Table of Contents s234

TABLE OF CONTENTS

Executive summary I-VII Acronyms...... I Chapter 1: introduction and background...... 2 Chapter 2: process established for the end-decade review...... 3 Chapter 3: Action at the national and international levels...... 4 Action at the national level...... 4 Policy and legal framework...... 4 Mechanism for ensuring the implementation of the United Nations Convention on the Rights of the Child...... 5 Financing of social programs...... 6 Action at the international level...... 7 Chapter 4: Specific actions for child survival, development, protection and participation 7 Child survival...... 8 Child health...... 8 Maternal health...... 9 Nutrition...... 10 Safe water and sanitation...... 12 Child development...... 14 Access to childhood care and development service...... 14 Access to basic education...... 15 Quality of education...... 16 Literacy...... 17 Child protection...... 18 Child protection goals...... 18 Justice system for children...... 19 Children in conflict with laws...... 19 Child labor...... 19 Neglected and abandoned children...... 20 Girl children...... 21 Victims of sexual abuse and commercial sexual exploitation of children...... 22 Children and HIV/AIDS...... 25 Children in especially difficult circumstances...... 27 Children with disabilities...... 27 Children and substance abuse...... 28 Children and unexploded ordnance...... 30 Ethnic minorities children...... 30 Children participation...... 31 Chapter 5: Best practices and lessons learned...... 32 Polio free program...... 32 Inclusive education for children with disabilities...... 33 Unexploded ordnance...... 34 Annex 1: List of organisations and persons involved in the preparation of the End-Decade Report...... 35 Annex 2: Indicators...... 36 0ceb5ab4a8fd92af213521db44a8270c.doc

Executive Summary

1. The GOL has long been committed to ensuring the rights of the children, particularly their rights to survival, protection, development and participation. The constitution enacted in 1991 recognized the rights of the child. The GOL recognized the important role of the child development in the national development by formulating the human resources development programme as one of the 8 national prioritized programmes and has mobilized external fund to expand the education system and health sector.

2. The Lao representative in the UN HQ signed the World Summit Declaration and the Plan of Action on July 4, 1991, which committed the Lao PDR to work toward the goals set during the World Summit. On June 7, 1991, the Lao PDR National Assembly acceded to the Convention on the Rights of the Child. Prior to signing the Convention, all pertinent Lao legislation was reviewed and, when necessary, appropriately modified to conform to the Convention

3. The GOL recognizes the need to ensure the full implementation of the UN CRC. A multi-pronged strategy is required involving (1)-establishing the NCMC and its affiliates network down to the village level, (2)-strengthen the capacity for all organizations associated with the NCMC activities, (3)-Intensifying advocacy and social mobilization efforts to ensure that the resources available from public, international organizations and communities were allocated for the benefit of the Lao children, and the GOL expenditure for social sector increased from 12.5 percent in 1994-95 to 26.6 percent in 1996-2000 and the public investment in education has increased by 400 percent and in public health by 644 percent in the period 1996 to 2000.

4. For implementing the Convention on the Rights of the Child, the NCMC formulated the NPA with established 22 indicators for the child survival, development and protection: indicators for child survival, water and sanitation, and education. Any indicators were established for the child participation.

5. The National Commission for Mothers and Children takes the lead in the preparation of the national report and tasks the MOH to carry out two multiple indicator surveys in 1995 and 2000 and the National Statistic Center in 2000 providing data needed for monitoring progress towards goals set in the World Summit for Children. Annual statistics of the MOE was compiled to analyze the achievement with regard to the end decade goals 2000. The feedback of the Committee on the rights of the children dated November 10, 1997 to the NCMC mid-decade report was taken into account in analyzing and preparing this report.

6. Government efforts in implementing the World Summit goals have generated substantial results. Progress of the NPA and World Summit goals for the period 1990- 2000 against the end decade goals were as follow: 3 indicators on child health and education exceeded the goals (IMR and U5-IMR, stunting rate), 10 indicators (7 indicators on child and mother health, and 3 indicators on basic education) have I 0ceb5ab4a8fd92af213521db44a8270c.doc

completed over 50% of the goals, 9 indicators (3 indicators on child health, 1 on child malnutrition, 3 on sanitation and 2 on the efficiency of the basic education) have had poor performance of less than 50% of the goals or even regressed and 4 indicators don’t have any data.

7. The financial crisis that swept through the Asian region in 1997 affected the country’s ability to respond to all the needs of the population. The mounting budget deficit brought in by a depreciation of national currency coupled with mounting inflation necessitated some cutbacks in government spending. This situation is exacerbated by reduced income for waged workers placing many service deliverers in jeopardy and therefore affecting the stability of the government run service. This had a negative impact on the country progress towards the achievement of the goals for children.

Child survival

8. The government efforts have paid off in reducing the IMR from 117/1000 LB in 1990 to 104/1000 LB in 1995 and 82 in 2000, and the goal 2000 of 85 per 1,000 live births of the NPA was exceeded. Under-five mortality rate (U5MR) remained at the same level for the period 1990 to 1995, and then obviously decreased from 170/1000 LB in 1995 to 102/1000 LB in 2000, and the goal 2000 of 127/1000 LB was exceeded.

9. The NPA goals 2000 for the EPI, with the exception of polio, were not met. The country was declared polio-free in November 18, 2000.

10. The maternal mortality rate (MMR) decreased from 653 in 1990 to 530 in 2000, a figure well below the 2000 goal of 326 per 100,000 live births.

11. Teenage pregnancy is a contributing factor to high MMR. Fourteen point 7 percent of adolescent females (aged 15-19 years old) number) have become mothers and 3.7% are currently pregnant with their first child. Overall 18.4% of Laotian adolescent have started childbearing. This is extremely high when compared with other countries in the region.

12. In 2000, 12.9 percent of babies are born of low weight, 20.3 percent of children are stunted and 3.3 percent of infant are estimated to weight less than 2,500 grams at birth. These figures reflected the malnutrition of children. The end-decade goals of 10 percent for low birth weight, 25 percent for under-5 stunting and 0 percent for waste have not been met.

13. The percentage of women having the rate of hemoglobin less than 4, 4-7 and 7- 11g/dl was 0.02 percent, 1.33 percent and 30.06 percent respectively. In respect of these the end-decade goal is unlikely to be met.

14. The percentage of children aged 0-5 years old with hemoglobin 4-7g/dl decreased from 20% in 1992 to 1.95% in 2000. The figures indicated that a lot of improvement was achieved, but a bit below the 2000 goal 0%.

15. The IDD end-decade goal was achieved and has been sustained. II 0ceb5ab4a8fd92af213521db44a8270c.doc

16. The percentage of children aged 6 to 12 years old with endemic goiter was 20 in 1990. In 2000, the goiter survey among children aged 6-12 years old revealed that 91 percent do not have goiter. A decrease of the 11 percent in comparison with 1990 figure, but the end-decade goal of 0 percent goiter among children aged 6-12 years old is unlikely to be met.

