Zerkalo, 9 April 2005 (Unofficial Translation)

BAKU, Azerbaijan - On April 7, World Health Day was celebrated globally and mother and child health was the focus of this year…

Wellbeing of the society is directly linked to the health and survival of mother and child. Logic of a closed circle, no matter how dull it may seem, is as follows: ensuring survival of mothers and their wellbeing contributes to survival and welfare of their children. And when mothers and their children survive and prosper, the society they live in thrives as well.

In accordance with the data of the World Health Organization, at present large number of mothers and children in the world decease or suffer from poor health, malnutrition and inadequate health care; every year over one million women die during delivery. Moreover, 10.6 million under-5 children decease from the illnesses that may be prevented or treated. Almost all death cases take place in countries with low or medium level of income and in particular among the poorest layers of population living in such countries. However, many of the mentioned death cases may be prevented through the use of accrued knowledge and tested methods.

As noted by WHO specialists in order to cope with this challenge governments, international donors, NGOs, private sector, mass media etc. must take active and concrete measures to ensure survival, health and wellbeing of mothers and children - future of any country. And how is the situation with our future? We posed this and other questions to Hanna Singer, the United Nations Children's Fund (UNICEF) Representative in Azerbaijan.

- You came to our country almost a year ago. During this period of time, did you get an impression that the attention of our society to child problems have increased, at least to some extent?

- I have been in Azerbaijan for less than a year, but I am pleased to note that concrete steps are taken in this direction in Azerbaijan. As you know, your country signed the UN Convention on the Rights of the Child in 1992 and undertook certain obligations by accession to this international document. UNICEF closely cooperates with the Government and NGOs in the spheres of child protection, education, health and nutrition in order to support Azerbaijan in creation of such conditions where rights of every child would be protected. Undoubtedly, much more is to be done.

At present, international donors provide a significant support to Azerbaijan. For instance, the World Bank provided financing to the health and education sectors, Asian Development Bank issued 12 million dollars for early childhood development, the Global Fund provided 6 million to combat HIV/AIDS…Of course, our present role does not imply simply providing a technical aid to the Government, it has a more consultative character, and of course, involves provision of information as well. In this way, while before our organization simply provided financing to Azerbaijan, now there is not a great need for that, and we mainly share our knowledge and experience.

Previously, UNICEF provided a technical aid in the areas of early childhood development, health care, education. Today Azerbaijan has stepped into a new phase of development - from a low-developed country to a medium-developed country, and such a situation has, in its turn, rather transformed the extent of the UNICEF's assistance to Azerbaijan.

- As is known, we have quite high child mortality rate in our country…

- The matter is that, there is no compliance in the statistics concerning this issue. For instance, the indicators in public statistics are much different - they are lower than the figures established in the surveys conducted by UNICEF in 2000 and 2001. However, the problem may not be resolved through decreasing actual figures. Now we should not search for guilty persons, but should try to find out the reasons, sources of the problem in order to succeed in settling it. But the very fact of keeping silence about the scale of the problem deprives us of a chance to settle it, as it usually happens.

Practice show that the situation in regions is much worse compared to the capital city and several other large cities. One of the Millennium Goals established by the United Nations is reducing child mortality by 2015. And in this regard, Azerbaijan needs to take concrete measures.

This year Azerbaijan Government, UNICEF and USAID are going to conduct a joint demographic medical-sanitarian study (DHS) that will help assessing the progress in approaching Millennium Development Goals and in particular reducing child mortality.

Other aspect of this issue is related to a safe motherhood. UNICEF promotes breastfeeding. By the way, a Law on Breastfeeding was adopted by Azerbaijan in 2003. The matter is that, if mother breastfeeds her child up to 6 months, it helps reduce child mortality by 50%.

- Improvement of quality of education is one of the major Millennium Development Goals as well…

- Undoubtedly. UNICEF works actively in this area. Children need to get involved into training process more actively. We have implemented pilot programs in some regions - in this process, new methodologies were introduced, trainings were held for teachers, so-called interactive education was put to practice - a child was not just a passive listener, but an active participant of a training process, in this way, cognitive skills of a child develops in communication with his peers and teachers, but not through passive comprehension. Practice shows that attendance, as well as progress of students increased after introduction of such classes at schools.

However, in general, education issues are particularly acute in some regions of Azerbaijan. For example, a gender problem. In southern regions - in Lankaran, in the districts bordering with Iran, girls go to school more rarely. And of course, such a tendency concerns us.

- As is known, currently UNICEF also works in the area of deinstitutionalization - getting children out of orphanages…

- It is not simply getting them out, but change to an alternative care system for the children living in state institutions. Such an alternative care is successfully practiced in many civilized countries for a long period of time, e.g. in 60-70s, in a number of Western European countries, in particular in Italy and France, where the number of child orphans increased drastically after the World War II.

Deinstitutionalization does not only imply closing down orphanages, but reducing the number of children in them, so we have to reject the system, where a child deprived of a parental care is placed immediately in an orphanage.

Official statistics show that up to 35% and even more of the children living in orphanages have both parents alive. There are several reasons of their placement in institutions, but one the most prevalent reason is financial problems of families. Having placed their children in an orphanage, the parents think they have made their life easier.

In West, the situation is different. In developed countries there is a large sector of so-called social workers. Children from problematic families are placed in the families, which are checked by all parameters ("foster families") and consent to raise the child until his adoption or up to a certain age. Government provides financing to the foster family to cover needs of the child. Meanwhile, social workers follow up child's life to see how the funds allocated by the government are spent, whether the child is restrained in family or not, how his health is…

Unfortunately, there is not such a practice in Azerbaijan yet. But if it is introduced in the country and a generation of social workers is "brought up", then the number of orphanages and internats will gradually reduce as the flow of children to and hence their quantity in the institutions will get down significantly.

Internats for the disabled children is another problem existing in Azerbaijan. An outsider may get an impression that this layer of population is completely forgotten in Azerbaijan. The children with limited physical and intellectual abilities are simply struck out from the life of the society, they are just placed in internats and that is all.

We are working with the Secretariat of the State Program for Poverty Reduction and Economic Development to ensure inclusion of child issues into the activities conducted by the Government.

In this regard, legislative base might play a special role, which is able to support such an activity…At present a Law on Foster Care is considered by the Parliament - adoption of this law will play a significant role in deinstitutionalization process.

We also lobby for adoption by the Azerbaijan Parliament of a law on fortification of the flour with iron. As is known, an analogous law on iodization of salt was already adopted in your country and after the passage of this law consumption of iodized salt by general population increased from 30% up to 70%. But this is not sufficient. Currently, we are taking measures to ensure obligatory fortification of flour with iron.

In general, Azerbaijan needs to develop a common concept to resolve these issues. UNICEF is providing its suggestions and at present helping the Government to settle these problems.

From this year, UNICEF initiates implementation of a new five-year country program jointly with the Azerbaijan Government and other partners. This program includes such sectors as education, child protection, early childhood health care and development.