Uzbekistan 2005 – 2009 Progress on key indicators

Key Progress Indicators

Policy and associated implementation mechanisms developed

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  Related regulations on basic education revised according to CRC and CFS concept.
  
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  National CFS concept developed and included into National School Charter.
  
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  Scientific Experiment to validate CFS experience has been initiated in Navoi Pedagogical Institute, which will provide evidence for countrywide expansion of CFS.
  

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  Strong Government commitment to evaluate CFS and use successful experience for nationwide replication
  
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  Capacity gaps due to changes in management at all levels in the Basic Education system.
  

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  State birth registration countrywide is in line with the WHO standards
  

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  The international standards for pregnancy, peri-natal and neo-natal care, IMCI and nutrition are implemented as standard care.
  

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  Two systems of live birth definition coexist. WHO LBD will become universal in 2010 according to the state plans.
  
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  Standards for peri-natal and neo-natal care are developed and implemented in 6 regions and will be scaled up nationwide by 2010
  

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  The existence of two parallel systems creates challenges in reporting, critical analysis of the situation, and planning processes.
  

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  % of households nationwide consuming iodized salt.
  

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  % of households nationwide consuming iron-fortified flour
  

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  A Nutrition Investment Plan, encompassing an integrated package of nutrition interventions, was developed and recently approved by the Cabinet of Ministers.
  
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  Law on Iodine Deficiency Disorders (IDD) was adopted in 2007 and the development of regional action plans for its implementation is in progress.
  
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  UNICEF supported the Government to set up a revolving fund for procurement of potassium iodine.
  
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  Sanitary and Epidemiological Services and Institute of Endocrinology have strengthened the monitoring system of iodization at all levels (production, packaging, sales, and households). In addition, a parliamentary group was established to monitor the implementation of the IDD law.
  

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  # of districts/cities reporting DPT3 coverage >90%
  

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  # of districts reporting measles coverage >95% Baseline no data available
  

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  The system to maintain the cold chain for vaccines’ appropriate storage was significantly strengthened through health care providers training and the provision of equipments to monitor energy cuts.
  
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  Pentavalent vaccine was introduced nationwide, although there is no information on coverage yet.
  
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  Approximately 4 million 11-18 years old children were reached by the mass measles vaccination campaign in 2007.
  

% of routine vaccine supplied with Government funds

National Protocols and Standards for Youth Friendly Health Services (YFHS) programming and quality assurance and associated implementation mechanism

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  YFHS standards adopted nationally according to the decree of the Ministry of Health
  
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  YFHS included into the curricular of post diploma training Institute of Medical Doctors and General Practitioners
  

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  YFHS is included into the National Strategy on HIV/AIDS Prevention for 2007-2011.
  
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  Health services for Most at Risk Adolescents (MARA) are not confidential
  

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  % of children enrolled in improved schools;
  
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  Number of child friendly schools in priority geographical areas
  

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  Following the decision taken during MTR 2007, the number of target schools has been significantly increased (from 51 to 700). Currently, the new target has already been surpassed (750 schools and 30% of enrolled children in the selected areas). By end of 2009 it is foreseen to reach 1,000 schools.
  
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  100% of schools offer health lessons which include information on HIV/AIDS prevention.
  
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  40 CFS were supported to improve their water and sanitation facilities and bring them in line with Child Friendly Schools standards.
  
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  Awareness raising activities on WASH have been realized in all CFS. Child participation mechanisms are in place to deliver WASH education activities.
  

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  Government is committed to national scaling up of CFS initiative;
  
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  Government provided funds for printing of textbooks on Health lessons for grades 1-4.
  

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  % of women, children and their families utilizing certified PHCs that provide medical services/health care in accordance with WHO protocols in priority geographical areas
  

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  % of PHC centers which are certified and provide medical services and health care in accordance with WHO protocols in priority geographical areas
  

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  % of baby-friendly maternity hospitals in priority geographical areas
  

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  Access to PHC services is generally high; there are some gaps in meeting international standards in service delivery. Trainings on WHO protocols were conducted for health professionals of 6 regions.
  
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  New standards for growth and development monitoring as well as for infant and young children feeding (WHO recommended) were included in the curriculum for undergraduate medical students.
  
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  Clinical guidelines on ARI and diarrhea are implemented in one region (Ferghana)
  
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  Supportive supervision activities (monitoring and enforcement training) took place in 70% of PHC in all selected areas with increasing clinical knowledge for 30% in low performing areas (MOH monitoring data 2008)
  

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  There is strong commitment from the Government to implement the Child and Newborn Survival Package nationwide.
  
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  Currently, not all PHC centers have all necessary equipment; therefore trained professionals have limited possibilities to apply the acquired skills. This situation will be assessed in 2009 and EU funding for MCH will also contribute to improve the situation.
  

% of families in priority geographical areas that employ appropriate child care and rearing practices in accordance with existing ECD standards

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  As in all cases of behavioral change, such interventions entail a slow process. Changes in child rearing practices were particularly challenging as they are deeply rooted in traditions.
  
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  The administrative structure of the implementing partner was highly effective in reaching targeted families (they have the proper know-how and a deep understanding of local culture and dynamics which allowed to use resources in a more efficient way).
  

