Kazakhstan's children should benefit from the country's economic growth, Hanaa Singer, UNICEF Representative in Kazakhstan
How did you become involved in work for children's rights, their survival, and development and protection?
I was originally an academician teaching and researching in different universities in political sociology. I was specialized in the Islamic revival in the Middle East at that time. One summer in 1986, I was asked by UNICEF to do an urgent research work on impact of the International Monetary Fund's structural adjustment on rural woman. It was my first encounter with life in the rural areas in Egypt. For three months I met and interviewed women from all parts of upper Egypt. I saw first-hand the problems of health, water, sanitation, education. I saw children getting sick and dying from preventable diseases. I saw the challenges women have to face daily to meet end needs. I was impressed by the courage and the strength of rural women, how they wake up so early in the morning to bake, cook and clean, then to take the animals out to the fields, then to work in the fields, then go back home to cook lunch, then back to the fields to feed the husbands and men, then taking back the animals home by sunset then, cooking dinner and taking care of children. They also had to take care of the budget of the house and accommodate their income to come cost of food, schools, health clothing. Yet with all these responsibilities, the Egyptian rural women had an amazing smile, and laughs and charm. In the middle of all their workload they will always welcome me with hugs and laughs and invite to wonderful food and jokes enjoying the natural beauty of rural Egypt. To me they were like magicians. It was then that I fell in love with my rural women and decided I would work for women and children. So I left my academic career and joined UNICEF full time. I started a journey that took me from Egypt, to Maldives, Sri Lanka, Burundi then, Haiti then served as regional emergency advisor for Central and Eastern Europe and CIS (CEE/CIS) and the Baltics based in Geneva, Switzerland. I was responsible for providing technical support to UNICEF offices in countries with an emergency situation, particularly in the North Caucasus, Kosovo, Macedonia, Georgia, Tajikistan and Bosnia. Then I became the UNICEF representative in Azerbaijan then I finally landed in your beautiful country.
How long have you been working in Kazakhstan? What do you think of Kazakhstani system of children's rights protection?
I have been Representative of UNICEF in Kazakhstan since September 2008. Prior to Kazakhstan, I was UNICEF Representative in Azerbaijan, I served as regional emergency advisor for CEE/CIS and the Baltics based in Geneva, Switzerland. I was responsible for providing technical support to UNICEF offices in countries with an emergency situation, particularly in the North Caucasus, Kosovo, Macedonia, Georgia, Tajikistan and Bosnia.
In Kazakhstan there is a tremendous progress in improving the legislative and practical base for the implementation of education, child protection and juvenile justice reforms for the better state of children in the country. The efforts of the Majlis on developing legislation for child protection and wellbeing are legendary and their work is among the best example of cooperation with UNICEF we have ever had globally.
We shall continue working with the Government and the Parliament to improve the current legislation on family, justice, the protection on child rights as well as narrowing the gap between legislative base and the application of law in practice.
How do you assess Kazakhstan's efforts in order to achieve the Millennium Development Goals?
While the problem of hunger is not relevant for Kazakhstan, it was recognized that imbalanced nutrition and the lack of essential nutrients poses a threat to the health of population. Therefore, the second task of MDG 1 was adapted to Kazakhstan and defined as to halve the proportion of the population lacking balanced nutrition by 2015.
MDG 2 commits the governments to ensure that by 2015, all the children are able to complete a full course of primary schooling. In its international definition, this Goal is not applicable to Kazakhstan, as the country inherited from the Soviet Union a system of universal primary and secondary education, and a 100% literacy rate. Unfortunately, there is still high number of children who do not have access to education, especially to good quality education. However, a concern over the decline of the quality of education in Kazakhstan has been expressed repeatedly at different levels of policy making. Therefore, the national goal in education is to improve access to quality education at all levels and stages.
Despite notable progress of Kazakhstan in gender equity and the achievement of Millennium Development Goal 3, there are a number of issues that UNICEF needs to address. This involves collecting and analysing data on gender equity in the most disadvantaged groups of children and women such as migrants, trafficked, exploited or left without parental, and gender based violence.
Goal 4 calls to reduce by two-thirds, between 1990 and 2015, the under-five mortality rate, while Goal 5 is to reduce by three quarters, during the same period, the maternal mortality ratio. Kazakhstan recognizes mother and child care as one of the state priorities, declared in the National Strategy Kazakhstan-2030. The MDG report 2010 in Kazakhstan recommended a number of actions that should be taken to achieve Goal 4, among which is the introduction of the Integrated Management of Childhood Illnesses programme to newborn pathology units, primary hospitals and primary health care units.
To achieve MDG 5 (maternal mortality rate), Kazakhstan needs to reduce its maternal mortality rate from 55 per 100,000 live births in 1990 to 14 in 2015. The achievement of this MGD in Kazakhstan will depend on how the legislation will change, how successful healthcare structural reform will be and how efficiently maternal mortality reduction will be managed and financed.
Regarding UNICEF's focus in achievement of MDG 6 (combating HIV/AIDS and tuberculosis), the ongoing partnerships in health sector resulted in first time with zero cases of Mother-to-Child Transmission (MTCT) of Human immunodeficiency virus (HIV) in South Kazakhstan Region and high national coverage by antiretroviral therapy (ARV) of pregnant women and children (97.6 per cent). A significant increase in ARV coverage (97.6 per cent) and available data show that the country is on track towards virtual elimination of MTCT. To continue the progress, political commitment should be strengthened to fight HIV/AIDS and access to ARV therapy to all patients in need should be provided.
What should the society and the state do to reduce infant mortality, maternal mortality, especially in rural areas?
