeliness of the data. The overall statistical capacity is calculated as the simple average of the three area scores on a scale of 0 to 100.

Reforming to foster healthier lives in Paraguay

To increase its chances of achieving universal health coverage, Paraguay’s health system requires systemic reform and a future vision. Maintaining the pace of growth of health funding while increasing the equity and efficiency of the service is a major challenge. The fragmentation of the health system into prepaid private, general budget-based public and insurance-based social security systems is a significant hurdle to ensure effective stewardship and efficient allocation of resources in the system. A national dialogue could determine what model the country chooses, in particular in terms of its financing – whether an insurance-based model in which coverage for those unable to pay is subsidised, preferably explicitly, by the public purse, or a national health service model in which a basic package of health services is provided for free to all citizens. In both cases, it is possible for the various segments that make up the system today to co-exist, but in a much more integrated fashion.

The Paraguayan health system is faced with major challenges in achieving universal coverage. To respond to the double burden of diseases among the population, it needs to secure sustainable funding, ensure it is run more efficiently and strengthen its stewardship (OECD, 2018[2]). The country has undertaken a series of reforms to modernise the system, laying the foundations for a new approach to health care based on primary care. However, it has not significantly altered the foundations of the health system and its fragmentation into multiple subsystems.

A series of primary indicators (general) and secondary indicators (to follow the policy recommendations of Volume 2 of the MDCR) were strategically identified. This compilation of indicators is included with the objective of providing a tool for monitoring progress towards the development objectives of Paraguay in the area of health (see Table 5.2 and Table 5.3).

Table 5.2. Primary health indicators

Indicator	2010	2011	2012	2013	2014	2015	2016	2017	2030 Target	Source
Access to healthcare (%) 1	71.94	-	69.30	74	80	81	75	71	80.1 n	DGEEC, EPH 2010-17
Population with health insurance coverage (%) 2	22.68	24.73	26.01	27.8	28.08	28.03	25.93	26.8	30.3 n	DGEEC, EPH 2010-17
Life expectancy at birth, total (years)	72.4	72.7	72.9	73.1	73.4	73.6	73.8	74.0	75.13 n	DGEEC, Projection of the National Population, urban and rural areas, by sex and age, 2000-25
Maternal mortality rate (per 100 000 live births)	100.8	88.8	84.9	96.3	63.9	81.8	86.4	67.3	≤70 n	MSPBS 2012-17
Births in health facilities (“institutional births”) (%)	94.4	-	-	-	-	-	-	97.9	99	MSPBS
Neonatal mortality rate (per 1 000 live births)	11.7	11.2	10.7	10.6	10.4	9.7	9.5	8.9	8.2 n	MSPBS 2012-17
Children mortality rate (per 1 000 live births)	-	-	14.7	14.6	14.5	14.2	13.7	-	12 n	MSPBS 2012-16
Mortality rate due to diabetes mellitus	27.8	26.7	28.4	32.7	32.3	34.5	37	31.3	23.1 n	MSPBS IBS 2017
Mortality rate due to diseases of the circulatory system	114.3	109.1	104.6	108.4	98.3	106.6	120	113.2	71.4 n	MSPBS IBS 2017
Mortality rate due to malignant breast tumour in women (per 100 000 pop.)	8.5	10.6	9.3	9.7	10.1	10.2	10.9	11.3	6.8 n	MSPBS IBS 2017
Mortality rate due to malignant cervical tumour in women (per 100 000 pop.)	7.5	8.2	7.7	8.3	7.9	8.8	8.5	10.6	5.9 n	MSPBS IBS 2017
Mortality rate due to land transport accidents (per 100 000 pop.)	19.6	19.0	18.0	18.2	16.8	17.1	17.5	17.2	8.6 n	MSPBS/DIGIES/DES (SSIEV)
Incidence of tuberculosis (per 100 000 pop.)	33.7	34.1	34.3	30.5	33.8	34.9	36.7	37	0 n	MSPBS IBS 2017
Registered number of new HIV diagnoses (per 1 000 inhabitants)	-	-	-	-	-	0.2	0.21	0.21	0 n	MSPYBS - PRONASIDA

Table 5.3. Secondary or follow-up indicators to the health policy recommendations

