Newsletter, N1 (10), 2006
UNICEF in Georgia
No 1 (10), 2006
The Newsletter of the UN Children's Fund, UNICEF in Georgia, is published annually by the UNICEF Office in Georgia in English and Georgian. The publication aims to provide information on UNICEF activities in Georgia. This is the tenth issue of the Newsletter. Your remarks and recommendations concerning the publication will be most appreciated. Please, let us know if you wish to obtain any additional information on UNICEF and its work. We welcome any feedback, suggestions and contributions.
If you wish to obtain a copy of the Newsletter or any other information, please, contact Maya Kurtsikidze, Communication Officer, at the UNICEF Office in Georgia.
As 2006 was the first year of our new country programme, we mainly focused on conducting various assessments and surveys in order to obtain important baseline data to measure the effectiveness of the five year country programme. Assessment of the perinatal care service in Georgia, child poverty study, survey on iodine deficiency disorders, study on child rearing, assessment of the child welfare reform implementation, assessment of disabled children in institutions, rapid assessment of internally displaced children living in collective centres, assessment of the administration of juvenile justice system have been carried out this year. Most of them have already been completed and major findings have been identified. Next year we will start transforming these findings into concrete programmes and projects to address existing gaps and main areas of concerns.
The health programme witnessed the development of the evidence-based national guidelines and protocols on perinatal care and under-five child health and development. The guidelines will soon be endorsed by the Government and put in practice that should considerably improve mother and child care practices in health facilities.
UNICEF continued to support the Government in procurement of vaccines for under-2 year old children. This year the Government has procured 50% of these vaccines and next year will totally take over the vaccine procurement process.
UNICEF in partnership with the Government partners developed the first comprehensive communication plan on immunization targeting the behaviour of mothers to take their newborn promptly and on schedule at two, three and four months of age to the nearest health facility for vaccination.
Considerable progress has been observed regarding the eliminating micronutrient deficiencies. As a result of close collaboration between UNICEF and Parliamentary Committee on Health and Social Affairs an Alliance for Improved Nutrition was created and 1.2 million USD was mobilized from the Global Allaince for Improved Nutrition (GAIN) on iron/folate fortification of wheat flour. One of the major initiatives for food fortification in Georgia was development of the national programme on Flour Fortification.
National programme and strategic plan for early childhood development has been elaborated as a result of the technical assistance from Yale University. The strategic plan will focus on child development in health and in pre-school education sectors.
Within the Child Protection programme the regulatory frameworks for child welfare were developed and national standards for the state, family support and family substitute services were set up.
UNICEF provided technical expertise to the Parliament in development of the draft laws on social assistance system, adoption, and Foster Care.
The strategies for transformation of Tbilisi and Makhinjauri Infant Houses were developed. UNICEF supported Family Small Group Home in Rustavi, and Community Centre in Tianeti set models for modern, alternative services in the country.
We are proud that only in 2006 more than 800 children were prevented from institutionalization and reintegrated into biological and foster families.
Within the new country programme UNICEF has initiated serious efforts to improve monitoring and reporting on child rights. In this regard UNICEF was active in supporting independent human rights institutions like public defenders’ office in enhancing monitoring capacity. UNICEF has partnered with the Public Defender’s Office to revitalize the child rights’ centre.
This would not be possible to achieve without close partnership with our government and donor partners. Our special thanks to the First Lady of Georgia Ms Sandra Elisabeth Roulofs, the Parliament of Georgia and especially to the Committee on Health and Social Affairs, Ministries of Health and Education, Ministry of Justice and Economy, our NGO partners and media representatives who supported us in mobilization of public attention to children and their rights.
I do hope we will continue this close partnership and next year we will be able to influence concrete policy changes in favour of children.
I would like to repeat the words of the famous Chilean poet Gabriella Mistral "Many things we need can wait, the child cannot...To them we cannot say tomorrow, their name is today."
On 11 December 2006, UNICEF in Georgia celebrated 60th anniversary of the organization at the conference in Tbilisi aimed at highlighting the situation of the most disadvantage children in Georgia. At the conference UNICEF presented the main findings of the surveys that were recently conducted to assess how Georgia was progressing towards meeting the Millennium development Goals.
“Today UNICEF celebrates its many achievements on behalf of children all over the world” said Giovanna Barberis, UNICEF Representative in Georgia at the conference in Tbilisi dedicated to the UNICEF 60th anniversary, “At this important day we are thinking of the most vulnerable children in Georgia and would like once again to highlight those issues that need our attention. We have to think how we can unite our efforts to tackle these problems and to help Georgia to achieve Millennium development Goals.”
The conference was attended by the First Lady of Georgia Ms Sandra Elizabeth Roelofs, Chairman of the Parliament Committee on Health and Social Issues, Mr George Tsereteli, government officials, NGOs, donors and UN agency representatives.
Other events in Georgia included launch of the TV spot dedicated to the 60th anniversary featuring famous opera singer and recently appointed UN Goodwill Ambassador in Georgia Paata Burchuladze; broadcasting of the 7 min video on UNICEF 60th anniversary on the nation-wide channel; production of the booklets and calendars dedicated to the 60th anniversary; releasing relevant articles in the newspapers.
UNICEF also supported a special Christmas performance for children staged by the Tbilisi’s ancient Marjanishvili Academic Theatre. The performance called “An Orange, Flout and..” was based on three famous fairy tales “Love of three oranges” by Carlo Goetz, “Magic Flout” by Mozart and Georgian fairytale “Natsarkekia”. The performance included messages on child rights articulated by the main characters of the play. Children had an opportunity to see the performance everyday during one month starting from 26 December 2006. UNICEF promotional video dedicated to the 60th anniversary was featured in the lobby of the theatre before and after of the performance as well as during the break.
Celebrating its 60th anniversary at the end of the year UNICEF gave special awards to those journalists who have partnered with UNICEF during the whole year to draw public attention to the problems of children in Georgia.