Regarding mortality rates, over 60 per cent of infant deaths are caused by poor care during perinatal period. Obstetrician-gynaecologist, neonatologists, midwifes and children's nurses should receive training on how to use most modern methods of births management and care for newborns and mothers. The state should ensure that efficient perinatal technologies are fully embedded in the practice in all health facilities in the country.
One of the causes of infant and mothers mortality is widespread anemia among women and children. This means that the Government should take measures to improve nutrition of families, especially women of child-bearing age and children in rural areas. Because, as you know, residents of rural areas earn less money and their low income affects their nutrition status. That is why this year we continued our advocacy efforts for ensuring mandatory flour fortification as a means to decrease anemia.
What are the outcomes of the Alma-Ata Declaration on Primary Health Care 30 years later? Are there any certain results for children, women and families?
In the Alma Ata Declaration, global health leaders defined primary health care as ensuring that all people - regardless of where they live, or whether they are rich or poor - have access to the services and conditions necessary for realizing the best possible health. Concrete gains have been achieved in public health, particularly in child survival. According to our global estimates, the absolute number of child deaths in 2008 declined to an estimated 8.8 million from 12.5 million in 1990, the base line year for the Millennium Development Goals (MDGs). Public health experts attribute the continuing decline to increased use of key health interventions, such as immunizations, including measles vaccinations, the use of insecticide-treated bednets to prevent malaria and Vitamin A supplementation. Where these interventions have increased, positive results have followed. Progress can be accelerated even in the poorest environments, through integrated, evidence-driven, community-based health programs that focus on addressing the major causes of death -- pneumonia, diarrhea, newborn disorders, malaria, HIV and under-nutrition.
What are the biggest challenges UNICEF is facing in the implementation of its projects in Kazakhstan?
Kazakhstan has been experiencing an accelerated economic growth, which, should be translated into adequate gains in social outcomes for children. Several challenges lie ahead. There is still a high level of infant and maternal mortality, youth mortality, large number of children in residential care institutions exposed to many risk like violence and exploitation, children with disabilities, low level of pre-primary education, and etc. One of the reasons for such a situation could be the inadequate financing of the social sector: in 2009, the country was allocating 3.9% of GDP to education, 2.6% - to healthcare and 3.9% to social protection - this should be also increased to compete with other middle-income countries with a similar GDP growth and pace of development.
UNICEF is working towards integrating prevention of mother-to-child transmission and pediatric AIDS services into the mother and child health care system, and increasing the quality of service that would include quality counseling services, testing for HIV in pregnant women and the provision of antiretroviral therapy for pregnant women who are HIV-positive.
Child abandonment, neglect and exclusion are the key areas to be addressed in child protection system. Every year about 2,000 children are sent to state institutions in the country. We need to develop together a more comprehensive and integrated protection system. Institutionalization should the last resort for children, as it negatively affects child's wellbeing, growth, development and success in life. We are working closely with the Ministry of Education and Science, Health and Labor and Social Protection in this area.
Millions of children of Kazakhstan enjoy rights enshrined in the Convention on the Rights of the Child (CRC). Those benefits are to be expanded even further - to include those who are the most vulnerable, neglected or marginalized, expelled because of a disability or HIV/AIDS.
UNICEF highly praises the fact that Kazakhstan is the first country in the CEE/CIS region which started seriously talking about social budgeting for children. The impact of public investments allocated to realizing children's rights would result in the enhancement of human capital, and hence, the smart economy in future. We can already see some progress: the Government preserved the social spending during difficult crisis times, increased the amount and variety of child benefits, started investing to the pre-school education, focused on the effectiveness and efficiency of social spending, and etc. However, there still some room for the operational mechanisms to be adopted: to bring social expenditures to the level of upper-middle and developed countries, target investments at critical junctures in a child and adolescent's development cycle, marry a package of basic services to all children with specific additional interventions for the most vulnerable and disadvantaged ones.
Would you like to describe your typical work day, if there is such thing?
It is very interesting to work at UNICEF. The work is hectic, challenging, and difficult. But what is important is that everybody who works for UNICEF realizes that he or she does a good cause - words for the sake of ensuring child rights. I run the office of 30 staff who are responsible for different programmes. We have the strong culture of team work, and everyone should understand his or her role and contribution to achieving the results of children. We regularly have joint meetings, discuss our challenges, plans and progress. My working day begins from checking the calendar of events, then I give the most important instructions to the staff, I check my email, and of course, every morning I am briefed by the communication staff on the most important events in the country. We keep in touch with our Regional Office in Geneva and HQ in New York that is why I often have video conference calls with them. Every day I have 3-4 important meetings with our partners from the line ministries, other UN agencies, NGOs and the diplomatic corps. I also travel extensively within the country to be constantly updated on the situation. My evenings are either attending social events of national days or government events or going to the health clubs for physical exercise.
What has been the most surprising thing when you arrived in Kazakhstan? Have you found anything special about our traditions, human values and interethnic relations among the peoples in Kazakhstan?
I was struck by the drive and tempo of development of Kazakhstan. The Government understands and recognizes existing problems in the social sector and that is why we fruitfully cooperate with the Ministries and other state agencies. I am impressed by commitment and the drive and the high level of education and the sophistication of the government partners. Regarding interethnic relations, I always say that this is the great treasure of Kazakhstan. It has shown to the rest of the world of how representatives of over 120 ethnic groups can harmoniously and peacefully live together. I pray other parts of the world learn the advantage of coexistence.
From the bottom of my heart I would like to congratulate Kazakhstan's people on their continuous success and wish them peace, lots of health, happiness and love. May you enjoy sharing your smiles with your families, friends and colleagues!
Thank you very much, Ms Singer!