17. In 2000, 28.8 percent of children aged 12 to 59 months received a high dose of Vitamin A supplement. Only about 4.4 percent of mothers with a birth in 1999 received a Vitamin A supplement within eight weeks of the birth. This is a significant implementation success, but effort to distribute Vitamin A to targeted children and women will decline if the NID nationwide ceases.

18. Although focus and resources are being put into women’s health and safe mother programs as well as expending the primary health care services, but resource levels are low relative to the need of the Lao PDR. The GOL has developed the PHC service through the loan from the Asian Development Bank, the World Bank and the European Union. Major constraints include the large number of women who currently receive little or no antenatal care. Only 35 percent of the women receive some type of antenatal care from various practitioners. There is high rate of unattended home birthing. At the existing health facilities serious deficiencies in the availability of trained care exits. There are no midwives below the level of the district hospital. At the provincial hospital level often there are inadequate supplies and equipment. Accurate data for planning and monitoring are inadequate. Facilities are not heavily utilized skill level are often low. The GOL makes these a priority with assistance partners, but the sheer scale of the task to be accomplished makes rapid progress difficult in the short term.

19. The percentages of rural population and urban population with access to clean drinking water increased from 15 and 48, respectively in 1992 to 37.6 percent and 75.5 percent, respectively of households with access to safe drinking water in 2000, but the 2000 goal of 80 percent access to drinking water for rural population was unlikely to be met. Any goal was set for urban population in the NPA.

20. The NPA goals 2000 of urban and rural population with access to sanitary means of excreta disposal was 75 percent and 45, respectively. In 2000, 67.1 percent and 19 percent of the population in urban and rural areas, respectively of Lao PDR was living in households with sanitary means of excreta disposal, largely lagging behind the NPA goal 2000.

Child Development

21. The GOL together with UNICEF and Save Children-UK and Norway launched successful community ECCD program in 8 of Laos’ 18 provinces. In 1999-2000, there were 12,754 children (or 10.4% of the children aged 0-5 years old), 22 districts, 125 villages and 10,631 households of the 8 provinces involved in this programme. It was a steady increase given that ECCD started with 15 villages in 1992-93. For the primary level, the net enrolment rate (NER) slightly increased from 63 percent in 1992 to 77.3 III 0ceb5ab4a8fd92af213521db44a8270c.doc

percent in 2000, below the NPA 2000 goal of 80 NER. The average percentage of repeaters did not much improve during the decade, it was 21 percent in 1992 and 19.9 percent in 2000, and was lagging far behind the expected 2000 goal of 4 percent. The retention rate of the students from grade 1 to grade 5 of the primary improved from 41.7 percent in 1991-92 to 56.6 percent in 1996-97 and 54.4% in 1999-2000, and given the trend, the end decade goal for retention rate of 80 has not been achieved. The adult literacy rate of over 15 years old increased from 60 percent in 1995 to 74 percent in 1999-2000, below the goal 2000 of 80 percent.

Child protection

22. The aim is to make the child protection goals the responsibility of all agencies and all citizens in the society. The following paragraphs highlight principal Lao legislation in which special consideration is extended to mother and children protection. Article 20 of the Constitution stresses the importance of mothers and children in Lao society. A directive of the party requires compulsory primary education for all children. In addition, the Prime-Minister decree and the education law lay the framework for the compulsory primary education as well. Articles 29-32 of the labor code provides protection for women and child workers, they include a list of dangerous activities in which women and children should not be engaged. Article 5 places the responsibility for mothers and children of broken households on the state and society; article 9 states the minimum age for marriage (18 years under normal conditions, between 15-18 years in special cases, and in no case less than 15 years); articles 28-36 state the rights and obligation of parents and children; articles 37-42 state the conditions and procedures for adoption of children; and articles 43-46 state the conditions for appointment, the rights and obligations of guardians.

23. For the justice system for children, the Ministry of Justice has cooperated with Save the Children-UK for providing series of training on Convention of the Child Rights with focus on the court and justice proceeding for the offenders who are children.

24. For the children in conflict with laws, the MoJ carried out training of trainers for establishing court committees for dealing with children cases at the provincial and district levels.

25. For the Child labor, various articles of the penal code protect the economically use of child labor and the protection against the illegal use of child labor. The LYU survey and participatory research projects on child labor and children who illegally cross the border to work in Thailand and the survey of the MLSW in 1997 indicated that there were 2400 children and 15,000 youth of Savannakhet, 1200 children of Champassack, and 302 children of Khammouane working illegally in Thailand. They were victims of labor exploitation and were not protected for their working conditions. Those who were returned through the border checkpoints received counseling for their re-social integration.

26. Neglected and abandoned children: there were 19,229 orphans of single parents and of both parents in Lao PDR in 1994. The MLSW in collaboration with an NGO (SOS or Save Our Soul) has implemented the project Children Villages Laos in February IV 0ceb5ab4a8fd92af213521db44a8270c.doc

1993 to host 370 orphan children in Vientiane Municipality, Pakse and Xiengkhouang. One is under construction in Luangprabang. Pre-school, primary and lower secondary education were located in the CVL campus for providing education and development for CVL orphans as well as children who came from neighboring communities. The number of orphan children hosted in the CVL was still limited, but the project keeps expanding each year. 27. The Lao government has also established, at its own cost, orphanage boarding schools in Bokeo, Luangprabang, Oudomxay, Huaphanh, Sayabuly, Vientiane and Savannakhet provinces to host orphans, neglected and abandoned children. The schools provide full accommodation, clothing, life skills learning, and formal education up to lower secondary level, protection and development for children aged 7 and over. 28. To contribute for the girl’s education, the GOL with the support of the ADB and Australia’s AusAid implemented a Girl basic Education project in 1999. The project aims at providing innovative approach in dealing with girls’ education. New materials and teaching methodology were developed for teaching Lao as a second language to ease the communication and the learning achievement of the ethnic girls and minorities students. One of the project components is to get the ethnic minorities girls enrolled in the Teachers Training Schools so that, upon their graduation, they could provide more appropriate teaching to their mates, who seldom speak the national language. 29. Child sexual abuse is a sensitive issue in Lao PDR and it’s not easy to protect children from it because of a traditional reluctance to intervene directly with the families. When child sexual abuse takes place, village leaders, including representatives of Lao Women Union, Lao Youth Union and police generally resolve the situation. Few data is available from official sources on child sexual abuse. In 2000, 5 girl children who were sent back to Lao PDR from neighboring country recognized that they were recruited by middlemen for working in factories, but in fact they had been lured into commercial sexual exploitation. The MLSW and the LYU surveys on commercial sexual exploitation in 1998 indicated that there were 20 children in Champassack province and 23 children in Khammouane province, with very high-risk of being sexual exploited. These were few cases that felt under the MLSW’s responsibility and recorded in the police files and trained for their social integration. There have been no programs in Lao PDR that specially address the needs of SEC or SAC. But there have been many projects recently implemented that aim to reduce the risk factors that leave children to all forms of exploitation and abuse. Projects and programs related to sexual abuse and sexual exploitation are research, counseling, and educational programs that address HIV/AIDS and various training. There are several law articles in the penal code that protects people against rape, incest, pornography, abortion and prostitution. There are also laws that may be used to punish children for having abortions or being engaged in prostitution. Some of the articles institute more severe punishments for crime committed against children than they do for crimes committed against adults. 30. While the number of children affected by HIV/AIDS remains very low, the reported cumulative HIV positive cases dramatically increased from 1 in 1990 to 86 in 1995 to V 0ceb5ab4a8fd92af213521db44a8270c.doc