“Journalists act as eyes, ears and voices of those who need our attention most of all. It is true that in our today’s world politics play the most important role in news coverage and very often children’s voice is not heard. But it is equally important to consider the ‘children’s angle’ in more conventional news coverage.” says Giovanna Barberis, UNICEF Representative in Georgia at the conference in Tbilisi dedicated to the UNICEF 60th anniversary, “In this view we would like to thank those journalists who have closely partnered with us during the year to highlight concrete issues related to the situation of children in Georgia.”
UNICEF presented special certificates of appreciation and small gifts to up to 20 journalists from various media outlets, TV, radio or press.
“We will continue to be a voice of children and hope this will be our contribution in overcoming those difficulties children of Georgia face nowadays”, says Nino Kvantrishvili from Imedi TV company.
UNICEF will continue to expend the group of child-friendly journalists in Georgia.
Children are the real indicator of a country’s progress – UNICEF
On 11 April 2006 the Prime Minister of Georgia and UNICEF’s representative in the country officially approved and signed the 2006 – 2010 Programme of Cooperation. The new programme aimed to assist implementation of adequate social policies and structures that will address the needs of the most vulnerable women and children in Georgia.
The programme has three main components: Early Childhood Care and Development, Child Protection, Advocacy and Social Monitoring for Children’s Rights.
“Within the framework of this programme, UNICEF will work actively with the government and other partners to protect the rights of the most vulnerable children in the areas of health, education and social welfare,” UNICEF Representative in Georgia Giovanna Barberis said. “We will also work to attract public attention to the rights and needs of those children who are suffering from social distress and stigma, with poor access to health or education and those living in institutions because of disability or poverty. Our efforts are aimed at influencing policies and systems to make them more child-friendly.”
This will be done through ensuring access to adequate social services and through improving their quality. The new country programme also aims at strengthening partnerships and monitoring systems at all levels to enhance inter-sectoral collaboration and evidence based local planning.
The programme will cover the whole of Georgia, though priority will be given to five specific regions: Imereti, Samegrelo–Zemo Svaneti, Kvemo Kartli, Samtskhe-Javakheti and Mtskheta-Mtianeti.
“The parliament of Georgia welcomes the signature of the new country programme. We do think it fully complies with the state policy and priorities in spheres of children’s health and social protection and it is based on the real needs of the country – says Mr George Tsereteli, Head of the Parliamentary Committee of Health and Social Protection – The Committee will provide the necessary legislative support to the programme and will carry out parliamentary monitoring to fulfil the assumed responsibilities and the Millennium Development Goals”.
UNICEF Georgia is carrying out a Child Poverty Study aimed at conceptualizing, analyzing and providing policy recommendations on child poverty in Georgia. The study in carried out by a research team led by Curatio International Consulting.
“Children are more vulnerable to poverty than adults and consequently, the effect of poverty is most severe in childhood - UNICEF representative in Georgia Giovanna Barberis says. “Many counties develop poverty reduction programmes – Millennium Development goals, poverty reduction strategies, etc. – but, problems related to children’s poverty are rarely addressed. The bottom line is to get countries to treat child poverty as a social policy priority.”
On 21 September, 2006, with the support of UNICEF and Curatio International Consulting the first in series of public consultations on the conceptual part of the study took place. UNICEF has asked the participants of the first public consultations, as well as other partners, to provide written comments on the concepts and terminology proposed in the first part, to share what they see as the most problematic issues related to the Child Poverty in Georgia and to reflect on the processes and mechanisms for strengthening and intensifying the partnership in this regard. Discussions have been ongoing in various formats and locations since then. UNICEF Georgia has also invited the partners to join an online discussion group: (http://groups.yahoo.com/group/UNICEF_ChildPoverty_Georgia/) where participants can express their position, participate in on-line discussions and view and upload materials on child poverty issues.
The conceptual framework proposed by the research team suggests that child poverty goes beyond ‘income’ and also includes child’s education, health and social participation. The proposed definition of “child poverty” uses a human rights definition of poverty, rather than the economic measurements of income or consumption per capita.
The research team is currently attempting to measure the level of child poverty based on the proposed conceptual definition. The team will measure the poverty level of the children themselves, and not that of larger communities, such as their families. Child poverty study is also a process to have a dialogue and a discussion on the most acute problems related to children and to develop concrete strategies to tackle these problems. The results of this analysis will be ready by early 2007.
A STEP FORWARD TO THE SAFE IMMUNIZATION
UNICEF continues to support the Government of Georgia in implementation of the Immunization Program in the country. This year the Government procured 50 per cent of routine under-2 child vaccination supplies for 2006 (vs. 0% in 2001) and is planning to entirely take over the vaccine procurement from 2007.
One of the most important aspects for the safe and effective immunization is to ensure maintaining relevant rules for vaccines delivery, transportation and their storage in all medical institutions involved in implementation of Immunization Program component.
In order to maintain vaccines’ high quality it is necessary to store them in adequate temperature conditions. UNICEF in partnership with Vishnevskaya-Rostropovich Foundation and USAID is providing all medical institutions, involved in Immunization Program with all the necessary equipment, such as: refrigerators, freezers and cold chain.
Presently there are about 1100 refrigerators in Georgia. There are two types of refrigerators, operating at +2 +8 degrees and freezers, operating at – 15 – 20 degrees.
There are about 1100 ambulatories in Georgia. ‘The vaccinations are made in the primary health care circuit and I may say that 90% of the requirement is satisfied,’ says Levan Baidoshvili, the Deputy Director of the National Center for Disease Control.
In 2006 UNICEF provided the Government with 100 refrigerators, 60 cold-boxes, and 1000 freeze tags.
On the base of joint memorandum between UNICEF, United State Fund of the Social Insurance and Ministry of Health, Labour and Social Affairs, total quantity of vaccines required for 2007 was purchased through UNICEF procurement service. If Georgia would have purchased vaccines, syringes and disposable boxes at market prices for GEL 800 000, UNICEF purchased them for GEL 450 000 and the Country saved GEL 350 000 by the deal.
With the help of UNICEF and different International Organizations vaccines, syringes, refrigerators are provided to the territory of Abkhazia and South Ossetia as well.