Recommendation	Indicator(s)	2010	2017	2030 Target	Source
Recommendation 1: Establish a vision for the health system
1.1. Define a vision for the health system	Approval of a consensus document on the vision for the system	-	-	Doc. approved	-
Recommendation 2: Sustainable funding
2.1. Diversify financing sources	Current expenditure on health (% of GDP)	2.1	3.0	5.0 n	MSPBS
	Taxes on tobacco (excise + VAT) (% of the sale value) 1	26	28 (2018)	75	MSPBS
2.2. Implement strategies to reduce out-of-pocket health expenditure:	Out-of-pocket payments (% of current expenditure on health)	46	44	38	MSPBS
	Population with health insurance coverage (%) 2	22.7	25.9		DGEEC, EPH 2010-16
2.3. Pool funds to cover key contingencies (such as high-cost treatments)	Households from the poorest decile that incur catastrophic expenses (% of total households) 3	-	7 (2014)	0	DGEEC, EPH 2014
2.4. Integrate civil servants to a social insurance scheme	Civil servants included in the social insurance scheme (%)	-	-
Recommendation 3: Strong governance
3.1. Strengthen the implementation of the health system’s governance framework	New organisation chart	-		Ministerial resolution	MSPBS
3.2. Give supervisory institutions sufficient autonomy and resources	Number of medical, legal and accounting audits carried out annually by the Superintendence of Health	-	-	-	Superintendence of Health
	Budget of the Superintendence of Health	-	-	-	MSPBS
3.4. Define a set of guaranteed health benefits	Implementation of a health benefits package	-	-	Ministerial Resolution	MSPBS
3.5. Consolidate integrated information systems	Integrity of birth registration (%)	63	66	76.5	MSPBS/SSIEV
	Integrity of the register of deaths with information on the cause of death (%)	28.2	37.1	55.6	MSPBS/SSIEV
	Unified information systems	-	Ambulatory, cardiovascular and odontology care	Vital statistics, SIP Plus, TB, SICIAP, non-transmissible, transmissible, INAN, road safety, internal and primary care, telemedicine, SIREPRO, intensive therapy beds, PRONASIDA, PAI and gender info.	MSPBS/DIGIES
	Medical centres and hospitals with systems for monitoring medical records (%)	-	3	60	MSPBS/DIGIES
Recommendation 4: Efficiently run services
4.1. Progress towards the integration of health services provision	Institutions in the public and social security subsystem with inter-agency agreements in force (%)	-	-	-	MSPBS/IPS
4.2. Design a system for paying suppliers that creates strategic incentives in the system	Number of suppliers incorporated into the payment by results scheme	-	-	-	MSPBS
4.3. Ensure that medicines and health products are available and affordable	Implementation of a new model for the supply of supplies and medicines	-	-	-	MSPBS
	Implementation of electronic invoices to the supplier	-	-	-	-
	Number of high-cost drugs purchased under the centralised purchasing model	-	0	20	MSPBS
4.4. Strengthen the integrated health networks for primary care	Number of Primary Healcare Units (Unidades de Salud de la Familia, “USF”)	-	804	1 500	MSPBS
	Hospital beds (per 1 000 people)	1.3	1.3 (2011)	3.1	WHO
	Physicians (per 1 000 people)	-	1.3 (2012)	1.8	WHO Global Health Workforce Statistics, OECD and country data
	Nurses and midwifes (per 1 000 people)	-	1 (2012)	4.1	WHO Global Health Workforce Statistics, OECD and country data
4.5. Invest in health promotion and disease prevention	Skilled attendants at birth (% of total births)	95.6	95.5 (2016)	98.1 a	UNICEF, State of the World’s Children
	Pregnant women receiving prenatal care (%)	-	85.3	95 n	MSPBS

Note: (1) The tobacco tax was modified by Decree 159/18 (Republic of Paraguay, 2018[3]), which set a tax rate of 18% on tobacco-related products. The values presented include the sum of taxes on tobacco (excise + VAT). According to the World Health Organization, “raising tobacco taxes to more than 75% of the retail price is one of the most effective and cost-effective tobacco control interventions” (WHO, 2015[4]). (2) Includes IPS and other insurance. (3) Currently, there are no official data from the Ministry of Health and Social Welfare (MSPBS) on catastrophic health expenditures (CHE) in Paraguay. Since it is not calculated by any official body, the incidence of catastrophic health expenditures was calculated for this report, using data from the EPH 2014 (DGEEC, 2014[5]), as the proportion of households that spend more than 30% of their income.