717 in December 2000. The reported cumulative cases of children under 13 years old were 2 for HIV positive and 2 for AIDS infection, all through mother. For those between 13-19 years old, 4 cases of HIV and 3 cases of AIDS infection, all through sexual transmission. These figures may be misleadingly low, but they are contrasting with the high risk-risk behaviors of young people aged 14 to 18 years old who are working in nightclubs, resort, guesthouses, hotels, and bar-restaurants and have high risk behavior for commercial sexual exploitation. There was high rate of sexually transmitted diseases (STDs) in the young population of Lao PDR. To combat the HIV/AIDS epidemic, the Lao government established the National Committee for the Control of AIDS since 1988. The NCCA have affiliates in the provinces and districts. The NCCAs and affiliates mandate is coordinate with concern institutions and provide technical assistance for the control of HIV/AIDS. 31. In 1996, the MLSW in collaboration with UNICEF, SC-UK and CWS implemented a project for children in especially difficult circumstances, the first of this kind, in Vientiane Municipality, Savannakhet and Bokeo provinces. The project objectives were (1)-to assist children in difficult circumstances. (2)-to find ways to protect them from dangers, (3)-to promote the enforcement of the child rights, and (4)-to maintain peaceful order. Various consultations and meeting at the central, provincial and district levels were held with LYU, LWU and concerned line agencies on CEDCs definition and status as well as on the promotion of the Child Rights among participants. 32. In 1994, there were 5,570 children with general disability, of which 1118 children were limbed handicaps and 5,610 children with hearing-vision-olfaction-speaking disabilities, nationwide. In 1992, under the cooperation of the Ministry of Education and the National Rehabilitation Center, Ministry of Health, a special school was opened for the first time for the blind and deaf children. There are now over 120 pupils. In the academic year 1993-1994, the Inclusive Education Project was piloted in one primary school in Vientiane Municipality for integrating children with mental and physical disabilities in the formal education setting and improving the quality of education. The enrolment of disabled children increased from 13 children in 1993-94 to 610 in 1999-2000. Most children are doing well in school, communities and families are active and supportive, and the general quality of education has been improved to a satisfactory level. There is still a long way to go before all children, especially the disabled, have access to education. The project keeps expanding and its continuity is ensured with the support of the international organisations. 33. For the Children and substance abuse, the LYU survey in Oudomxay, Luangprabang, Bokeo, Phongsaly, Luangnamtha and Sayabuly indicated that youngsters aged 8 to 18 years old or below were increasingly addicted to substance abuse, especially meth-amphetamine and opium. Few addicted were gone through the treatment and rehabilitation centers. A school survey on drug abuse among youth in 13 schools in Vientiane Prefecture in 1999 indicated that the most popular drug use (lifetime use) by youths were solvents (5.4%), ATS or “Yabaa” (4.8%) and abuse of prescribed drugs (4.7%). The data shows that the most susceptible age group is between 12 to 19 years old. Boys in the 17 years old age group have extremely high lifetime prevalence rates of ATS use (14.1%) and solvents (11.4%). Facing with this menace, in 1999 the GOL seriously tackled the problems at the beginning by establishing ad-hoc committees to combat drug abuse at the central level (government VI 0ceb5ab4a8fd92af213521db44a8270c.doc

and ministries) to the provincial, district and grassroots levels (schools and communities). The short-term objective was the establishment of school and community-based anti-drug abuse task forces whose mandate was investigating in and out-of-school children drug abuse-related behavior and providing counseling and mitigated measures in connection with peers pressure, parents, community leaders, grassroots mass organizations and security networks as well as an anti-drug abuse curriculum and related recreational activities for children in primary and lower secondary schools in 10 provinces. Community-based drug abuse prevention activities were also introduced and integrated in poppy reduction and rural development programs in areas of high prevalence rate of drug abuse. These measures created positive impact on parents and community awareness against drug abuse. The long- term objective of the task forces is to develop a full-range of measures, including mandate, revised legislation, means and mobilizes fund to combat drug addiction among in and out of school youngsters. 34. Children and unexploded ordnance: More than 3 million tons of bombs were dropped onto Laos during the Indo-Chinese war, especially between 1964-1973, and 30 percent of the ordnance dropped did not explode. Fifteen provinces out of 18 were severely to moderately affected by the unexploded ordnance. There were nearly 10,649 UXO related accidents, which have occurred since 1973. Of the accident victims, 4 percent are girls and 27 percent are boys. The strategy to address the unexploded ordnance includes (1)-community awareness, especially focus on children for reducing risk behavior that lead to accidents among children through intensive community- based activities and school curriculum and teaching activities, (2)-training and capacity building, (3)-survey for developing integrated UXO database, and (4)-mine clearance. 35. Ethnic minority children: Lao PDR is composed of 47 ethnic minorities who have achieved different socio-economic development. In some cases, their children could not attend school because the schools are located far away from their villages, and the cultural difference and social development status, formal schooling and curriculum for the primary education could not meet their requirement. To address the above- mentioned constraints, the GOL constructed and funded 17 ethnic boarding schools in predominantly ethnic areas such as Luangprabang, Oudomxay, Huaphanh and Champassack provinces. There were 8,121 ethnic children in 1997-98 and 5,186 ethnic children (1,417 girls) in those boarding schools. The schools provided full accommodation, formal education, protection and development for children between 7 to 14 years old. These children after their graduation could continue on their study at the upper secondary schools and other vocational schools and become equal members of Lao citizenship.

Children participation

36. The pioneer organization was institutionalized in the schools since 1975. It is a national organization specific targeting at the children aged 6 to 14 years old. It main mandate is to foster children participation and mutual assistance, respect of the rules, improve hygiene and awareness of the four aspects of child right through activities and games. Pioneer members increased from 66,786 in 1995 to 136,667 (up 100%) in 2000, of which 51 percent are girls. Its members were increasing at 5 percent yearly.

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Best practices and lessons learned 37. The NCMC has identified 3 programs/projects that could be considered as best practices, or practices worth sustaining. The criteria used are (1)-it has been implemented, (2) innovative approach in addressing the issues, (3)-can be duplicated or has been scaled up, (4)-it has impact on disadvantaged group of children or has national impact, and (5)-it has been monitored, evaluated and documented. Based on these criteria, 3 projects were selected, namely 1-the polio eradication programme, 2- the inclusive education for the disabled children, and 3-children and unexploded ordnance. See detail in chapter 5.