Qualified medical personnel is a guarantee of the general health level improvement in Georgia
During September 2005 – April 2006, under the aegis of UNICEF and Vishnevskaya-Rostropovich Foundation, training program for medical personnel was organized. 61 two-day seminars were held in 35 towns of Georgia. Approximately 1700 medical personnel participated in the training program. Among them were 1417 paediatricians, 124 epidemiologists, 60 neurologists, 51 infectious disease specialist, 29 neonatologists and 22 immunologists.
The training program was attended by the medical personnel of clinics and ambulatories, directly involved in the process of immunization.
For the training purposes, practical immunization modules published by the World Health Organization in 2005 were translated, printed and handed over to the participants of the seminar.
New modules shall help medical personnel in management of infectious diseases, transportation of vaccines, their use and storage, immunization planning and administration of safe vaccination.
“The training results are noteworthy. I think that retraining of medical personnel involved in immunization, is a must for a proper implementation of the State Immunization Program and for the prevention of infectious diseases” – says Lika Jabidze, representative of National Center of Disease Control.
Communication for Behavioural Impact for Immunization in Georgia
COMBI is social mobilization process which blends a variety of communication interventions intended to engage individuals and families in considering recommended healthy behaviours and to encourage the adoption and maintenance of those behaviours.
As part of the consultancy a five-day training Workshop was conducted on February 20-24, 2006 for 26 participants drawn from various government institutions. The workshop culminated in the presentation of two draft plans developed by the participants one on safe motherhood, and the other on immunisation.
In August 2006 the Ministry of Labor, Health and Social Affairs of Georgia initiated the implementation of communication strategy for immunization in partnership with the Ministry on Education and Science.
The strategy is based on marketing methodology widely used is private sector. The major focus is made on beneficiary and the desired behaviour is identified based on marketing research and situational analyses. The immunization strategy focuses on the ultimate results of mothers taking their newborn promptly and on schedule at two, three and four months of age to the nearest health facility for the various vaccines to be administered at those ages for protection against polio, diphtheria, pertussis, tetanus, and hepatitis. The strategy is based on some understanding of those factors which would hinder this behavior and those factors which would facilitate it.
Within the scope of the project, UNICEF initiated the base-line survey in order to set the benchmark data against which the effectiveness of the immunization campaign could be measured. The purpose of the assignment is to conduct in-depth research of the immunization behaviour among health professionals and caregivers in order to develop a comprehensive understanding of the current communication/behavioural gaps.
The communication strategy on immunization includes a mix of interventions, such as Administrative Mobilization, Public Relationship, interpersonal communication, Advertisement through mass-media, School Promotion and Business Partnership for Immunization.
The official launch of the campaign is planned in January 2007.
UNICEF EVALUATES IMMUNIZATION PROGRAMME INFLUENCE ON PUBLIC HEALTH IN GEORGIA
UNICEF in collaboration with the Ministry of Labor, Health and Social Affairs of Georgia initiated a nation-wide survey to evaluate influence of the Immunization Programme Management on the health care system in Georgia.
Various components of the immunization programme were assessed: the programme management, service delivery, immunization strategy, policies and schedules, immunization coverage and monitoring, disease supervision, immunization quality and safety, advocacy and communication, financing and sustainability. Overall six regions and Abkhazia, 15 districts and 28 health facilities were visited.
According to the survey, the immunization coverage has significantly improved. This is the result of strong financial sustainability of the programme, for three years already, with the active support of UNICEF, the state finances children mass immunization programme. Qualified medical personnel, vaccine delivery and store management, improved computerized recording and effective communication strategy can be considered as strong aspects of the national immunization programme.
Thus, there are still some gaps that need to be addressed in future, lack of financial incentives for higher coverage and new guidelines for medical personnel are not yet fully implemented. There are also significant communication challenges facing the immunization programme: inconsistent and unqualified media commentary and opinions by some neuropathology’s and clinicians have a dramatic effect on the credibility of the primary health care staff and the programme in general.
Finally, with the help of the survey the Government of Georgia will have a very clear vision of the immunization programme advantages and its weaknesses to work out a realistic action plan that will ensure future success of the immunization program.
Infant mortality reduction - is one of the priorities for the healthcare system in Georgia. The surveys showed that infant mortality is especially high during the first 28 days after delivery.
“The reason is that we have no minimal standards of perinatal care in the country, which means that during pregnancy neonatology is not applied in a timely manner, there is no list of measures to be applied in certain cases” – says Zaza Bokhua, the head of the Healthcare Department of the Ministry of Labour, Health and Social Affairs of Georgia – UNICEF provides huge assistance in this regard. In 2006 with the support of UNICEF we are elaborating minimal perinatal care standards for the Georgian healthcare system”.
UNICEF has supported national professional associations and academia to develop a total of 28 national guidelines/protocols and to draft relevant modules of training curricula in perinatal care and early child care.
“It will control performance of neonatology doctors, gynaecologists; it will partially be a quality controlling measure, which may be considered as the guarantee of the healthcare system development” – says Zaza Bokhua.
Different trend associations are working on guidelines and protocols for neonatology doctors and gynaecologists. The results are checked and adjusted comprehensively. In order to give them a complete form on a later stage these guidelines and protocols shall be rechecked by independent experts. From January 2007, every perinatal care provider will be able to obtain the new guidelines and protocols for medical personnel.
The starting point for developing a successful healthcare system in Georgia should be reforming and improving perinatal care system, as these are the centres where new lives are born and the first step towards a healthy lifestyle is taken.
In 2006, UNICEF in collaboration with Curatio International Consulting conducted a
According to the assessment general physical infrastructure of maternity houses is satisfactory, but antenatal clinics in the rural areas are not in adequate conditions. In majority of maternity settings necessary equipment for delivery management are available.
In local maternity houses, even when a facility is provided with all necessary equipment other problems occur - medical personnel are not motivated to handle complicated cases as they are not reimbursed for doing so. This may be very harmful for the patient; moreover it has a negative impact on the performance of the local personnel.
According to the survey professional development of the new personnel is also unsatisfactory. The patients in Georgia usually give an advantage to the doctors of older generation, as they believe that younger ones are less experienced. Consequently they become unmotivated and loose their skills and qualifications.
