UNICEF Turkmenistan focuses on priority areas related to improved maternal, newborn and child health and nutrition, as well as on prevention of infectious diseases, to assist the Government in achieving international development goals. UNICEF supports government in the formulation of child-centric national laws, development of national capacities, and building of critical linkages that enable professionals in the country to access the best international practices.
Supporting Quality Care
Despite a notable downward trend, under-5 and infant mortality rates in Turkmenistan require further reduction, as do malnutrition rates and micronutrient deficiencies. Considerable disparities are found between geographic regions.
Quality care for young children is being ensured by UNICEF’s promotion of exclusive breastfeeding; improved knowledge of families and caregivers on appropriate care for newborns and young children, including Infant and Young Child Feeding (IYCF) and Integrated Management of Childhood Illnesses (IMCI); and addressing of knowledge and skills of health workers. Development of a preventive health and nutrition policy and strategy are being pursued.
Strengthening National Capacities and Generating Knowledge
Attention is particularly being given to the strengthening of Government capacity for planning, monitoring and evaluation, and quality assurance of successful, nationally owned immunisation, flour fortification and salt iodisation programmes; all of these programmes have resulted in notable advances in ensuring the survival and health of children in the country. Elimination of Vitamin A deficiency is being promoted through a supplementation programme. Efforts to integrate prevention of mother-to-child transmission of HIV (PMTCT) into effective perinatal care also are being kept on the agenda.
UNICEF has been especially successful in supporting a series of strategic studies to generate key knowledge. For example, results of the National Nutrition Survey 2011, which confirmed that nutritional deficiencies among children and women remains to be a public health problem in the country, have provided evidence for development of a national strategy on tackling anaemia and Vitamin A deficiency.
Institutional capacity development has emphasized strengthening of Primary Health Care (PHC) services, based on evidence from the UNICEF-supported PHC Mother and Child Health (MCH) assessment. As part of this strengthening, for example, an updated PHC nursing module has enhanced counselling capacities of nurses in pilot districts, which in turn has led to improved relevant knowledge and skills of parents in critical areas of child care such as nutrition, immunisation, Early Childhood Development (ECD) and injury prevention.
UNICEF has provided key support on health systems strengthening with regard to ECD as well, including upgrading the effectiveness of the home visiting system. Notably, the opportunity exists for Turkmenistan to be a global pioneer in enhanced home visiting for improved well-being and development of young children, through cross-sectoral cooperation and development of new and more effective systems models.
The culture of evidence-informed decision making and supportive supervision in child survival and health has been cultivated at the national and district level through introducing of new methodologies, such as real-time monitoring for assessing the quality of MCH care and strengthened facility-level analysis of the causes of child deaths.Assisting the Development of Improved Policies
Major achievements at policy level include UNICEF support to development of the Law on Protection and Promotion of Breastfeeding and Requirements for Infant Feeding Products, National Early Childhood Development Programme, National Nutrition Programme and National Mother, Newborn, Child and Adolescent Health Strategy.Key Strategic Initiatives
Turkmenistan’s increasing responsiveness to its international commitments is illustrated by the Government’s signing of the global initiative on child survival, A Promise Renewed. Under this, the country has pledged additional focus on child health and development issues, particularly the deaths of children under age 5, in collaboration with UNICEF. For its part, UNICEF is focused on reaching the most difficult-to-reach and the most disadvantaged children.
At the same time, the Government is strongly interested in promoting developmental paediatrics and early detection and intervention with regard to child developmental delays and disabilities. As a result of UNICEF’s continuous effective advocacy and knowledge management, the Government has decided to introduce early detection and intervention services for children with developmental difficulties into the MCH system. Establishment of a Developmental Paediatrics Department has been proposed at a newly built MCH centre, and technical assistance is under way to development of a National Concept for Introduction of Developmental Paediatrics.
Leveraging Government finances remains a key programmatic strategy for health.Lastly, Communication for Development (C4D) has been an intrinsic component of cooperation between UNICEF and the Government, especially through the partnership with the National Health Information Centre. This longstanding cooperation has enabled effective behaviour change interventions for caregivers and children to sustain healthy lifestyles through health communication, as well as capacity and confidence development in the areas of MCH, ECD and life skills.
With the support of the German company RWE DEA AG, the promotion of the Facts for Life booklet, which elaborates on essential behaviours and practices for saving and protecting the lives of children, has been extended to PHC workers, as well as academics and medical specialists. Key Facts for Life messages have been channelled through various media platforms, including puppetry. An interactive play, “The Childhood Rainbow,” focused on the promotion of equity and respect for human diversity, integrating holistic themes related to health, education and child protection; it reached thousands of children and parents, including in remote parts of the country.
In addition, partnership with the health and education Ministries and development partners resulted in rolling out an adolescent health and development campaign, promoting healthy lifestyles and prevention of risky behaviours among 12- to 17-year-old boys and girls. UNICEF also has contributed to the National Road Safety campaign through communication interventions for children and adults alike.