VIII Acronyms AIEP Assessment of the implementation of education plan 1996-2000 BCG Bacile Calmette Gerin (vacin) CMC Commission for Mothers and Children CRC Convention on the Rights of the Child CVL Children Villages Laos CWS Church World Service DCCA District committee for the control of AIDS DPT Diphtheria pertusis tetanus GOL Government of Lao PDR IDA International development agency IDD Iodine deficiency disorder IE Inclusive education IMCI Integrated mother and childhood illness IMR Infant mortality rate IMSD Integrated mother service delivery JICA Japan International Co-operation Agency LABEP Lao Australian Basic Education Project Lao PDR Lao People’s Democratic Republic LRHS Lao reproductive health survey MAF Ministry of agriculture and forestry MCH Mother and child health MCTPC Ministry of communication, transport, post and construction MFA Ministry of Foreign Affairs MICS Multiple Indicator Cluster Survey MIH Ministry of industry and handicraft MLSW Ministry of Labor and Social Welfare MOE Ministry of Education MOH Ministry of Health MOJ Ministry of Justice NCCA National Committee for the Control of AIDS NCMC National Commission for Mothers and Children NHS National Health Survey NPA National Program of Action NPPD National policy on population and development of Lao PDR ORT Oral rehydratation treatment PCCA Provincial committee for the control of AIDS PCMC Provincial Committee for Mothers and Children PHC Primary health care SC-UK Save Children Fund-UK SDC Swiss development cooperation SOS Save Our Soul SPC State Planning Committee STD Sexually transmitted diseases STEA Sciences, technology, environment agency TBA Traditional birth attendant TTC Teachers Training College TTS Teachers Training School UN CRC United Nations Convention on the Rights of the Child UNDCP United nations Drug Control Program UNDP United Nations Development Programme UNICEF United Nations Children Fund 0ceb5ab4a8fd92af213521db44a8270c.doc

UXO Unexploded ordnance

FOLLOW UP TO THE WORLD SUMMIT FOR CHILDREN THE LAO NATIONAL REPORT

Chapter 1: introduction and background

1. The GOL has long been committed to ensuring the rights of the children, particularly their rights to survival, protection, development and participation. The new constitution enacted in 1991 recognized the rights of the child. The GOL recognized the important role of the child development in the national development by formulating the human resources development programme as one of the 8 national prioritized programmes. The allocation of national budget and increasing external investments for expanding the education and health systems as well as the institutionalization of the mass organizations, in particular the Lao Youth Union and the Lao Women’s Union in the national administration structures, from the central level to the grassroots level, nationwide, were part of the GOL efforts to address the child development and participation.

2. After the United Nations approved the Convention on the Rights of the Child on 20 November 1989, the GOL took measure to pave the way for its ratification.

3. On 29-30 September 1990, the GOL joined the World Summit for Children, which resulted in the adoption of the World Declaration on the Survival, Protection and Development of Children and a corresponding Plan of Action for its implementation. The Lao representative in the UN HQ signed the World Summit Declaration and the Plan of Action on July 4, 1991, which committed the Lao PDR to work toward the goals set during the World Summit.

4. On June 7, 1991, the Lao PDR National Assembly acceded to the Convention on the Rights of the Child. Prior to signing the Convention, all pertinent Lao legislation was reviewed and, when necessary, appropriately modified to conform to the Convention, i.e. the Constitution, the Labor Code, the penal Code, and the Family law. The Rights of the Child are de facto recognized in the Lao PDR Constitution, which was effective since August 8, 1991.

5. The GOL formulated the National Programme of Action (NPA) with established Goals for Children since 1992 in the areas of survival, development, protection and participation.

6. Article 44 of the United Nations Convention on the Rights of the Child requires the Member States to submit periodic reports to the UN Committee on the Rights of the Child every five years on the implementation of the United Nations Convention on the Rights of the Child. In compliance with this, the GOL produced the mid-decade report, which was submitted to the UN Committee in 1997.

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7. To ensure that information gathering in preparing these reports, MICS surveys were conducted in 1995 to measure the mid-decade progress and in 2000 to provide end- decade information on many of the indicators. Information on other indicators not covered by the MICS was compiled from the vital registration and various diseases monitoring systems.

8. The midterm review of the mid-decade goals indicated some progress in attaining the NPA since 1990. By 1995, advances were made in some aspects of child survival, especially those related to EPI and micronutrients as a result of a major push to reach the mid-decade goals targets. However, these achievements established a foothold in what will a long struggle to achieve sustainable results.

9. Government efforts to attain the goals for children are manifested in a viable political will and technical expertise to face the challenge of achieving some World Summit Goals for Lao PDR by 2000. Improved performance was noticed in the child survival indicators. However, the financial crisis that swept through the Asian region in 1997 affected the country’s ability to respond to all the needs of the population. The mounting budget deficit brought in by a depreciation of national currency coupled with mounting inflation necessitated some cutbacks in government spending. This situation is exacerbated by reduced income for waged workers placing many service deliverers in jeopardy and therefore affecting the stability of the government run service. This had a negative impact on the country progress towards the achievement of the goals for children.

10. This report presents the achievements of the Lao PDR vis-à-vis the NPA targets in the areas of child survival, development, protection and participation in the past decade. However, attempt was made in this report to highlight progresses and approaches to address issues in the Mid-Decade raised by the UN Committee on the Rights of the Child.

Chapter 2: process established for the end-decade review

11. The National Commission for Mothers and Children takes the lead in the preparation of the national report. The Ministry of Health’s National Management Health Agency in collaboration with the State Planning Committee’s National Statistical Center was tasked by the NCMC to carry out the multiple indicator survey, which was financially and technically supported by UNICEF-Laos office, WHO, WFP, Lao-EU malaria program, GTZ and JICA. This is the second survey of this kind for providing up-to-date information for assessing the situation of children and women at the end-decade and providing data needed for monitoring progress towards goals set in the World Summit for Children. The MICS 2000 was a sample survey, which covered the whole country including 128 districts, 264 villages and 6,600 households, in which 18 percent was urban and 82 percent was rural areas.

12. The State Planning Committee’s National Statistics Center and the Ministry of Health’s National Institute of Public Health carried out a National Health Survey in December 2000. The survey report provided information for end-decade report. The NSC also carried out survey on Lao reproductive health survey in 2000 to 3 0ceb5ab4a8fd92af213521db44a8270c.doc

provide up-to-date information on fertility, family planning, infant and child mortality, reproductive health and child health, including breatfeeding and knowledge of RTIs/STDs and HIV/AIDS. This information was analyzed against the goals 2000.

13. Annual statistics of the MOE was compiled to analyze the achievement with regard to the end decade goals 2000. The SPC reviewed the National Policy on Population and Development (NPPD) of the Lao PDR, which was adopted at the national meeting on June 3-4 1999. With respect to this latter document, the national goals 2000 set forth in the NPA were reviewed as follow: the IMR goal 2000 is 85/1000 LB instead of 50/1000LB and the U5MR is 127/1000LB instead of 70. These revised goals will be used to monitor the progress of the child health.