The survey reveals that State benefits to pregnant women (vouchers) are not appropriately communicated to the target audience. Only 45.2% of post-partum women knew and had the voucher for delivery services.
According to the survey obstetrics/gynecologists are often not adequately qualified. At least 1 out of 10 surveyed doctors have inadequate experience in the emergency situations. Apart from the practical skills their theoretical knowledge is also unsatisfactory. While in majority of cases (96%) neonatologists’ theoretical knowledge of life-saving interventions is good, however practical skills are insufficient.
As for the maternity institutions the internationally recognized methods such as breastfeeding supporting practices, skin-to-skin contract, early attachment and rooming-in are widely introduced. However, these interventions are not properly implemented by the local staff.
Although very few women complain about poor attention from the medical personnel or improper care the survey data stress again necessity to change attitudes toward the clients. Principles of the women friendly environment should be encouraged, where women’s dignity, right and opinion is respected.
An absence of the well-structured medical card remains as the major concern. However the available medical records are not maintained at a satisfactory level that hinders adequate assessment of the professionals’ performance.
“The survey’s results show that there is no regionalized perinatal care system in Georgia represented by different levels of care with a defined volume of services, staff and equipment,” says Ivdit Chikovani, the manager of the Perinatal Care Assessment Programme at Curatio. “This was the main goal of the survey – to discover the problems within the system and plan the strategy of actions for the perinatal care system development.”
Learn more from TV Talk Shows about child healthcare
“The programme was very successful and very popular”, says Eka Gamtsemlidze, the show’s producer from Imedi TV. “It ranked second according to the latest survey of popular TV shows. A lot of viewers called in during the show with various questions. This makes sense, because many of them cannot afford expensive medical services for their children. They saw this show as an opportunity to get free consultations from the best professional doctors in the country.”
Georgia committed to achieve sustainable elimination of iodine deficiency disorders and to ensure universal salt iodisation by 2005.
UNICEF continues to support the country achieving this commitment and in fighting iodine deficiency disorders that severely affected country’s population. In 1997, 57 per cent of the population was suffering from the endemic goiter; in 54 per cent of children population Iodine Deficiency caused serious disorders.
In February 2005, in order to prevent diseases caused by Iodine Deficiency, a new law, banning the import and sale of non-iodized salt came in force. This Law is the result of active cooperation between UNICEF and the Committee for Health and Social issues of the Parliament of Georgia. “Adoption of the Law is the great success for the Country and UNICEF’s contribution is huge in this regard. The State Regulations control over iodine content in salt is the only way to fight against Iodine Deficiency in the country”, says Giorgi Gegelashvili, First Deputy Chairman of the Committee for Health and Social issues of the Parliament of Georgia.
In 2005-2006, National Center for Nutrition and UNICEF carried out the research to determine the area of goiter spread among the whole Georgian population. A cross-sectional school-based cluster survey of children aged 6-12 years measured urinary iodine excretion and the iodine content in household salt. Children were randomly selected from 30 secondary schools selected by population proportional to size sampling.
Urinary Iodine Excretion analysis revealed adequate iodine status among the school children – only 4.4% were found to have low urinary iodine level. Rapid testing of 900 salt samples revealed 90.6% of salt to be adequately iodized
Examination of 4420 children by palpation revealed 32.4% of children to be affected by goitre vs. 36-39% reported by the National Centre for Nutrition within 1998-2003 period. As per the international evidence it takes 3-5 years for goitre prevalence to decrease once the population iodine status is improved. Thereby improved goitre trends is evident however the universal salt iodization has to be sustained in Georgia to achieve the international criteria of up to 5% goitre prevalence.
“These results were positive at this time, says Rusudan Kvantchakhadze, Deputy Director of the National Centre for Nutrition, and they indicate dramatic improvements both in prevalence of low urinary iodine excretion among Georgian children and in the percentage of Georgian households using salt with adequate iodine.’
The survey findings conclude that Georgia now meets the core international criteria for iodine deficiency elimination. Although total goiter rate remain high (32%), sustained consumption of iodized salt by the population will ensure further decrease of the goiter prevalence.
Fortified wheat flour can prevent anaemia
In February 2005 as a result of the long-standing advocacy and technical support by UNICEF and USAID the Parliament of Georgia has adopted a Law on “Prevention of Iodine, other microelement and vitamin deficiencies” The primary focus of the law is the universal salt iodization strategy with banning import, production and sale of non-iodized salt. Furthemore as an umbrella document the law stipulates creation of supporting economic environment for import, production and sale of other fortified food as a public health priority and articulates provisions for adoption of regulations, national standards, quality control and quality assurance mechanisms for food fortification initiatives.
In line with adoption of the legislation the Parliament of Georgia through UNICEF support established a national task force – Alliance for Improved Nutrition. The Alliance acting as a joint forum for policy and programme development and inter-agency coordination of mirconutrient malnutrition and food fortification initiatives is chaired by the Parliamentary Committee on Health and Social Affairs. The form brings together representatives of the government line ministries (Ministry of Labour, Health and Social Affairs, Ministry of Finance, Ministry of Agriculture), other national authorities (National Centre for Nutrition, National Centre for Disease Control and Medical Statistics, State Department of Statistics), private sector (local food industry & importers), NGOs and professional association.
One of the major initiatives for food fortification in Georgia was development of the national programme on Flour Fortification. Starting from 2005 UNICEF supported the Parliamentary Committee and the National Alliance for Improved Nutrition to develop a national programme and the country proposal to the Global Allaince for Improved Nutrition (GAIN) on iron/folate fortification of wheat flour.
In 2006 as a result of external expertise for food fortification standards and the country assessment visits GAIN Secretariat approved the Georgia’s proposal for Flour Fortification for 2006-2008 with a total budget of 1.2 million USD.
