Our response
Child Health: UNICEF continues to provide evidence-based advocacy and technical assistance to the Ministry of Health (MOH) on upgrading policy, developing quality care standards in accordance with international recommendations, modelling new practices in mother and child health care and setting up monitoring mechanisms for their implementation. UNICEF advocacy greatly contributed to the government’s acceptance of the need to fully adopt the WHO Live Birth Definition. A Ministry of Health task force is working on the development of necessary regulations and statistical forms and on an action plan for transition to the new system with technical support from UNICEF. UNICEF is supporting the MOH in developing and implementing policy and clinical protocols in perinatal care with focus on neonatal care based on international standards and best practices. The new policy on maternity and neonatal care was developed and endorsed by the MOH in 2007. Core packages of clinical protocols (in total 24) on priority subjects such as essential newborn care and neonatal resuscitation were developed by a local group of trained experts under the stewardship of international consultants and endorsed by the MoH in 2008. Other two packages are in the process of development. The MOH has also upgraded antenatal care policy and developed an antenatal care clinical protocol on management of physiological pregnancy with technical assistance from UNICEF. The new policy and clinical protocols are envisaged to serve as a foundation for standardized ante- and neonatal care in accordance with international recommendations complementing the implementation of the State Programme on Mother and Child Health for 2006-2010. UNICEF supported MOH in strengthening institutional capacity in neonatal care through competency-based training courses on neonatal resuscitation and essential newborn care in maternity homes/perinatal centres in Baku and 15 districts, including pilot districts of the Health Sector Reform project. Establishing Training Resource Centres on neonatal care in Baku (Institute of Obstetrics and Gyneacology) and in Ganja (Perinatal Centre) and equipping them with essential clinical training supplies with UNICEF support envisions replication of updated knowledge and skills to health staff in the regions. Four maternity facilities selected by the MOH are provided with essential training for staff and core medical equipment for quality introduction of acquired skills and serve as models of excellence on neonatal care for nationwide scale up of live-saving practices. One of the most important issues for UNICEF is that policy and health-related strategies are based on solid evidence. Therefore, UNICEF is providing technical and financial assistance for the Ministry of Health to conduct a study of the causes of under-five child mortality. The study is examining 70 per cent of under-five deaths for the year 2006 and thus will provide an evidence base for development of a comprehensive child survival strategy and as a part of that, the IMNCI strategy directed to save children’s lives against main killer diseases. Nutrition: UNICEF aims to support the government in developing an evidence-based nutrition strategy that will promote proper infant and young child feeding practices to prevent stunting and wasting among children, both of which are widespread. Breastfeeding is also a key component of UNICEF's Informed Mother – Healthy Baby Initiative. This is a communication campaign run with support from Procter and Gamble that has seen information materials given out to more then 35,000 mothers a year on care during pregnancy and the first two years of life. The campaign has also featured a television programme for parents on popular channel to reach even more people. UNICEF has also been running a highly successful campaign to increase consumption of iodine in Azerbaijan. This campaign has seen a significant reduction in iodine deficiency disorders among children and pregnant women. In 2000, when UNICEF began work to fight iodine deficiency disorders, only a quarter of all households were using adequately iodised salt.[1] By 2006, this had doubled to more than half of all households.[2] In 2007, a UNICEF-supported study of around 1,000 children and 300 pregnant women found adequate average levels of iodine in their urine (iodine levels are best measured by testing urine samples).[3] In other words, the problem had largely disappeared in less than a decade. This success has been the result of a long-running and wide-ranging campaign, involving everything from improved science to better legislation and TV campaigns. It all started in 2000, when UNICEF campaigned hard for a new law to mandate the production of iodised salt. This appeared a year later, when Azerbaijan became one of the first countries in the region to pass such a law. After this, UNICEF worked with government officials to improve their ability to monitor salt production and iodine consumption by providing test kits and helping to establish a bio-monitoring laboratory in the State Medical University, which made possible widespread testing of iodine levels in women and children. We also worked with salt producers to improve their ability and willingness to iodise salt by lobbying and upgrading production facilities. Currently UNICEF is supporting government in evaluating iodine nutrition levels in the population and strengthening the monitoring system and interagency coordination to achieve sustainable IDD elimination in the country. HIV/AIDS: UNICEF has been working since 2000 to raise awareness among young people and provide youth-friendly health services: places where young people feel comfortable going to get information and services. Youth-Friendly Health Clinics have been established in Baku and four