14. The feedback of the Committee on the rights of the children dated November 10, 1997 to the NCMC mid-decade report was taken into account in analyzing and preparing this report. Many baseline data in 1990 were not available. The NPA indicators were projected based on the 1992 data and the mid-decade report was evaluated against the 1992 data. So the end-decade progresses referred to the same baseline data.

15. All memberships (ministries, agencies, mass organizations) and all 18 provincial Commission for Mothers and Children have been tasked to carry out the assessment in their respective sectors and to report to the NCMC.

16. The report was widely discussed and commented by the NCMC and submitted to the GOL for getting necessary guidance and approval.

Chapter 3: Action at the national and international levels

Action at the national level

Policy and legal framework

17. The National Program of Action (NPA) reconciles the national goals for the children with World Summit ones. The NPA established twenty-two indicators for the child survival, development and protection. These are health indicators (infant mortality, under five mortality, maternal mortality, low birth weight, severe and moderate malnutrition, iodine deficiency disorder, iron deficiency anemia, vitamin A deficiency, measles, EPI percentage coverage, neonatal tetanus, diarrhea, acute respiratory infection), water and sanitation (rural and urban water supplies, rural and urban sanitation), and education (NER, retention, repetition and adult literacy). Any indicator was set for the child participation and protection.

18. While the GOL ratified the UN Convention on the Rights of the Child in 1991, number of news laws of Lao PDR has already come into effect in 1990. In reviewing the main national legislation, it was found that many articles already guarantied the rights and interests of children in line with the provision and principles of the Convention. The Ministry of Justice has considered the Lao tradition and custom, international law and the implementation arrangements in order to make the laws dealing with children relevant to the Lao situation.

19. In consideration of the UN Committee of the Rights of the Child’s concerns vis-à-vis the Lao PDR Mid-decade Report (CRC/C/Q/LAO.1, February 1997), the following actions with regard to the legal issues have been considered by the GOL. The existing laws in the Lao PDR that do not respond fully to the Convention, were in the process of reviewing by the MoJ to make them compatible with the Convention, for example, (1)-action research for establishing the juvenile court, (2)-revision of the criminal law in those articles related to child crime, and (3)-training for professionals in juvenile justice.

20. All the conventions ratified by the GOL are observed and incorporated into the constitution and national legislation. Efforts were made to implement articles of the Convention relevant to the Lao PDR context.

Mechanism for ensuring the implementation of the United Nations Convention on the Rights of the Child

21. The GOL recognizes the need to ensure the full implementation of the UN CRC. A multi-pronged strategy is required involving (1)-establishing the NCMC and its affiliates network down to the village level, (2)-strengthen the capacity of the government line agencies and administrations at the central, provincial, district, and village levels for all organizations associated with the NCMC activities, and (3)- Intensifying advocacy and social mobilization efforts to ensure that the resources available from public, international organizations and communities were allocated for the benefit of the Lao children.

22. The NCMC under the chairmanship of the Deputy-Prime Minister was set up in 1992 and reshuffled in 1996 and affiliates at the provinces, districts and villages were set up in 1993. The PCMCs were tasked to support, coordinate and monitor the implementation of the EPI activities and other activities relevant to mothers and children.

23. A National Meeting on Mothers and Children, which focused on a review of the Decade Goals for children, was conveyed by the NCMC in August 1996. This was the first time that central level of Government, all provincial governors and their PCMCs teams had come together to discuss past constraints and approaches for addressing the United Nations Convention on the Rights of the Child. This illustrated the political commitment and the meeting agreed to continue on efforts

for implementing measures for the child survival, the immunization program and other preventive health programs.

24. The NCMC hosted a meeting on Joint Government-UNICEF Strategy and five year program (1996-2000) for improving the situation of Lao children. The Joint program seeks to consolidate the gains of the past 5 years in the survival and development areas and initiate the emerging protection issues. This has widened the mandate of the NCMC, its province, district, and village affiliates from an EPI focus to monitoring and advocating all aspects of the CRC. The NCMC issued directives and targets on organizational improvement, child survival, development, protection and participation for its affiliates at the province, district and village levels for implementing in their respective areas. Each level of affiliate held meeting with organizations, including LWU and LYU for assigning tasks and monitoring the targets.

25. The LWU with 770,000 memberships in its organization networks from the central level to the province, district and village levels is the representative of the multi- ethnic women and children’s rights and interests. The LWU has carried out specific activities as follow: 1)-advocacy for all strata of the society on the articles of the constitution and the laws related to the women and children, the convention on the rights of the child, the convention on the elimination of all forms of discrimination against women through consultative meeting, workshops, and training of disseminating teams, 2)-establishment of advisory office to address women, families and children problems since 1997, and 3)-coordinate with concerned parties to widely disseminate the Beijing declaration on women and children for implementing and improving the gender equity in the families and society.

26. The LYU as a national organization plays an important role in shaping up the social development projects and programs for the Pioneer Organization under its umbrella. The LYU and through the joint efforts of UNICEF, and NGOs such as Save Children Norway and SC-UK for improving of child rights with regard to labor and risk of sexual exploitation, children and youth were represented in various consultative meeting at the central, provincial, district and local levels. Pioneers organize and implement preventive drug education games in schools and participate in the clean up of the public and community areas. This is seen as part of the fulfillment of the children’s rights to participate in governance with a special focus on disciple and moral education.

27. The full implementation of the UN CRC requires strengthening existing NCMC and its affiliates. Systematic data collection, documentation, and regular reporting at each level need to be established in order to monitor progress of indicators related to child survival, development, protection and participation.

Financing of social programs

28. An important aspect of implementing the Convention is the availability of resources from the government and external assistance funds. To this end, the government agencies involved in implementing programs for children such as the MOE, MLSW, MoH, MoJ, LYU, and LWU have prepared their national plans and budgets for specific programs and services for children.

29. The 1995 World Summit for Social Development encouraged the national governments and international donors to allocate 20 of their budgets on human priority expenditures in order to help nations achieve decent levels of human development.

30. The GOL expenditure for social sector increased from 12.5 percent in 1994-95 to 26.6 percent in 1996-2000 and the public investment in education has increased by 400 percent and in public health by 644 percent in the period 1996 to 20001.

Action at the international level

31. The Lao PDR actively participated in the Hanoi Plan of Action in 1996 and the Bangkok Declaration and Plan of Action in 1998 on the survival, protection, participation and development of children in 2000 and beyond.

32. The GOL will participate actively in the Fifth Asia and Pacific Ministerial Consultation, 14-16 May 2001 and adopt the Beijing Declaration on Commitments for Children in the East Asia and Pacific Region for 2001-2010.

33. The Convention on the Elimination of all forms of discrimination against women was ratified by the GOL on August 14, 1981. In fact the GOL has promoted equal right and social equity between females and males, and increased the role of females, including females ethnic minorities in the high leadership and management positions.