The 3-year programme supported by GAIN envisages fortification of over 80% of locally produced wheat flour with iron and folic acid. The ultimate goal of the national Flour Fortification programme is to enhance the national response to iron and folic acid deficiencies among the general population of Georgia, especially among the vulnerable social-economic groups. Wheat floor was identified as the most appropriate food vehicle that reaches the vast majority of the population, is widely available and routinely consumed by all households, including the most vulnerable.
The programme officially launched in October 2006 envisages:
UNICEF having played a critical role in leveraging the GAIN resources for the national flour fortification programme will continue to provide relevant technical assistance to the Government and the National Alliance for succesful implementation of the initiative.
Communication on avian influenza in Georgia
The first case of avian flu in Georgia was officially reported on February 21, 2006, when a dead swan found by a lake in the Ajara Region (near the Turkish border) tested positive for the H5N1 virus. Very soon after, a second migratory bird tested positive for the virus in the same region.
UNICEF was among the first who reacted over the outbreak and in collaboration with the Ministry of Labor, Health and Social Affairs and the Ministry of Education and Science produced and distributed informational leaflets and posters about Avian Flu, 7,500 posters and 531,600 leaflets were printed and disseminated to families and children throughout Georgia including conflict areas of South Ossetia and Abkhazia. UNICEF also took action to get various media outlets to cover stories on the issue and broadcast public service announcements regarding Avian Flu on TV and radio.
While as of yet there have been no cases of human infection, the outbreak of Avian Influenza has highlighted the critical need for a comprehensive communication strategy in Georgia.
The Georgian Government has moved quickly to respond to the threat of Avian Influenza through establishing government steering commission on Avian Influenza under the chairmanship of the prime minister. Under coordination of the Commission, an emergency preparedness working group drafted a National Avian Influenza Preparedness Plan. As part of this planning initiative, the Ministry of Heath has been mandated to take on the responsibility of public education and enlightenment regarding Avian Influenza prevention and control among animals and humans. In order to achieve this, the Inter-sectorial Group assembled the Communication Subgroup on Avian Influenza under the leadership of UNICEF, which has since been tasked with developing the dedicated Avian Influenza Strategic Communications Plan for Georgia.
To support the Government, in October 2006, UNICEF invited a consultant to finalize the national communication strategy on Avian Influenza. The strategy has been completed and soon will officially be adopted by the government.
Along with the strategy development, a two-day workshop for members of the Government Communication Subgroup on Avian Influenza was held on major aspects of behavior change communication.
UNICEF has also initiated knowledge, attitude and practice study on Avian Influenza which aims to identify cultural, economic, behavioral and other factors that act as barriers and enablers among key target audiences, for the adoption of healthy behaviors and safe practices related to poultry keeping, raising, handling and consumption.
UNICEF is in the process of preparing an Avian Influenza informational package for schools in order to educate primary and high school children on safety measures regarding AI.
No More Domestic Violence
The new law adopted by the Georgian parliament "on protecting and providing aid to the victims of domestic violence" entered into force in 2006. A draft action plan on implementing the law is currently under development. The action plan needs to be improved in order to better protect children who are victims of violence. Among the recommended improvements are requiring certain professionals to report cases of domestic violence against children; providing healthcare professionals with screening tools to identify cases of domestic violence and involving appropriate child protection organizations in the implementation of the law.
Several round table discussions were held on modifying the action plan. UNICEF and other UN agencies made their comments and suggestions, which were incorporated into the draft action plan.
“The round table meeting with UNICEF and other agencies was very helpful, said Nato Shavlakadze, a representative of the Anti-Violence Network. “Their experts gave us very useful suggestions that were ultimately included in the action plan.”
UNICEF helps children to return to their families
Child day Care Centre in Tianeti
Since 1999, UNICEF has assisted the Government in developing policies to prevent institutionalization of children while promoting alternative, family-based child care practices.
In 2005 Government of Georgia declared that children deinstitutionalization is one of the country policy priorities. The process implies reform of the child-care system through development of family-based care alternatives, transformation of residential institutions and reintegration of children into the family environment.
Transformation of the Tianeti children’s institution into the day care centre is one of the good examples of the reform implementation. When Tianeti institution was closed, 140 children returned to their families, others were relocated in the recipient families. From now on they will live in their own houses with their own families. The main goal of the project is not only to prevent intake of children in institutions, but also to develop the relevant community based social services at the local level. In particular, the relevant building was selected and renovated, technical equipment was provided, trainings for the day care center personnel and community members were organized about repheral system and foster care parents were identified.
The Day care centre will offer disadvantaged children a better possibility to learn and to develop. For those children, whose parents work long hours Tianeti Day Center offers special service - an extensive academic group. In addition to the academic course, various amateur circles, such as music, singing, and painting will be offered.
The Project has been implemented by the Ministry of Education and Science with the support of UNICEF and ‘Every Child’.
It is plan to set up the similar child care centres in Rustavi and Akhmeta in the near future. In 2007 it is foreseen to increase a number of the Day Care Centres in the country that will consequently decrease the number of the boarding school inhabitants by 40 per cent.
Mariam’s storyMariam Mamadashvili was born in 1992 in Tianeti. Within the scope of the Programme on “Prevention of child abandonment and de-institutionalization” Mariam was able to return to her biological family in January 2006.
The reason that forced the family to send Mariam to the institutions is very common – severe social-economical conditions. Mother could not provide her daughter with basic nutrition and living conditions. Mariam’s parents got married in 1990; her mother had a son from the first marriage. Family had problems from the very beginning, especially considering the fact that Mariam’s brother had very bad relations with the step-father. The financial difficulties forced Mariam’s father to leave for Volgograd, Russia and seek job opportunities in another country. Later on the whole family moved to Russia, though soon father left his family living them in very difficult conditions. The economic hardship forced Mariam and her mother to return to Georgia; attempts to find a job were unsuccessful. Finally Mariam’s brother left to live with his father’s parents. Mariam’s mother started to work at Tianeti public school as the cleaning lady.
Within the scope of the state programme the Ministry of Education and Science rendered financial assistance to Mariam’s family, but they still live under the risk of loosing their house - currently they live the in the block which is due to privatization and if they do not pay the respective fee, family will have to leave the apartment. Considering the importance of maintaining the sustainability of the family environment for Mariam, the social workers work closely with the local government to find the best solution for the problem.
