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World Bank Document Report No. 24491 -AM Armenia Public Disclosure Authorized Child Welfare Note December 9, 2002 Human Development Sector Unit Europe and Central Asia Region Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Document of the World Bank TABLE OF CONTENTS Acknowledgements ................................................................ 3 Executive summary ................................................................ 4 1. Introduction ................................................................ 7 2. Economic and social developments in Armenia during the 1990s ......................................... 8 3. Material well-being ............................................................... 12 4. Health and nutrition ............................................................... 14 5. Education ............................................................... 17 6. Safety nets ............................................................... 20 6.1 Background ............................................................... 21 6.2 Cash benefits ............................................................... 23 6.3 Residential care for vulnerable children ............................................................... 27 7. Summary of major recomm.iendations aimed at improving children's well-being ............... 39 References ............................................................... 42 ANNEX 1: Summary of major social protection programs in Armenia .............................. 42 ANNEX 2: A Draft National Program of Actions for Protection of Children's Rights: 2002-2012: A list of the program goals ................................................... 43 Vice President: Johannes F. Linn Country Director: Donna Dowsett-Coirolo Sector Director: Annette Dixon Task Team Leader: Aleksandra Posarac 2 ACKNOWLEDGEMENTS The Armenia Child Welfare Note was prepared by Aleksandra Posarac, (Senior Economist, Team Leader) Human Development Sector Unit, Europe and Central Asia Region (ECSHD) and Hjalte Sederlof (Consultant). The team benefited greatly from discussions with Judita Reichenberg (UNICEF Geneva Office), Branislav Jekic (UNICEF Office, Yerevan), and Boris Tolstopiatov (UNICEF Regional Office for the South Caucasus). Razmik Martirosyan, the Minister of Social Security of Armenia, and his staff, as well as the staff of the Ministry of Education, the Ministry of Health and the State Department of Statistics provided valuable insights, information and support. 3 EXECUTIVE SUMMARY The Armenia Child Welfare Note looks at child welfare developments and outcomes in Armenia during the 1-990s. Children are future human capital, which has long been identified as one of the key determinants not only of individual welfare but also of overall socioeconomic growth and development. Developing highly educated and skilled labor force is crucial for Armenia's future economic and social development-Armenia is a small, natural resources poor, landlocked country in the Caucuses. Its people are its most precious resource. The Note was prepared in response to the needs for technical assistance expressed by the Ministry of Social Security of Armenia. The Ministry, whose institutional responsibilities include social assistance, social insurance, and labor market policies, is responsible for child protection policies as well. Jointly with the Ministry of Education and Ministry of Health, another two key players in the area of child welfare, the Ministry of Social Security is developing a child welfare strategy, which will feed into the Poverty Reduction Strategy that is currently being drafted by the Armenian Government. The purpose of the Note is to assist the preparation of the child welfare strategy by identifying major issues in family and child welfare, assessing efficiency and effectiveness of current policies and suggesting measures that would better ensure the well-being and future of Armenia's children. What happened to child welfare in Armenia during the 1990s? Over the 1990s Armenia went through dramatic political, economic and social changes. Some of them, especially prolonged economic hardship and extensive out-migration have had a critical impact on child welfare: they have weakened the capacity of Armenian families to manage risks, as well as the ability of the state to provide meaningful support. Poverty risk is high. Poverty in Armenia is pervasive, deep and severe. More than half of Armenia's one million children were poor in 1998/99, and of these, a quarter million were extremely poor. The poverty risk is particularly high for children from single parent and multi-child households, as well as for young children (0-5 years of age). Children are poor because parents have no jobs or the jobs they have do not provide sufficient income. Low health and- nz4rtion-status. Armenian children have a relatively high risk of morbidity and mortalit-y'co6mpared to the average for other transition economies. This reflects low access to basic health services, low nutritional status of many mothers and children, and-high risk fettility behaviors (mothers too young or too old, a high share of unattended-births),. Poor children have less access to education. While overall access to general education remains high, there isant-increasing bias against children from poor families: early childhood education,iarticularly important for future success of poor children in the education system, hasi-¶become less accessible to poor children, as pre-schools have closed, and fees have b-en imposed in existing ones; and poor families sometimes cannot afford the clothes and materials that are necessary for their children to be able to attend 4 school. Moreover, quality of education may have deteriorated in poorer areas, because of lack of resources. The effects of migration. Children face higher risk of living in a family where one parent (in most cases a father) has left the country to work elsewhere. While this practice may stabilize household income flows, it has been shown to place significant stress on the family life. In some cases, a migrated father "forgets" his family, which as a rule leads to substantial worsening of family and the child well being. Deprivation offamily upbringing-the risk ofjoining an "underclass" of children has increased. Children face an elevated risk of being deprived of family upbringing and placed in institutions if they are disabled, come from poor families or families that are dysfunctional. Institutionalized children are at a significant disadvantage in adapting to mainstream society once they graduate. What should be the Government's response? The Government will need to focus on a number of key issues in creating an environment that ensures family and child well-being and allows the child to grow up and integrate into mainstream society. First and foremost it has to create conditions for steady, inclusive economic growth and development, so that parents can gainfully participate in the labor market and provide for the material well-being of their families. It will also have to provide adequate support to families in need, so that they can sustain and care for their children. This includes facilitating access to adequate health care and education, especially for poor families; and it involves providing at-risk families (and substitute caregivers) with both family-level outreach and community-based services. On occasion, it will have to substitute for the family by providing family-based care anrangements, such as adoption and guardianship, or even institutional care. In health care, more attention must be given to antenatal and postnatal care, as well as to reducing high risk behaviors among women-the rising number of unattended births that take place in the home, and birthing by mothers who are too young or too old. And efforts have to be made to more strongly address female morbidity, especially the occurrence of anemia among women of child-bearing age. While there may be little opportunity to significantly increase public resources going into health care, a more focused allocation of scarce public resources to deal with high risk fertility behavior and nutrition deficiencies might provide significant returns in terms of child well-being and longer terms opportunities of children to develop. In education, attention needs to paid to addressing equity concemns in the general education system-by opening up early childhood education opportunities to poor children, and by seeking ways to overcome the costs that poor families face in sending their children to school, possibly by considering targeted stipends or conditional transfers. More generally, the Armenian education system lacks information that would allow the introduction of viable conventional performance and outcome monitoring indicators that would provide early signals on the performance of the system, and on rising inequities and the reasons for them. The social safety net needs to be maintained and further improved to better support at- risk families. As public resources are constrained, improvements will mainly will have to be 5 qualitative. The child-focused benefits currently are the family benefit, targeted at poor families with children, the benefit for maternity leave, a one-time newborn allowance, and a child allowance to working mothers for children from birth to twenty four months. The principal benefit is the family benefit. It is a well-targeted benefit that appears to have a significant poverty alleviating effects. It should
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