districts, with equipment and training from UNICEF. These model clinics offer information, counselling and voluntary testing in a friendly and non-judgemental environment. Their operation is to be reviewed by the Ministry of Health and based on lessons learned the Ministry is to mainstream youth-friendly services into the general healthcare system, making information and services available to all young people in Azerbaijan. In order to facilitate the overall process UNICEF assisted MOH in development of National Framework on Youth Friendly Health Services which is being review by the MOH. We have also been building up a core group of trained young people to provide peer-to-peer education on healthy life-styles and the prevention of risky behaviour. A summer camp in 2006 saw the training of 24 young people from universities in Baku who went on to deliver essential information to some 3,000 of their fellow students. In 2007, this was repeated with 55 students from 24 regional universities who returned home to spread the message to thousands more young people. Another camp was organized in 2008 with young people from districts with high HIV prevalence levels, and a further 2,600 most-at-risk children have also been reached with peer education sessions promotion of Healthy life style through sport. At the same time, UNICEF has supported the development and broadcast of a 12-part television series on HIV/AIDS and issues of stigma and discrimination. The show featured leading music and television personalities and reached an estimated 1.3 million people. As head of the UN Theme Group on HIV and AIDS, UNICEF is well placed to ensure that the needs of children, young people and women are taken into full consideration in national policies, including the National Plan of Action on HIV/AIDS. Avian influenza: UNICEF coordinated the efforts of other UN agencies and donors to ensure that they speak with one voice in supporting the government's efforts to contain AI. We have also steered the National Task Force, whose members include embassies, UN agencies, NGOs and high-level staff in key government ministries, and produced a newsletter to inform and influence all stakeholders. Our role ensured that the needs of children are taken into consideration in national planning and that children know how to keep themselves safe. More directly, UNICEF has run an awareness campaign that reached every state school in the country to teach children about avian flu and general health and hygiene issues. As part of this, 4,660 teachers were trained on how to conduct avian flu prevention lessons and equipped with teachers' and students' books and posters. In partnership with Save the Children, UNICEF also supported a series of weekly television talk shows, puppet shows and community theatre performances about bird flu. These efforts were complemented with a social mobilisation campaign in 80 vulnerable communities lying along bird migration routes that saw young people disseminating key messages in their communities. UNICEF has also helped train government officials on how to communicate in the event of a major outbreak and worked with media professionals to ensure ethical and accurate coverage of avian influenza and regular broadcast of UNICEF-produced PSAs. These activities have led to a huge change in attitudes and awareness. In 2006, a UNICEF survey revealed that fewer than 20 per cent of children and young people were aware of avian flu. Follow up studies in 2007 by UNICEF and John Hopkins University found that awareness levels had increased dramatically, to over 90 per cent. Most children were able to describe how avian flu is transmitted, what the symptoms are and how to avoid catching it. Children also described how their behaviour had changed over the past year: now they avoid touching birds, wash their hands with soap more frequently, wash eggs before cooking them and wear gloves and cover their mouths when looking after poultry. Child protection: UNICEF works for creating a protective environment, where girls and boys are free from violence, exploitation, and unnecessary separation from family; and where laws, services, behavior and practice minimize children’s vulnerability, address known risk factors, and strengthen children’s own resilience. UNICEF’s assistance to the Government’s child protection reform is focused on promoting the recognition of child rights and shifting the approach onto one where children are not any longer treated as objects of mercy but are recognized and treated as a subject of rights. UNICEF centres on strengthening the Ombudsman Office’s capacities as a vital part of the Azerbaijani child protection system to better protect children from violence, exploitation and abuse in law, policies and practice. The support provided to the Ombudsman Office is aimed at increasing the capacities of its Child Rights Unit in child rights monitoring, investigation, data collection, advocacy and child rights promotion. Strengthening the government’s internal mechanisms for the coordination of the Convention on the Rights of the Child implementation and reporting, UNICEF assists the State Committee on Family, Women and Child Affairs in becoming a key partner for the coordination of child rights implementation. This includes development of a databank on the situation of child righst in Azerbaijan, as well as preparation of CRC periodic state reports. UNICEF began working on child social protection reform five years ago and has been lobbying the government to change the system. This advocacy bore fruit in 2006 when the President signed the State Programme on Deinstitutionalisation and Alternative Care, a policy document put together with UNICEF's help, which represents the first official recognition by the state that institutions are not good for children. The