Back to home, Oleg’s story
The programme provides the family with the financial assistance, but they still live in acute financial hardship. What was important the family provided Oleg with the warmth and care he was missing in the institution, but he still has low self-esteem, has communication problems, is shy and is not active. Considering these facts, the social workers try to include him into different educational activities, excursions and other cultural events. Social workers also plan to support his inclusion into the activities of the community center of Tianeti village. This will ensure his integration into the society and adaptation to the social environment.
The child welfare reform is being implemented in the seven regions in Georgia (Tbilisi, Kutaisi, Telavi, Tianeti, Zugdidi, Batumi, Rustavi). The programme was first initiated by UNICEF and other donors and then entirely taken over by the Government. As of now about 1500 child have returned from institutions to the family environment thanks to the programme.
Only in 2006 total number of children who have returned to their families children was 342, number of children placed in foster families – 108 and 383 children were prevented from abandonment.
Natia, 14, Ia, 13 and Tatia, 10, Revishvili are among these children. They were placed in Etseri children’s institution near Kutaisi, west Georgia when their mother passed away in 2004. Parents of the girls were not married and the father was living with his official wife and his little son, brother of the girls. After the de-institutionalization programme was launched in Kutaisi, it became possible to reintegrate Natia, Ia and Tatia Revishvili into their biological family. Now the girls are living with their father, step-mother and a little brother, in their own family.
Since 2002, in total 218 children have been returned to their own or placed in foster families in Kutaisi.
The most important aspect of the child welfare reform is development of the National minimum standards for statutory, family support and family supplement services which aims at elaborating norms and regulations for all types of child care units, state institutions or alternative child care services like day care centre, group family etc.
Technical working group created by the Inter-Ministerial Commission on Child Protection and Deinstitutionalization and supported by UNICEF developed a comprehensive set of the National Minimum Standards for the State, family support and family substitute services. The standards will set national norms for the implementation and monitoring of these services.
These standards do not imply determination only of minimal living space for children or defining nutrition ration: “child care must be ensured at adequate level at different institutions” – says Nino Kupatadze Coordinator of Technical Secretariat of the Governmental Commission on Child Protection and Deinstitutionalization. -We must establish a system that will protect child rights, will ensure children’s independent decision-making, and will assist children’s personal development and their integration into the society”.
By the year 2008 elaboration of efficient regulation system is planned, afterwards it will be quite easy to implement, inspect and require adherence to the standards.
More social work professionals will care for the people in need
In the framework of the project, the association is developing a comprehensive package of social work practice standards and creating an effective mechanism for the professional licensure of social workers in Georgia. The work is expected to be completed in December 2006. Five highly qualified consultants (with master degrees in social work) and representatives of the local government and non-governmental organizations are participating in the project’s preparatory work. A legal consultant from the Ministry of Labour, Health and Social Affairs is involved in the development of a licensure mechanism, while other experts from the ministry are providing feedback and consultations. Through this inter-sectoral collaboration, the association aims to build the capacity of the ministries’ staff and integrate their input into the project.
Social work standards will promote the establishment of effective social work services in Georgia and create the opportunity for professional monitoring and supervision. A social work licensure mechanism in line with professional standards will ensure the high quality of social services and promote increased accountability in social service delivery. Stakeholders, such as social service providers and the general public, will benefit from the outcomes of the project.
Within the framework of the project, a one-year social work curriculum was developed at Tbilisi State University. The principles of the social work curriculum are entirely in line with the standards that have been adopted by Tbilisi State University in the framework of ongoing reforms.
The curriculum was funded by Tempus only for 2006, so additional financing was needed in order to fully implement the project. “UNICEF helped made it possible to continue this training, which is extremely important,” says Iago Kachkachishvili, Director of Sociology Department at the Tbilisi State University, Faculty of Social and Political Sciences. “That the programme is necessary is evidenced by the fact that today in Georgia we have 150 social work specialists, but we could only afford to train 44 of them. That is why we needed additional funding to train all of the country’s social workers. With the help of UNICEF we can receive new applications to start another course in 2007.”
The University has already launched the BA course for social workers and next year it is expected to receive MA students as well.
Since 2002 UNICEF in Georgia has been partnering with the Ministries of Health and Education as well as with World Vision and Every Child to prevent infant abandonment by providing support to single mothers to cope with the social and financial pressures that lead them to abandon their infants. The project has developed and documented new modalities of child care and support to mothers. As part of the project, Mother and Infants’ Shelter was opened at the Tbilisi Infant's Home in April 2003. Since then, social workers have identified 208 mothers at risk of child abandonment.
Niko is four years old. He is proud of his new twin brothers David and Giorgi. His mother Maia was thinking of abandoning newly born twins because she could not take care of them. Fortunately, it did not happen and Maia found support she needed so desparetely. Now they are at the home for abandoned mothers. This shelter funded by UNICEF and World Vision gives her the chance to keep her family with her.
"It provides an alternative to child abandonment", says Giovanna Barberis, UNICEF Representative in Georgia, "Mothers are staying with their babies. We help them to find some way of living and thus stay together".
Irina came to the shelter directly from the Maternity Hospital. The people at the shelter give employment assistance and training for the mothers while they are there. As part of the employment assistance, she was offered to study as a seamstress at a local design studio. It gives her the chance to learn sewing and design techniques.
“I am more confident in myself now”, Irina says. “I want to learn more and probably one day I will be able to open my own shop. Maybe my own design studio”.
“It was a hot August day, when I gave birth to my baby. I called her Ann. Only my closest friends congratulated. My parents never came to see my daughter. So, at the Maternity Hospital I already knew that from now on I had to take care of myself and my new-born daughter. I had to find a home and to ensure an income for living. It was the hardest time for me.”
At the fifth maternity hospital, with the help of a hospital lawyer Lali found out about Mother & Infant Shelter, established with assistance of UNICEF and World Vision. Social workers contacted Lali at the maternity hospital and offered their help. “I was left alone with my infant. But still, it was not easy for me to ask strangers for those things that were supposed to be provided by myself and my family. I simply had no choice. My social worker provided us with essential goods – food products, toys, clothes. I am very thankful for both material and moral support!”
