September 2004, Presentation to Executive Board
Draft 3, Aug 31
Presentation to Executive Board, September 2004Summary of MTRs and Major Evaluations CEE/CIS/Baltics
Regional Director, Central and Eastern Europe, the Commonwealth of Independent States and the Baltics
Mr/Madam President, Distinguished Members of the Executive Board,
I am addressing you today as we confront the most devastating trauma for our region – the deaths of more than 150 children at School Number One in the city of Beslan, Russian Federation. It is hard to find words in the face of such horror. What can one say? It is, as our Executive Director has said: “a new low.” But we are UNICEF and it is not in our nature to hang our heads in despair or to give up. There is only one option, to continue to push, with all our energy, for a world fit for all children.
Let me tell you more about our region. The countries of Central and Eastern Europe, the Commonwealth of Independent States and the Baltics have been through dramatic and sometime traumatic changes over the last decade, perhaps more so than in any other region. Our region is one of only two regions worldwide where social indicators reversed in the 1990s, with the erosion of social services such as health and education and with the growing exclusion of the most vulnerable groups – the poorest, the ethnic minorities and, increasingly, girls.
It is hard to keep pace with the scale and speed of the changes taking place around us, which makes the regular and continuous evaluation absolutely essential in a region that is, in UNICEF terms, still very young. Evaluation is essential to map the ever-changing face of this region and the ever-changing situation of children. From economic slump to economic expansion, from conflict to peace, we need to know how well we are doing. In a world of constant change, of which our region is a prime example, we need to know whether our programmes are having the desired impact, whether we are headed in the right direction, or whether we have – in all honesty – been overtaken by events.
The three Mid-Term Reviews presented to you this year from our region include one country, Albania, that is part of a sub-region subjected to periodic outbreaks of ethnic conflict; one country, Georgia, that is going through rapid political change but remains plagued by poverty; and one middle income country, Turkey, that is aiming for EU accession.
The Mid-Term Review is an opportunity to take stock, to take a strategic look at our future cooperation with governments and other UN partners, to examine the performance of our programmes, to strengthen the rights-based approach, and to draw out key lessons learned from the current programme cycle. It is, in effect, a stepping stone to UNDAF.
Albania is one of the countries moving towards ‘financial sustainability’ of immunization, with a government financing mechanism now identified. And, very importantly, greater attention is being given to social policy and to the promotion of exclusive breastfeeding for all infants. While progress has been modest, it is steady. Our MTR suggests that Albania is moving in the right direction.
The MTR in Georgia drew on a national youth opinion poll that called for improvements in child development and child protection. Despite severe economic difficulties, Georgia has recorded excellent progress of salt iodisation and the establishment of Baby-Friendly hospitals – hospitals that promote and support breastfeeding. And, the country programme made an important shift from pilot projects to policy level initiatives – an example of flexibility and honesty in the face of changing circumstances.
In Turkey, the MTR concluded with a strong endorsement of the drive for girls education – a drive highlighted by the Prime Minister for special attention in his intervention in the MTR. And, for the first time, HIV was recognised as a potential threat to the country, as was the need to take action to avert an epidemic and prepare a state response.
Let me now share with you just three of the 190 studies and evaluations carried out in our region in 2003.
First, Education for Peace and Tolerance in the Former Yugoslav Republic of Macedonia (Maria – did you visit this programme during your trip? If so, it would be good to add a personal impression). Last week we were all reminded – as if any reminder were needed – of the desperate need to foster peace and tolerance in our region. And of the terrible cost of failing to do so (probably too political!). Again, this is an issue of region-wide concern. One third of the countries in our region have experienced conflict since 1989, and the age-old resentments between ethnic groups that spurred the violence are still there, simmering beneath the surface, ready to erupt as we know to our cost. The only solution lies in the next generation – in their ability to set aside old differences and empathise with those from different backgrounds, cultures and religions.
This evaluation, carried out by the Centre for Human Rights and Conflict Resolution, examined the impact of an innovative project to challenge ethnic stereotyping among school children. The project aims to help children resolve their conflicts without violence and boost their knowledge of other groups, building an understanding of the whole principle of non-discrimination. The findings of a small sample in four ethnically mixed schools were positive, but it was clear that the perceived impact of the programme varied among different ethnic groups, suggesting that alterations are needed. Nevertheless, the findings have been welcomed by the Ministry of Education, leading to the integration of education for peace and tolerance in life skills-based education, art and music.
Second, the Fortification of Flour with iron in Kazakhstan. Iron deficiency anaemia is a major issue for women and children across our region and a major threat to the brain development of children under the age of two. In the nine countries with available data, iron deficiency rates among children range from 23 per cent in Turkey, to 49 per cent in Kazakhstan – the focus of this evaluation (figures taken from Sanjiv’s presentation to the Istanbul Health and Nutrition meeting). Our goal is to reduce the prevalence of anaemia across the entire region by one third by 2010.
Kazakhstan produces good quality flour and bread consumption is universal (and among the highest in the world). Yet efforts to fortify flour have not had universal support. This evaluation, carried out in collaboration with the Asian Development Bank and conducted by the Kazakh Academy of Nutrition in collaboration with UNICEF, highlighted the cost effectiveness of fortification of flour, with a predicted break-even point within two years. At the beginning of this year, the findings of this study led to the adoption of a law for mandatory flour fortification and a national alliance of producer and consumer groups is now in place.
Third, child abandonment in Romania. The abandonment of infants by their mothers is a tragic and growing phenomenon in our region. And, with growing numbers of HIV positive mothers abandoning their babies, it is likely to increase. This innovative project aims to prevent abandonment of children in maternities in Romania by establishing counseling units in maternity wards. Using qualitative research methodologies, the evaluation identified the pathways that led mothers to abandon their children, and stages along those pathways where prevention could be strengthened. This evaluation found that the clinic was merely the end of a long journey to child abandonment, with the problems starting way before the mother came through the hospital doors. The findings are significant not only in relation to the abandonment of children by disadvantaged groups, such as Roma, but also to the whole issue of child abandonment by HIV positive mothers. In each individual case, as this evaluation makes clear, we need to be working with mothers before they set out on their journey, rather than dealing with the end result – an abandoned baby. Our goal should be the prevention of such tragedies.
What lessons have we learned?
One is the general value of such studies, given the lack of information in such a young region. Another is that there are serious gaps in our knowledge – often in relation to child protection – that we must fill if we are to bring about lasting change. And we have learned that a focus on cost effectiveness has a real impact when it comes to advocacy with decision-makers for greater resources.
The evaluations also underline the importance – particularly in our region where we do not have decades of experience in evaluation – of capacity building among national institutions and networking. The strategy adopted across the region (and in each of these evaluations) has been to boost evaluation standards among professionals and share examples of best practice.
Finally, we see the value of organizing ‘thematic’ evaluations on issues that concern a number of countries across the region. And this leads me to the future and to an exciting development – thematic evaluations in partnership with young people. They have a fascinating insight into what works and what doesn’t, in terms of our programming and we are excited at the prospect of working with them to evaluate our youth participation programmes across the region.
So, I am very much looking forward to reporting back to you next year with some preliminary results of this strategic evaluation.
But above all, I hope to be reporting from a region that is, at last, at peace with itself.