Situation of children
Half of the children under 5 suffer from chronic malnutrition, putting Madagascar among the six worst countries in the world with the highest rates. Maternal mortality has stagnated at 498/100,000 live births, neonatal mortality is at 24/1,000 live births and only 69 per cent of children below one year are completely vaccinated against DTP. The number of non-vaccinated children is on the rise since the beginning of the crisis with more than 107,888 children in 2012, an increase of 11 per cent since 2011. An increasing number of primary health care centers are also closing down, by the end of 2012 121 CSBs (about 5% of all CSBs) were closed, mostly due to lack of human resources. Many of the CSBs are only functioning with one staff.
While access to safe water is relatively high in urban areas, rural areas are suffering from a serious lack of service with less than 34 per cent of population indicating they have access to improved drinking sources2, resulting in Madagascar being placed as the fourth worst country in Africa with regards to water access. Sanitation also remains a major challenge with over half of the population lacking adequate access to proper latrines, which puts Madagascar together with Mozambique at the lowest levels of access to sanitation in southeastern Africa. This situation is exasperated by the fact that the government budget allocation for water and sanitation has more than halved since 2010.
Prior to 2009 Madagascar seemed to be on track to achieve universal access in education, but by 2012 many key indicators were either stagnant or in decline. An increasing number of school aged children have poorer access, experience weaker quality of education and increased inequities are apparent nationwide. More than two million children do not attend pre-school and approximately 1.5 million children of primary school age are out of school. Only 3 children out of 10 who start primary school complete the cycle and two thirds of teachers have not received any formal training at all. The government budget allocation for education has declined by nearly 4 per cent since 2009, and costs of education for families have therefore significantly increased to compensate for this reduction in funding. At the start of the 2012/2013 school year, most primary schools continued to demand registration fees from parents to compensate for the lack of funds arriving at school level for basic operating functions. Overall it is estimated that the average Malagasy adult has only completed 4.4 years of formal education.
Next to the lack of financial and human resources, challenges in delivering quality social services to the population also include the difficult physical accessibility of large parts of the country and behavioral factors of large parts of the population which follow deeply rooted beliefs. These vary widely between groups but range from different concepts of family and community to a strong adherence to traditional belief systems which include taboos impacting the whole life-cycle, such as nutritional restrictions during pregnancy or the rejection and stigmatization of twins.
There is concern about the increasing number of children living without parental care, which further contributes to an increase in violence against children and treatment of children by the judicial system. These form the backbone of the issues raised in the recommendations of the United Nations Convention on the Rights of the Child Committee’s 59th meeting in January 2012. A draft action plan to implement these recommendations is currently being prepared by government and will be properly integrated into the next UNICEF programming cycle.