Moving towards social protection for all in Paraguay

Paraguay should standardise its pension system to increase the system’s equity. At present, the various pension plans’ parameters (e.g. contribution rates, retirement age and replacement rates) vary widely, which leads to inequality. Paraguay should reform its pension system to overcome these inequalities. Key steps towards an equitable system include unifying the retirement ages, the benefit calculation base and the replacement and accrual rates. All retirement pensions would be updated using the same method.

Strengthening the link between benefits and contributions is essential to ensure the system’s sustainability. This link can be reinforced by increasing the number of years used to calculate the retirement pension and by regularly reviewing the benefit level and contribution rates. Benefit levels should have a ceiling and reflect the decreasing contributor-per-pensioner ratio. The periodic review of contribution rates should be based on actuarial studies, demographic developments, the economic situation, the ratio between pensioners and contributors, and the financial soundness of each pension plan.

A series of primary indicators (general) and secondary indicators (to follow the policy recommendations of Volume 2 of the MDCR) were strategically identified. This compilation of indicators is included with the objective of providing a tool for monitoring progress towards the development objectives of Paraguay in the area of social protection (see Table 5.4 and Table 5.5).

Table 5.4. Main social protection indicators

Indicator	2010	2011	2012	2013	2014	2015	2016	2017	2030 Target	Source/ comments
Self-employed workers, total (% of total employment) 1	47.3	46.6	47.7	44.6	43.7	43.8	44.2	44.3	37.1	ILOSTAT database
Vulnerable employment, total (% of total employment) 1	42	41.4	42	38.2	37.2	38.7	39.1	39.2	33.4	ILOSTAT database
Share of youth not in education, employment or training, total (% of youth population)	33.1	34.7	39.2	36.1	38.8	35.5	37.7	18.1	20.7 14.1 a	ILOSTAT database

Note: (1) ILO modelled estimate.

Table 5.5. Secondary or monitoring indicators for social protection policy recommendations

Policy recommendation	Indicator	2010	2017	2030 Target	Source/ comments
Recommendation 1: A pension system with expanded coverage
1.1. Start implementing a strategy to expand coverage	Population with social security (%)	40.4 (2012)	43.4	100 n	DGEEC, EPH 2012-17
	Coverage of social protection and labour programmes (% of population)	54.2	-	75.2 a	ASPIRE (World Bank)
1.2. Improve incentives for formalising employment and for social security contributions	Informal employment (% of total non-agricultural employment)	69.8	65.4	43.5	ILOSTAT
	Formal establishments (%)	40.2 (2012)	46.9	100 n	DGEEC, EPH 2012-17
	Wage and salaried workers, total (% of total employment) 1	52.7	55.7	62.9	ILOSTAT
	Active contributors to an old-age contributory scheme as a percentage of the labour force	18.9 (2011)	-	47.1	ILOSTAT
	Active contributors to an old-age contributory scheme as a percentage of the working-age population	13.5 (2011)	-	33.6	ILOSTAT
Recommendation 2: A fairer and more sustainable pension system
2.1. Improve equity in the pension system by aligning parameters	Tax burden (tax revenue/GDP)	12.7 (2012)	13.1	18	SET
2.2. Strengthen the link between benefits and contributions through parametric reforms	-	-	-	-	-
Recommendation 3: A better integrated pension system
3.1. Integrate the contributory and non-contributory pensions into one multi-pillar pension system	-	-	-	-	-
Recommendation 4: Strengthen governance of the pension system
4.1. Establish regulations and a supervisory body for the pension system	Inspectors per 10 000 employed persons	0.1	0.1 (2015)	0.7	ILOSTAT database

Note: (1) Modelled ILO estimate

Towards an education and skills system that fosters inclusiveness and employability in Paraguay

Transforming the education and skills system in Paraguay is vital to foster inclusiveness and better access to good-quality jobs. Education and development go hand in hand, and Paraguay’s success in achieving its main development objectives, as set out in the Paraguay 2030 National Development Plan, will depend largely on its capacity to improve the education and skills system.