Chapter 4: Specific actions for child survival, development, protection and participation

34. This section presents the progress achieved in the area of child survival, development, protection and participation vis-a-vis the national and international goals that the GOL has committed to.

35. Significant progress of child survival, development, protection and participation were threatened by the Asian financial crisis which started in 1997 and broke the growth momentum of the Lao economy and caused adverse social impacts, some of them long-term. The long-term impact of the regional financial crisis is on the delivery of basic education and health service. For the education sector, at the household level, economical constraints have increasingly pull out from school female students during the past 2 school years. This is a result of combined effect of the substantial

1 Implementation of the CRC, NCMC paper. 7 0ceb5ab4a8fd92af213521db44a8270c.doc

decrease of national recurrent budget allocated for the basic education and the increase cost of parents’ contributions for the schooling of their children. On the other hand, the decrease of the GOL recurrent budget negatively impacts on the regular payment of teachers’ salary and the quality of education delivery, nation wide.

36. Despite these setbacks, significant progress has been achieved in the area of health, nutrition, education and access to basic facilities during the past decade. The end- decade goals for infant mortality rate and under five-mortality rate have been met. While progress has been achieved in some areas, in the other areas the pace of improvement has been inadequate for the country to meet its year 2000 goals.

Child survival

Child health

37. Government efforts have paid off in reducing the IMR from 117/1000 LB in 1990 to 104/1000 LB in 1995 and 82 in 2000, and the goal 2000 of 85 per 1,000 live births of the NPPD was exceeded. Under-five mortality rate (U5MR) remained at the same level for the period 1990 to 1995, and then obviously decreased from 170/1000 LB in 1995 to 102/1000 LB in 2000, and the goal 2000 of 127/1000 LB was exceeded.

38. The decline in the mortality rates was due to the significant success of the expanded program in immunization (EPI), the introduction of Vitamin A supplementation, a long tradition of breastfeeding practice (94.9% of children had ever been breastfed2), and the promotion of ORT. The EPI aims to reduce infant and child mortality due to the six immunizable diseases (tuberculosis, diphtheria, tetanus, pertusis, poliomyelitis and measles). In 2000, approximately 69.33 percent of children aged 12-23 months received a BCG vaccination by the age of twelve months and the first dose DPT was given to 83.2 percent. The percentage declines for subsequent doses of DPT to 67.5 percent for the second dose, and 52.8 percent for the third dose. Similarly, 81.2 percent of children received polio1 by age 12 months and this declines to 57.1 percent for the third dose. The coverage for measles vaccine by 12 months is lower than the other vaccines at 41.8 percent. The percentage of children who had all eight recommended vaccinations by their first birthday is low only at 32.4 percent. The NPA goals 2000 for the EPI, with the exception of polio, were not met.

39. The country was declared polio-free in November 18, 2000. By harnessing a systematic effort, the NCMC has forged a control network to combat polio in partnership with the concerned agencies, WHO, UNICEF, JICA, AusAid and NGOs. Polio drops were provided at the same time as Vitamin A to children 1-5

2 NHS, p.98. 3 NHS, page 84, BGC: 56; DPT: 23; complete dose of polio: 35; measles: 43; all type of immunization: 19. 8 0ceb5ab4a8fd92af213521db44a8270c.doc

years old. The coverage rate of polio drop increased from 86 percent in 1996 to 90 percent in 2000 for under-five children.

40. A National Committee for testifying the polio eradication was established on April 4, 1998 for producing evidences on polio eradication in Lao PDR to the Regional Committee of the Western Pacific Region. The latter was satisfied with polio status in Lao PDR and adopted a polio free declaration for Lao PDR as well as other countries in the region.

41. The current child health program works relied on the following strategies: (a)-maintain universal routine EPI Plus through village outreach 4 times per year to children 0-23 months, combined with Vitamin A supplementation and promotion of breastfeeding and ORT, (b)-maintain National Immunization Day strategy to ensure a comprehensive disease prevention approach for young children: undertake epidemiological surveillance to identify epidemic areas and target intervention more specifically in especially vulnerable and isolated areas, and (c)-stimulating health facilities for better service in zone 0 areas.

42. While slight progress has been noticed in the area of child health, future strategies shall focus on addressing the high levels of malnutrition, sustaining high levels of EPI coverage (with special focus on measles control), and integrated management of childhood illness (IMCI), especially to the North and the rural areas.

Maternal health

43. The maternal mortality rate (MMR) decreased from 653 in 1990 to 5304 in 2000, a figure well below the 2000 goal of 490 per 100,000 live births. The MMR is a major health priority. The provision of mother-friendly services is an important key determinant in improving the maternal mortality and morbidity rates. There are large disparities across provinces.

44. Teenage pregnancy is a contributing factor to high MMR. Most teenage pregnancies occur between the ages of 15 and 19 years old. Fourteen point 7 percent of adolescent females (aged 15-19 years old) number) have become mothers and 3.7% are currently pregnant with their first child. Overall 18.4% of Laotian adolescent have started childbearing. This is extremely high when compared with other countries in the region: 7% in the Philippines, 9% in Mongolia and 11% in Indonesia. The proportion of adolescent who have started childbearing rises with increasing age: increasing sharply from 3.5% among adolescents 15 years old to 40% among adolescents aged 195. Adolescent pregnancy increases maternal and fetal complications. Fetal mortality rate for teenage pregnancies is higher than those of mothers 23-24 years old. Finally, there is greater risk of premature births, low birth weight, inborn defects, mental retardation, and blindness.

4 NHS, page xv. 5 LNHS 2000, page 34 and 35. 9 0ceb5ab4a8fd92af213521db44a8270c.doc

45. Maternal malnutrition is a major factor affecting the unborn child’s chances for survival and normal fetal development. With the increasing recognition of the magnitude and the urgency of the problem, the Lao PDR has given priority to women’s health and safe motherhood since 1995. Strategies undertaken for providing mother friendly services as an important key determinant for improving maternal mortality and morbidity rates include (a)-expand access to, and usage of, existing quality basic health and nutrition services, especially in zone 0, (b)-mobilize community participation and involvement in the planning and development of community health and nutrition programs, and (c)-strengthen the integration and the convergence of health and nutrition services at the district and community levels by improving the package of comprehensive MCH package of intervention, including immunizations, Vitamin A supplementation, ORT promotion, breastfeeding education, growth monitoring and IMSD and STD treatment and HIV/AIDS prevention education and malaria prevention.

46. Although focus and resources are being put into women’s health and safe mother programs as well as expending the primary health care services, but resource levels are low relative to the need of the Lao PDR. The GOL has developed the PHC service through the loan from the Asian Development Bank, the World Bank and the European Union. Major constraints include the large number of women who currently receive little or no antenatal care. Only 35 percent6 of the women receive some type of antenatal care from various practitioners. There is high rate of unattended home birthing. At the existing health facilities serious deficiencies in the availability of trained care exits. There is limited number of midwives below the level of the district hospital. At the provincial hospital level often there are inadequate supplies and equipment. Accurate data for planning and monitoring are inadequate. Facilities are not heavily utilized skill level are often low. The GOL makes these a priority with assistance partners, but the sheer scale of the task to be accomplished makes rapid progress difficult in the short term.