Lali still lives in Mother & Infant Shelter. Her daughter is already fifteen months old. For the New Year’s time Lali intends to reconcile with her parents and plans to return to parents’ home with her baby.
“With the help of UNICEF the same project was implemented in Adjara” – says Maya Tsereteli, manager of the project. Presently there are 2 Infant Houses in Georgia – in Tbilisi and in Makhinjauri. The managers of Mother & Infant Shelter together with UNICEF are developing three-year strategy concerning the transformation of infant houses in Georgia.
Assessment of Internally Displaced Children and Teenagers Living in Collective Housing Centres in Georgia
In the early 1990s Georgia underwent two bloody conflicts in the regions of Abkhazia and South Ossetia that forced hundreds of thousands of people to flee their homes and seek shelter elsewhere in the country.
Many of these internally displaced persons (IDPs) do not have access to necessary social services. In order to determine the needs and problems of the internally displaced population, especially children and young adults living in collective housing throughout the country, UNICEF and the Norwegian Refugee Council conducted a rapid assessment in August-October 2006.
With the government of Georgia currently finalizing its National Strategy on internally displaced population, the assessment was recognized as a significant step towards gaining a better insight into issues concerning IDP children and teenagers.
The rapid assessment was carried out by two teams of “youth researchers” in Tbilisi and Zugdidi (in western Georgia, near the Abkhaz border). Each group included three adult research advisers - one international and two local. They gathered information from 18 collective housing centres in urban and rural areas in and around Tbilisi, Rustavi, Gori, Tskaltubo, Zugdidi and Senaki.
The concerns most frequently expressed by the focus group members dealt with the lack of proper housing and employment opportunities. They also noted that Internally Displaced children sometimes take risks by paying short visits to the conflict zones to see their families and tend to their lands. In addition, they are ostracized by local children for being internally displaced and for living in collective housing centres, which leads to further psychological and adaptation problems such as inferiority complexes and social isolation.
Internally displaced population are under the constant fear that the government will force them to leave their homes and friends at any moment. Although they live in the collective housing centres with poor environmental and sanitary conditions that often cause various health problems among Internally Displaced Population, they call it a home. Moreover a lack of information regarding the spread of HIV/AIDS creates an increased risk of infection among IDP-s.
During the first stage of the project number of seminars and training events were held regularly for justice ministry officials, including juvenile detention centre Officials, judges, police officers, for prosecutor’s officials and journalists. “The aim of the seminars was to familiarize the law enforcement community with the international standards of juvenile justice and to ensure that Georgian legal system is brought in line with Human Rights Law related to Juvenile Justice- says Ucha Nanuashvili, Director of the Human Rights Information and Documentation Center - seminars for journalists were organized to get them acquainted with the international standards of reporting on children in conflict with law. The main objective of the programme is to implement the quality and decent alternative places for deprivation of liberty for the children in conflict with the law in Georgia.”
The one of the main objectives of the programme was to improve juvenile offenders’ employment prospects after their release by preparing them in various subjects and giving them opportunity to develop their skills in various fields. Accordingly computer, English language and carpentry classes were carried out for Juvenile prisoners. A special rehabilitation center was established for the juveniles with asocial behavior in the colony, where they were able to get the relevant psychological assistance.
The Ministry of Justice with technical support of UNICEF built the capacity of all personnel working in the penitentiary and probation systems in social work was established. Respective adjustments have been made to the training programme, which was incorporated into the national Pre and In Service Training curriculum. In mid and long terms, the convicted juvenile prisoners in the penitentiary and probation systems will benefit from the improved social welfare and justice provided by the trained personnel.
How to reform the system of juvenile justice administrationUNICEF’s technical support to the Government was significant in the formulation of an action plan for the reform of the system for children in conflict with law. This partnership reaffirmed the centralized approach to assess the situation in reflecting international child justice norms and standards in relevant national laws and policies.
For this propose UNICEF invited international expert, professor of law of the Essex University Caroline Hamilton visited Georgia in October-December to assess the situation in relation of juvenile justice administration in Georgia and to draw up concrete recommendations for policy reform.
Ms Hamilton had meetings with the representatives of the Parliament of Georgia, Ministries of Interior Affairs and Justice, Supreme Court. She visited children in pre-trial detention facilities, police isolators and colonies to get a clear picture of the situation and to define further actions.
“The main area of concern is the issue that Georgian criminal justice system is very rigid and does not meet children’s needs”, says Caroline Hamilton, “Considering existing gaps in the system it is very easy to criminalize children”.
Deprivation of child’s liberty should only be used as a last resort and for the shortest possible period of time. Unfortunately, detention in Georgia is used as the first and the only resort that is not compatible with international legal standards for the administration of juvenile justice. Detention before trial should be avoided to the greatest extent possible, and all efforts should be made to apply alternative measures.
State efforts should be directed towards prevention of juvenile offences. The Government should address offending behaviour of children, to study the reasons behind this behaviour and try to change this. The reasons can be different like poverty, poor parenting, and homelessness. Efforts should be directed towards eradicating these causes and thus changing the offending behaviour of children.
If child is involved into the criminal justice system, current law and practice should focus on the rehabilitation process. A range of non-judicial alternatives and sentencing options like release under supervision of parents, bail foster care etc should be applied.
The administration of juvenile justice requires specific skills. International standards envisage setting up a comprehensive child-centered juvenile justice process administered by specially trained police officers, lawyers, prosecutors and judges. It is recommended to create juvenile courts and special procedures designed to take into account the specific needs of children.
“Impact of juvenile justice system is extremely negative on the lives of children. It severely affects the psycho-social and emotional development of a juvenile offender, and fails to promote the recovery and social reintegration of a child into siciety”, says Caroline Hamilton.
Based on the recommendations of Ms Hamilton, UNICEF will facilitate setting up a group of experts to develop further strategy for juvenile justice system reform.