Substantial progress has been made, but further reforms are needed, as set out in Volumes 1 and 2, of the Multi-dimensional Review of Paraguay, namely:

• Coverage and funding: Policies must continue to expand education coverage and foster completion of studies, particularly among the most disadvantaged groups.

• Quality of education: Policies to improve learning outcomes must focus on teachers, educational resources and the management of schools.

• Relevant teaching: Policies to make education more relevant must focus on reforming the curriculum of upper secondary education (educación media) so that it favours labour-market insertion and provides a more solid basis for accessing higher education.

• Education for employment: Policies to favour good-quality school-to-work transitions in Paraguay must move towards a national, integrated technical and vocational education and training (TVET) system.

• Skills supply and demand: Policies to improve the match between the supply and demand of skills in Paraguay should not be limited to improving the relevance of skills.

A series of primary indicators (general) and secondary indicators (to follow the policy recommendations of Volume 2 of the MDCR) were strategically identified. This compilation of indicators is included with the objective of providing a tool for monitoring progress towards the development objectives of Paraguay in the area of education (see Table 5.6 and Table 5.7).

Table 5.6. Primary-education indicators

Indicator	2010	2011	2012	2013	2014	2015	2016	2017	2030 Target	Source/ comments
Government expenditure on education, total (% of government expenditure)	18.8	23.3	19.6	-	-	-	-	-	15.5 16.5a	UNESCO Institute for Statistics
Government expenditure on education, total (% of GDP)	3.8	5	5	-	-	-	-	-	4.9	UNESCO Institute for Statistics
Adult literacy rate, population 15+ years (%)	-	-	94.2	95.1	95	95.6	94.7	94.2	100n	DGEEC, EPH 2012-17
Average years of study, population 20-35 years	-	-	7.8	8.42	8.69	8.72	8.49	8.8	17n	DGEEC, EPH 2012-17
Average years of schooling (ISCED 1 or higher), population over 25, both sexes	8.2	8.6	8.5	9	9	8.4	-	-	9.4	UNESCO Institute for Statistics
Students achieving basic skills in reading (%)	-	-	-	-	-	32.2	-	-	79.9*	PISA-D OECD (Level 2 or higher)
Students achieving basic skills in mathematics (%)	-	-	-	-	-	8.3	-	-	76.6*	PISA-D OECD (Level 2 or higher)
Students achieving basic skills in science (%)	-	-	-	-	-	23.8	-	-	78.8*	PISA-D OECD (Level 2 or higher)
Population age 25+ with completed lower -secondary education (%)	-	-	-	-	46.7	48.1	-	-	66.9	UNESCO Institute for Statistics
Population age 25+ with completed upper secondary education (%)	-	-	-	-	36.6	38.1	-	-	52.2	UNESCO Institute for Statistics

Note: (*) These targets are the OECD averages in 2015.

Table 5.7. Secondary or follow-up indicators to the education policy recommendations