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  % of children participating in group child care and learning activities in priority geographical areas
  

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  Policy developed as part of the “Healthy Generation” state programme
  

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  Since the development and adoption of the national policy on establishing alternative forms of preschool has taken two and a half years, the access to this type of service is increasing more slowly than expected.
  
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  As a result of the adoption of the above regulation as well as the advocacy efforts held at local level, mahallas have started to take the initiative in establishing alternative forms of preschool.
  

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  Due to the variety of stakeholders involved, the process to develop and adopt the policy has been longer than expected.
  
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  Preschool education is becoming a higher priority due to evidence-based policy dialogue.
  

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  Existence of a standard data collection mechanism for vulnerable children in the pilot districts
  

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  # Family and Child Support Services (FCSS) staffed with certified social workers in pilot regions
  

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  Minimum standards of care for current institutions developed
  

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  Family and Child Social Services (FCSS) are established in all five priority regions to improve gate-keeping mechanisms, prevent institutionalisation of children and provide family support and alternative care arrangements.
  
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  Social work field is registered as a profession with its own budget allocation, and three universities offer social work education at undergraduate level and one at graduate level.
  
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  Thirty social workers of FCSS and one hundred child protection professionals received the first diplomas of social work as a second profession.
  

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  The yearly Child Protection Forums held since 2004 contributed to a better coordination and allowed the Government and the Social Adaptation Centre to take the lead on the child care system reform
  

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  Insufficient data on child protection indicators
  

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  # of national laws adopted to comply with CRC and other child rights related international conventions
  

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  # of secondary legislation developed, and legislations amended to comply with CRC
  

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  # of international conventions related to child rights ratified
  

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  Existence of a coordination body as well as an independent monitoring mechanism for observance of the rights of the child
  

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  National laws adopted are: Law on the “Guarantees of the Rights of the Child”, Law on juvenile justice (draft), Law on Child Ombudsman (draft).
  
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  Secondary legislation are: Guidelines for justice professionals working with children, Regulations on ‘Adoption/Patronage’ and ‘Family type housing’ (amended), Regulation on Children’s Towns, Regulations on current state orphanages (amended), Minimum standards of care (drafted).
  
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  International conventions ratified: ILO 182 and ILO 138; 2 CRC optional protocols, Palermo protocol on human trafficking
  
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  The Public Council formed under the Republican Social Adaptation Centre is in charge of coordinating CP issues.
  
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  A course on Child Rights (including juvenile justice) is introduced in Tashkent Law Institute at Master level and approved by MoEd to be included into the curriculum of all law schools.
  

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  Government’s commitment
  
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  CRC concluding observations provided key recommendations.
  
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  NPAs on CRC concluding observations, ILO Conventions 138 and 182
  

Constraints:

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  Gaps in coordination mechanisms and holistic approach in addressing CP issues
  
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  Good laws but weak implementation mechanisms/capacity at operational level.
  

% of MARA with knowledge about HIV/AIDS, STI drug use prevention and testing/treatment in priority geographical areas

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  1% of adolescents injecting drugs named correctly all modes of HIV transmission and the means of reducing the risks of contracting (KAPB survey, 2006)
  

2.8 60% MARA in priority areas of Ferghana region (Ferghana town, Bagdad, Margilan, Quva, Kuvasay, Kokand, Bagdad districts), Tashkent city (Chilanzar and Unusobod districts), Samarkand, Andijan cities and Tashkent region have access to quality Youth Friendly Health Services (YFHS).

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  % of YFHS operating in line with international standards in priority geographical areas.
  

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  % of MARA who have access to quality YFHS in priority geographical areas
  

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  % of MARA utilizing youth friendly HIV/AIDS testing and counseling services in priority areas
  

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  Thirty five out patient clinics in five hot spot regions are progressively implementing YFHS standards (UNICEF monitoring, 2008)
  
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  In five hot spot regions there are thirty five out patient clinic. More than 3,500 MARA used YFHS in the priority regions in 2008 (UNICEF monitoring, 2008).
  
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  53% of MARA involved in selling sex did blood tests for HIV/STIs (Formative survey)
  

Access to prevention means is still limited.

% of regions in priority areas with integrated plan for basic services that benefits the most vulnerable children and their families developed and implemented.

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  All six regional governments progressively implemented the NPA on Child Welfare. Out of these, 2 were provided technical support by the Academy of State for Social Construction (ASSC) and UNICEF to develop comprehensive integrated regional action plans.
  
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  Capacities of regional governments strengthened by ASSC in managing and coordinating children’s programmes.
  
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  Training programmes on results based management for child welfare were integrated into the regular curricula of ASSC.
  
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  ASSC and the Center of Economic Research, who participated in the regional planning exercise, got engaged in Child Poverty and Social Budgeting Studies.
  
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  DevInfo was piloted at the regional level to further promote the tool nationwide for child rights’ monitoring.
  

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  Advocacy with the Cabinet of Ministers, ASSC and national research institutes facilitated a better understanding on the importance of national and regional government partnership in management, coordination and monitoring of child rights.
  
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  The decentralization policy is in its first implementation stage, therefore decision making at the sub-national level is still in process of expansion