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CEECIS - Achieving MDGs with Equity: Reaching the most Vulnerable and Excluded

Most countries and territories in Central and Eastern Europe and the Commonwealth of Independent States are on track to achieve many of the Millennium Development Goals for children and women by 2015. The main challenges are child mortality and HIV/AIDS prevention and care which are still off-track in a number of countries. The Region has very positive headline data, with some of the best development figures in the world.

This is thanks to several waves of reforms which governments have led over the past two decades to cope with the impact of the economic and social transition on children and women. It is to their credit, and to the credit of millions of parents and communities, that the Region has overcome some of the worst consequences of the fast pace of liberalisation of the social and economic systems, and that progress for children, albeit uneven, has taken hold for many.

It is, however, becoming increasingly evident that, in the wake of these reforms, large sections of the population are being left behind. A swelling number of children and women whose rights are violated are marginalised and excluded.

Most countries in the Region have experienced almost a decade of double-digit economic growth. Yet, there are as many as 160 million people in CEE/CIS that are considered vulnerable because they live on less than 5 dollars per day.  The number of children deprived of parental care has not decreased, and in many cases has actually increased: 1.3 million children are currently deprived of parental care and live in different forms of family substitute care, with some 600,000 of them growing up in institutions. The Region has one of the highest rates of suicide and unemployment among young people.  The highest rate of growth of HIV/AIDS in the world is in CEE/CIS, which is now also home to 3.7 million people who inject drugs, representing one quarter of the world’s total. For many affected children and families, HIV has become synonymous with a life of stigma and exclusion.

These are clear manifestations of deeply-rooted problems of exclusion from social services, marginalisation and entrenched discrimination against certain population groups. The benefits of economic growth and social development are not helping children of ethnic minorities, those with disabilities, and those living in rural or marginal urban areas. For example, in some countries, children from Roma communities are 8.5 time less likely than children from the general population to have access to early childhood education, and the net enrolment rate of Roma girls in primary schools is just less than 60 percent, while it is almost universal among the general population.

Experience from other parts of the world shows that social exclusion and marginalisation of the magnitude that now exists in CEE/CIS tends to become so entrenched that these factors may well present a real obstacle to reaching many of the Millennium Development Goals. Research also shows that reversals are likely to occur in the well-being of children and women.

What is more worrying is that there is evidence of deterioration in the quality and relevance of services that will only perpetuate inequities and will deprive socially-excluded children and adolescents of the opportunity to develop their abilities.  

In MDG 2, we see that CEE/CIS has the best net enrolment rate for school attendance outside the industrialised world – over 90%. But about 1.8 million children of primary school age, and another 1.5 million adolescents of lower secondary school age were not in school in 2007. For millions of children, their school journey is often marked by late entry, grade repetition and dropout with few if any ‘second chance’ opportunities to return to school. Gender disparities in school enrolment are also still conspicuous in some countries.

Regarding gender equality (MDG 3), between 6% and 18% of women (20 to 49 years) in the Region were married before age 18. Women with lower levels of education are more likely to be married by age 18 than women with higher levels of education.

While headline data for immunization coverage puts CEE/CIS on track to achieve its MDG 4 goals, the reality is different at a sub-regional level and among ethnic minorities. The Region this year had the dubious distinction of being the world leader in new polio cases. 75% of the world’s new polio cases were recorded so far in Central Asia. Among the Minority Roma in Eastern Europe immunization coverage rates are also alarmingly low.

For MDG 6, although absolute numbers of young people living with HIV are currently lower than those in other developing regions, Eastern Europe and Central Asia are the only parts of the world where the HIV epidemic is clearly on the rise. The highest worldwide prevalence of injecting drug use is found in four countries of the Region. Without policy reforms, programmatic shifts, and a reallocation of resources to strengthen health and social protection systems it is unlikely the HIV-AIDS epidemic will be halted or that the Region will meet its MDG targets.

We have just five years left to accomplish the future we envisioned in 2000, and to vindicate the commitments countries made to meet the MDGs. Actions must be taken to reduce inequality, ensure the national systems respond to exclusion issues by adopting more equitable policies and by improving the quality of services. As a priority, governments must focus on the poorest, the most marginalised and the most vulnerable members of society by committing to:

  • Embed equity into national statistics and ensure adequate data collection and management systems are in place to identify the most vulnerable and excluded populations and to reflect disparities within a country; 
  • Commit to ongoing public sector reform aimed at enhancing equity in social protection systems for children, and support these reforms with adequate funding;
  • Ensure the participation of socially excluded families and communities when  formulating national and local policies;
  • Improve quality of services so that the poorest 20% of children, women and ethnic minorities can benefit from them
  • Monitor impact of reforms, policies and activities on socially excluded populations and progressive realisation of children’s and women’s rights.

UNICEF today has released its ninth edition of Progress for Children which is a report card on progress towards the MDGs. It has also released a parallel study which makes a case for investing in cost effective measures to narrow disparities within countries.

UNICEF operates in 22 countries and entities in the CEE/CIS Region with programmes aimed at supporting Governments to realise the Millennium Declaration and meet the MDG targets. Our programmes have purposefully re-focussed on specific reforms of the public sector aimed at reaching the most excluded, marginalised, disadvantaged and vulnerable children and women in four areas:

  • Child survival and early childhood development
  • Inclusive education for children with disabilities and Roma
  • HIV/AIDS prevention and treatment programmes for the most-at-risk mothers, children and adolescents
  • Reform child care systems, particularly to support deinstitutionalisation, and juvenile justice reform.





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