Journalists Training Curriculum on Children’s Rights
The university has long offered Bachelor’s and Master’s degree courses in journalism, though until recently, it has relied on a largely academic and theoretical approach to this profession.
UNICEF Georgia, in partnership with the journalism department of Tbilisi State University as well as other media training institutions, initiated the process to institutionalise children’s rights in journalism curricula, so that the new cohort of journalists are aware of the rights of children, and the methods of reporting on the subject.
From 23 September to 8 October 2006, UNICEF consultant Mike Jempson, from the Media Wise Trust, British media ethics organization, visited Georgia to support UNICEF in developing a training curriculum on child friendly reporting. During the two week consultancy, a draft training module on child-friendly reporting was prepared and a three-day workshop was conducted for representatives of Tbilisi State University, the Caucasus School of Journalism and Media Management and other training institutions. The workshop’s aim was to devise a practice-based training course on reporting on children’s issues that would improve professional standards of journalism within Georgian media.
As a result of the consultancy a complete set of indicative training materials has been devised together with guidance on their implementation. It is planned to finalise the curriculum and to further pilot the training materials to assist trainers in production of their own materials and to ensure that they are confident about how to apply them. This will be undertaken during the next phase of the consultancy planned in 2007.
UNICEF has initiated serious efforts to improve monitoring and reporting on child rights. In this regard UNICEF was active in supporting independent human rights institutions like public defenders’ office in enhancing monitoring capacity.
UNICEF continuous advocacy with the Public Defenders’ Office in Georgia resulted in re-creation of the child rights’ centre within the Public Defenders’ Office. Thanks to UNICEF efforts the revitalised child rights centre became a member of the European Network of Children’s Ombudsmen (ENOC) and the representatives of the centre attended the ENOC meeting in Athens.
UNICEF also supported representatives of the Public Defenders’ Office to undertake a short-term study visit to the Ombudsman’s Office in Spain having the most successful experience in child rights’ monitoring. As a result of the visit in December 2006, a concrete plan of action to further enhance monitoring of child rights by the PDO centre was developed.
The Leave No Child Out project was launched by UNICEF and other partner agencies in 2003 as an offshoot of the Regional Network Campaign. Its main objective was to establish and develop children’s rights institutions in Central and Eastern Europe and in member countries of the Commonwealth of Independent States.
The first phase of the project (January 2003 – May 2004) focused on regional and sub-regional activities: conducting a needs assessment survey, compiling a list of children’s rights trainers and existing materials on the subject, developing and piloting a Children’s Rights Resource and Training Manual and organizing five sub-regional training workshops for future instructors.
Phase II of the Leave No Child Out project covered the period December 2005-June 2006 and focused on national level activities: training workshops and the development of country-specific manuals concerning children’s rights.
With the active support of the LNCO project, a country-specific training manual was developed for Georgia. In May 2006, three five-day training workshops were held for NGOs, Public Defender’s Office employees, media representatives and university professors. In addition to the workshops, five one-day round-table meetings were organized on the following topics: strengthening cooperation between NGOs and the Public Defender’s Office; initiating the inclusion of training manuals in the national curriculum; beginning discussions with government representatives regarding the latest recommendations of the CRC Committee on children’s rights and the feedback of the countries involved to these recommendations and beginning discussion between the children’s rights consortium and media representatives regarding the enhancement of further collaboration, which will ensure journalists participation in the monitoring process.
The results of the project were presented at a round table and at the Second General Assembly of the Regional Network for Children held in Tbilisi on 8 – 12 June 2006.
UNICEF, together with its partners Coca-Cola and Elit Electronics, have come together to support an annual global football tournament for children, both boys and girls, under 13 years of age. The Jetix Kids Cup, formerly known as The Fox Kids Cup, is organized by Rustavi-2 TV, one of Georgia’s leading media outlets.
The Jetix Kids Cup kicked off on 14 April 2006. Its aim was to promote a healthy, lifestyle, as well as intercultural ties among young people from all over the world.
The project coordinator from Rustavi-2 TV, Jano Zhvania, says that The Jetix Kids Cup is the only football tournament in the world organized by the media and that it was the best way to encourage children to live a healthy and active lifestyle and form sports clubs.
The Jetix Kids Cup, which has been held for the past three years in Georgia and for the past seven years internationally, has already gained an enormous popularity. Some 4,000 children participated in the tournament, which covered 20 Georgian cities. The final tournament was held in Tbilisi on Children’s Protection Day in Georgia on 1 June. The winning teams represented Georgia at The Jetix Kids Cup 2006 finals in July in Munich, Germany at the Munich Olympic Stadium, where the FIFA Football World Cup 2006 was held. Representatives of 14 countries all over the world participated in the finals. Georgia was the only participant country from the CEE/CIS region. The tournament’s main partner is UNICEF worldwide.
“Football is more than a game for UNICEF. We think that it is a very influential and therefore essential tool to promote tolerance and peace among the younger generation,” UNICEF representative in Georgia Giovanna Barberis said. “Since 2001 UNICEF has been energetically supporting various football tournaments and we will continue to use football and sport in general as a very vigorous tool for education and the promotion of core values of self-respect and cooperation.”
Georgia was not among the winner of the final tournament but little Georgian footballers did whatever adults could not do. Georgian flag was flying on Munich Olympic stadium during the World Cup Days.
Forum Theatre in Georgia
The performance is part of the interactive theatre initiative designed by the British Council and implemented in Georgia, Azerbaijan and Armenia. The launch of the performance was held on 1 December with the support of the British Council and BP.
UNICEF support came in extending the performance to the different regions of Georgia. The performance focuses the problems of street children in Georgia and uses the participatory technique called the forum theatre.
The forum theatre enables the audience to get involved into the performance and influence the outcome of the play. Some characters (“the oppressors”) remain the same, while the other characters in the scene (“the oppressed”) will be replaced by audience members who apply different scenarios to prevent or stop the violence as it is happening. Audience members are allowed to attempt their solutions until they feel satisfied they have done everything they have wanted to do. Several audience members can replace the same character if they desire. After the forum scene has been worked through, discussion takes place about the issue.