Nutrition

47. Although no nutritional survey has yet been undertaken to ascertain the nutritional status of the population, existing data indicates that 20 percent in 1996 and 12.9 percent in 2000 of babies are born of low weight or too thin for their age. In 2000, 20.3 percent of children are stunted or too short for their age and 3 percent are waste or too thin for their height. More significantly, 3.3 percent of infant are estimated to weight less than 2,500 grams at birth. Children in the South are more likely to be under weighted, stunted and wasted than other children. Boys appear are more likely to be under weighted, stunted and wasted than girls. The age patterns shows that a higher percentage of children aged 12-23 months are more wasted than other age groups and children aged 24-35 months are more under weighted and stunted than other groups. This pattern is expected and is related to the age at which many children cease to be breastfed and are exposed to contamination in water, food and

6 MICS II, P.26, para. 5, NHS: page 79: 45% of women receives some type of prenatal care. 10 0ceb5ab4a8fd92af213521db44a8270c.doc

environment. The end-decade goals of 10 percent for low birth weight, 25 percent for under-5 stunting and 0 percent for waste have not been met.

48. Aware of the severe consequences of the micronutrient deficiency malnutrition, and the more immediate and visible effects of intervention that address micronutrient malnutrition, the GOL agreed to concentrate its efforts on the prevention and control of micronutrient starting in 1995.

49. The NPA defined the decade goal of anemia as the percentage of women with hemoglobin levels below 10grams/100ml. The percentage of women having the rate of hemoglobin less than 70grams/liter of blood was 35 in 1990, but the blood test in 2000 specified a range of minus 4, 4-7 and 7-11g/dl according to the WHO standard. The percentage of women having the levels of hemoglobin less than 4, 4-7 and 7-11 grams/dl was 0.02 percent, 1.33 percent and 30.06 percent respectively. In respect of these the end-decade goal is unlikely to be met7. Severe anemia during pregnancy is still prevalent in Lao PDR. To treat this condition, irons pills are supplied to pregnant women during their antenatal care visits. Since the usage of iron pills is extremely low, intensive efforts need to formulate realistic strategy and actions to prevent anemia during pregnancy.

50. Blood test was performed in 2000 with the target studies population. It was found that 1.95 percent of children aged 0-5 years old was severely anemic (hemoglobin 4- 7g/dl). This level of anemia was predominantly shown in the South of 1.64 percent than in the other part of the country. Females and males were slightly suffered from this level of anemia equally, 1.33 percent and 1.05 percent respectively, as well as rural and urban dwellers with more than 1 percent (1.50 percent) and less than 1 percent (0.63 percent). Less than 1 percent was severely anemic8.

51. The IDD had steadily improved since 1995 and is no more a major cause of preventable mental retardation. The IDD end-decade goal was achieved and has been sustained. In 2000, seventy six percent of households have adequately iodized salt. The percentage of households with iodized salt ranges from 72 percent in the South to 80.1 percent in the North.

52. In 2000, in testing the urinary iodine concentration of children aged 8 to 12 years old, it was found that 7.0 percent was in the status of iodine deficiency. The prevalence was more stressed in the South than in the North and Central with 8.0 percent, 7.8 percent and 5.6 percent respectively. Rural areas showed higher percentage when comparing to urban setting with 9.3 percent and 3.1 percent respectively. The deficiency was more prominent in girls than boys with 9.1 percent and 5.2 percent respectively.

53. The percentage of children aged 6 to 12 years old with endemic goiter was 20 in 1990. In 2000, the goiter survey among children aged 6-12 years old revealed that 91 percent do not have goiter. A decrease of the 11 percent in comparison with 1990

7 NPA, page 23 and NHS, p. 111. The NPA defined the decade goal as the percentage of women with hemoglobin levels below 10grams/100ml while the WHO defines anemia as a state of having the rate of hemoglobin less than 70grams/liter of blood. 8 NHS, p.112. 11 0ceb5ab4a8fd92af213521db44a8270c.doc

figure, but the end-decade goal of 0 percent goiter among children aged 6-12 years old is unlikely to be met. Children living in the Central region were not affected by goiter enlargement more than those living in the North and the South; 93.0 percent, 91.1 percent and 88.3 percent respectively. Children living in urban areas do not have goiter enlargement more than those living in rural setting; 92.6 percent and 90.0 percent respectively. Boys were free from goiter enlargement more than girls; 92.1 percent and 89.9 percent respectively. Nine percent of children were suffered from goiter level 1+2.

54. Vitamin A supplementation program for the children aged 12 to 59 months and for mothers started in 1996 to address the severe deficiency in the country. In 2000, 28.8 percent of children aged 12 to 59 months received a high dose of Vitamin A supplement. Only about 4.4 percent of mothers with a birth in 1999 received a Vitamin A supplement within eight weeks of the birth. This is a significant implementation success, but effort to distribute Vitamin A to targeted children and women will decline if the NID nationwide ceases.

55. The strategy adopted to address micronutrient malnutrition involved external assistance for Vitamin A supplementation and iodine mixture provided to salt factories in the short-term. The approach adopted for the prevention and control of young child malnutrition, especially protein-energy malnutrition is through parents’ advocacy. Nutrition is also directed at improving maternal nutrition and assisting with reducing MMR.

56. The Vitamin A supplementation is specifically targeted at postpartum women within one month of childbirth through integration with TBA training and the mother friendly/baby friendly initiative in the community health/safe motherhood project areas.

57. In the long-term, the strategy for IDD is on the sustaining of iodized salt production and supply and the elimination of IDD through a specific campaign to increase the adequate utilization, appropriate storage and consumption of iodized salt.

Safe water and sanitation

58. The World Summit goal for 2000 set a universal access to safe drinking water. The percentages of rural population and urban population with access to clean drinking water increased from 15 and 48, respectively in 1992 to 37.69 percent and 75.5 percent, respectively of households with access to safe drinking water in 2000. A steady increased access since 1992, but the 2000 goal of 80 percent access to drinking water for rural population was unlikely to be met. Any goal was set for urban population in the NPA.

59. In rural areas, by order of importance, 15.7 percent of safe drinking water originated from tube well/bore hole, 8.1 percent from gravity fed system and 7.4 percent from protected dug well. Obviously, although the results represented a tremendous effort of the GOL, but it was far behind the World Summit goal of universal access to safe

9 NHS, p.32. 12 0ceb5ab4a8fd92af213521db44a8270c.doc

drinking water and the NPA goal of 80 percent for rural population with access to safe water as the start-up levels were very low. In 2000, approximately 75.5 percent used safe water in urban was higher than in rural 37.6 percent. Both percentages were higher in the South than the Central and the North areas, 58.7 percent, 54.3 percent and 43.0 percent respectively. Significantly, the percentage of time spend for getting water by region indicated that the 35.0 percent of the households spend time more than 10 minutes as the sources of water were approximately far from household.