Recommendation	Indicator	2010	2017	2030 Target	Source
1. Move towards a better education system for all
1.1. Adopt the PNTE 2030 national pact on education, based on a consultative process: ● Set specific targets and milestones for the areas of action ● Establish financial commitments ● Mobilise international expertise	-	-	-	-	-
1.2. Expand coverage and foster completion, particularly in pre-primary and secondary, and among the most disadvantaged groups: ● Produce better statistics to evaluate challenges, monitor progress, and inform policy ● Support access in remote areas and across the most disadvantaged socio-economic groups ● Policies to favour school retention and completion, avoiding repetition and dropout	School enrolment rate for 3-year-olds	5.2 (2012)	8.8 (2016)	70 n	MEC 2012-16
	School attendance rate, 5-year-olds	70 (2012)	75.8	100 n	DGEEC, EPH 2012-17
	School attendance rate, 6–14 year-olds	96.6 (2012)	97.4	100 n	DGEEC, EPH 2012-17
	Average school-attendance rate	77.9 (2012)	78.9	92 n	DGEEC, EPH 2012-17
	Net intake rate in grade 1 (% of official school-age population)	73.1	70 (2012)	76.5 a	UNESCO, UIS
	Vulnerable population with tertiary education	35 955 (2012)	40 158	251 685 n	DGEEC, EPH 2012-17
	Net enrolment rate in indigenous primary education	66.6 (2012)	80.1 (2014)	100 n	Indigenous Census 2012–14
	Literacy in the indigenous population (age 15+)	62.4 (2012)	70.9 (2016)	100 n	Indigenous Census
	School enrolment, pre-primary (% gross)	39.6	37.7 (2012)	70 n	UNESCO Institute for Statistics
	School enrolment, primary (% net)	89	88.5 (2012)	100 n	UNESCO Institute for Statistics
	School enrolment, secondary (% net)	61.5	66.5 (2012)	92 n	UNESCO Institute for Statistics
	Progression to secondary school (%)	93	94.5 (2011)	98.9 a	UNESCO Institute for Statistics
	Proportion of students at the end of primary education achieving at least a minimum proficiency level in reading, both sexes (%)	-	70.9 (2013)	80.5	UNESCO Institute for Statistics
	Proportion of students at the end of primary education achieving at least a minimum proficiency level in mathematics, both sexes (%)	-	70.2 (2013)	80	UNESCO Institute for Statistics
1.3. Policies to improve learning and the overall quality of the education system: ● Improve evidence on learning outcomes to inform policy making ● Improve teaching to achieve better learning outcomes	Pupil–teacher ratio, pre-primary	-	24.1 (2012)	17.5	UNESCO Institute for Statistics
	Pupil–teacher ratio, lower secondary	-	19.1 (2012)	16.9	UNESCO Institute for Statistics
	Pupil–teacher ratio, upper secondary	-	17.6 (2012)	15.5	UNESCO Institute for Statistics
	Trained teachers in pre-primary education (% of total teachers)	-	91.9 (2012)	76.4 81.4 a	UNESCO Institute for Statistics
	Trained teachers in lower secondary education (% of total teachers)	-	85.9 (2012)	78.6 80.5 a	UNESCO Institute for Statistics
	Trained teachers in upper secondary education (% of total teachers)	-	75.4 (2012)	80.8 78.3 a	UNESCO Institute for Statistics
2. Improving education for access to better-quality jobs
2.1. Modernise the upper secondary curriculum: ● Prioritise 21st century skills ● Develop mechanisms tailored to the industry’s changing demands by involving the private sector and other stakeholders ● Develop technical skills and soft and basic skills for the workplace	-	-	-	-	-
2.2. Strengthen the TVET system: ● Strengthen the accreditation process for Higher Technical and Vocational Institutes to improve the quality of education ● Modernise the curriculum to make it more relevant and connected with the private sector ● Build vocational education and training pathways to support students’ transition to the workplace ● Support education for adults and establish a system for the recognition of skills acquired in the labour market	Proportion of 15–24 year-olds enrolled in vocational education, both sexes (%)	4.2	5.4 (2012)	6.9 9.3 a	UNESCO Institute for Statistics
2.3. Improve the match between labour supply and demand through: ● Active labour-market policies to favour employability in formal jobs: training and intermediation systems ● Information systems to attract students to sectors with higher demand ● Skills councils in dynamic sectors (e.g. agroindustry) and an observatory for skills demand	Companies that claim to have had difficulty filling vacancies, despite having candidates for the position (%)	-	81.8	-	Manpower

References

[5] DGEEC (2014), Encuesta Permanente de Hogares [Permanent Household Survey] (database), Dirección General de Estadística, Encuestas y Censos, Fernando de la Mora, http://www.dgeec.gov.py/microdatos/index.php.

[2] OECD (2018), Multi-dimensional Review of Paraguay: Volume 2. In-depth Analysis and Recommendations, OECD Development Pathways, OECD Publishing, Paris, https://dx.doi.org/10.1787/9789264306202-en.

[3] Republic of Paraguay (2018), Decreto Nº159/18: Por el cual se fijan las tasas del impuesto selectivo al consumo para los bienes comprendidos en la sección I del artículo 106 de la ley N° 125/1991, Asuncion.

[1] Republic of Paraguay (2014), Plan Nacional de Desarrollo Paraguay 2030 [National Development Plan 2030], Asuncion.

[4] WHO (2015), WHO Report on the global tobacco epidemic, 2015. Raising taxes on tobacco, World Health Organization, Geneva.