major focus of the Program is to reduce the number of children placed in the residential care institutions (currently almost 15’000 children) and to establish a sustainable system of alternative child care and family support. The desirable aim is to gradually phase out the institutions and to move to more family oriented community services. UNICEF continues its enhanced assistance to the Government in the implementation of the State Program in all of the main three aspects: i) developing legal framework; ii) capacity building and iii) increasing awareness of the right of every child to grow up in a family-like environment On the ground, UNICEF is working in six pilot districts to set up integrated social services for vulnerable children and their families. We have trained more than 500 local government officials, managers of childcare institutions, NGO staff and community leaders to carry out basic social work in their communities. Following the recent important acknowledgement of the need for juvenile justice reform by the Azerbaijani Government, UNICEF intensified its assistance provided in this area. It includes increasing the capacities of the key staff of the judicial and law enforcement system, developing feasible for nationwide replication models of alternative solutions to imprisonment for juvenile offenders and special protection measures for juvenile victims and witnesses of crime, as well as identifying and supporting structural, organisational and legal changes required for the establishment of an independent juvenile justice system. UNICEF has also trained more than 400 judicial professionals, including judges, prosecutors and police officers, on how to deal with children and on child rights, and has drawn up curricula for inclusion in the training of all new police officers, judges and prosecutors. UNICEF has been supporting the Azerbaijan National Agency for Mine Action to provide mine risk education for children in affected areas, including refugees and other people displaced from their homes during the Karabakh conflict. Mine risk education has now been included into the curricula in almost 800 schools, with information on how to identify and avoid mines and other unexploded ordnance. As a result, the number of child victims has fallen precipitously, from 10 deaths and 22 injuries in 2005 to zero deaths and one injury in the first quarter of 2008. Education: The government recognises the need for change and is undertaking a root and branch reform of the entire education sector, in collaboration with the World Bank and UNICEF. Part of this reform is something called "Active Learning" – a new way of teaching and learning championed by UNICEF for implementation in all of Azerbaijan's schools. The Active Learning programme started in 2000 with UNICEF-supported pilot projects in five primary schools. These schools have seen the introduction of modern techniques in classrooms, such as the use of group work and student presentations to improve children's critical thinking skills and their ability to participate and express themselves. These techniques are backed up with new gender-sensitive textbooks written to be relevant to the world children live in today. Anecdotal feedback from teachers and students has been universally positive: teachers testify to their students' improved confidence, interest in lessons and performance in exams; students say they enjoy school more and get more out of going to class. Mainstreaming active learning into the education sector reforms proceeded encouragingly with active learning integrated into the pre-service and in-service teacher training curricula in 2008. UNICEF has further supported the development of textbooks to ensure that active learning is practically embedded into all textbooks, teacher guides and children’s workbooks, thus integrating active learning in every grade and classroom in terms of teaching and learning processes. Additionally, UNICEF provided technical assistance on strategic planning in-service teacher training and pre-service curriculum. Active learning fits into a broader UNICEF programme called child-friendly schools, which seeks to ensure that all schools in Azerbaijan meet certain minimum standards for effectiveness, safety and participation. In practice, this means that schools use the active leaning method to maximise children's educational results. It means that schools make an effort to bring in children who are often excluded, including the disabled, children living with HIV and the children of the very poor. It means that parents, community figures and children themselves are involved in the running of the school. It means that schools have decent buildings, toilets and recreational areas that are safe and hygienic. And it means that systems are in place to identify children suffering from abuse and to get them the help they need. UNICEF has successfully advocated for the government to include early childhood development in the second stage of its education reforms and there is high-level agreement on the importance of improving the situation. In 2007, the President signed a decree on reform of the pre-school system. The Presidential Programme on Modernisation of Pre-schools calls for building new kindergartens and renovating the existing ones. It also mandates a new curriculum (which has now been developed by UNICEF) and the creation of alternatives to meet current demand such as short-term play groups. [1] UNICEF. Multiple Indicator Cluster Survey. 2000. [2] State Statistical Committee, Ministry of Health, UNICEF and USAID. Demographic and Health Survey. 2008. [3] Ministry of Health, UNICEF. Report on National Representative Survey of Iodine Nutrition and Implementation of USI program in Azerbaijan, Baku. 2007.
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