60. The water supply coverage had steadily increased since 1992 due to the support of UNICEF and a contribution in cash, labor and local materials from the local communities.

61. The strategy adopted was a decentralization of the water and environmental hygiene service to the province and district level and the provision of safe drinking water with the community contribution.

62. The NPA goals 2000 of urban and rural population with access to sanitary means of excreta disposal was 75 percent and 45, respectively. In 2000, 37.3 percent of the population of Lao PDR was living in households with sanitary means of excreta disposal, largely lagging behind the NPA goal 2000. There was large disparity between urban and rural areas, 67.1 percent and 19.0 percent respectively. Based on region, the South was very much less likely than other regions to use sanitary means of excreta disposal. This percentage was only 19.2 percent in the South, 45.0 percent in the North and 43.9 percent in the central.

63. Stools of young children under 3 are a problem because they are not adequately disposed. Forty-six point three percent of households did not dispose, 12.6 percent threw it outside the yard, only 12.6 buried it in the yard and 12.0 percent threw it in the toilet.

64. The NPA end-decade goals of 75 percent of urban population with access to sanitary means of human disposal and 45 percent of rural population with access to multi- user solid-waste disposal systems were not likely to be met. But the urban goal was nearly achieved while the rural goal did not improve much. The below target progress could be attributed to the smaller budget usually allocated for sanitation activities compared to the provision of safe water program. Other factors, which inhibited the achievement of the goals are the rapid population growth, especially in the rural areas, inadequate funding of the local administration to manage and implement water and sanitation program, weak monitoring scheme, low priority given to sanitation at all levels.

65. Despite these setbacks, the government is serious in trying to improve the situation and is addressing the sanitation problem together with the water supply problem.

66. To improve the use of human means of excreta disposals, communities were mobilized to participate in its construction. Hygiene advocacy was disseminated at the

communities and hygiene education was in integrated in the primary education curriculum.

Child development Access to childhood care and development service

67. The period from birth to age 5 is defined as early childhood and has been established as the most critical in a child’s life since what happens to the child in these years set the stage for long-life health, learning and behavior. Providing early childhood care and development (ECCD) services means addressing the need of the whole child for survival, growth and development. The ECCD services entail providing an integrated manner health, nutrition and psychological intervention for children aged 0-5 years. The GOL in its Education Development Plan set an increased target of 3 percent for the kindergarten and 5 percent for the preschool, yearly.

68. In 1999-2000, the total enrollment of the pre-school was 7.31 percent or 35,231 children aged 3-5 years old and the total enrolment of the crèches was 2,555 children aged 0-3 years old. The private crèches and kindergarten and pre-school altogether intake accounted for 18 percent of the total intake. Obviously, preschool education is largely urban and institution-based and could not be the sole response to the ECCD.

69. The GOL together with UNICEF and Save Children-UK and Norway launched successful community ECCD program in 8 of Laos’ 18 provinces. In 1999-2000, there were 12,754 children (or 10.4% of the children aged 0-5 years old), 22 districts, 125 villages and 10,631 households of the 8 provinces involved in this programme. It was a steady increase given that ECCD started with 15 villages in 1992-93.

70. The strategy adopted for ECCD include (a)-develop and use of media to reach parents, especially those in remote areas, (b)-carry-out parent education, and (c)-using media to promote better early childhood development in the country.

71. A preliminary evaluation of the ECCD program indicated that children health, nutrition, physical and cognitive development has steady improved and the villages have improved in health and nutritional patterns. According to the school year 1998-99 data, the percentage of primary grade 1 entrants with ECCD experience is 20.0%, girls 22.5%. The survival rate to primary grade 5 of children is 54.4%, girls 53.6%10 and contribution of children with ECCD experience is validated in improving this rate. They perform better than those who haven’t gone to the ECCD program do. The target areas were still limited due to limited fund, but it appeared to households and communities that ECCD is a positive alternative to formal pre- schools and kindergartens.

10 The survival rate of grade 1 to 5 is 53% in 1999-2000, Report on the assessment of the implementation of the education development plan (AIEP) 1996-00 and education plan 2001-05. 14 0ceb5ab4a8fd92af213521db44a8270c.doc

Access to basic education

72. The GOL education development plan formulated an education for all for the children aged 6-10 years old. The strategy adopted was two-pronged; one is to achieve the quantitative target of 80 percent net enrolment rate and the qualitative improvement of the service delivery for 2000. Large educational investment programs in cooperation with the World Bank, Asian Development Bank, UNICEF and NGOs started in 1992 to support the GOL education development plan.

73. The net enrolment rate (NER) of primary education slightly increased from 63 percent in 1992 to 77.3 percent in 2000, below the NPA 2000 goal of 80 NER. Female students represented 45 percent of the total primary students. The private primary schools represented 2.03 percent of the total primary enrolment in 2000. Large disparities in primary enrolment were noticed between provinces, ethnic groups and vis-à-vis remoteness. The highest NER was Vientiane province (94 percent) and the lowest were Xekong province (51 percent). In comparison with 1998-99, some provinces regressed, namely Oudomxay, Sayabuly, Xiengkhouang, and Attopeu.

74. In 1999-2000, the gross enrolment rate (GER) for grade 1 was 112.16 percent and the NER was 54.9 percent11. Girls represented 45 percent of the total new intake for grade 1. Vientiane province and Vientiane prefecture recorded high NER for grade 1, 86 percent and 82 percent respectively, while Phongsaly, Oudomxay and Attopeu provinces were the lowest, 24 percent, 24 percent and 23 percent respectively. Recently the trend was a decrease of the new NER in grade 1.

75. Access to basic education was expanded through three pronged strategies of increasing the teacher ratio, expanding schools in school-less villages and completing “incomplete” schools. Where it is possible, expand the multi-grade classes. The teacher pupils’ ratio decreased from 33 in 1991-92 to 30.1 in 1999- 2000, the number of schools increased from 7,148 to 8,161, and the number of incomplete schools was down from 5,005 to 4,394 for the same period. The number of multi-grade classes in the primary complete schools increased from 895 to 1,175, but decreased in the incomplete schools from 3,467 to 3,16312 for the same period. This latter figure indicates that the number of pupils per school was increasing.

76. The average percentage of repeaters did not much improve during the decade, it was 21 percent in 1992 and 19.9 percent in 2000, and was lagging far behind the expected 2000 goal of 4 percent. Most importantly, the repetition rate of grade 1 was down from 43 in 1991-92 to 33.9 percent in 1999-2000, there was substantial improvement during the decade, better than the average percentage of repeaters for the five grades.

77. Despite the low investment per primary student, the GOL had make substantial progress in term of access to basic education. On the other hand, the slow

11 Report on the implementation of the education sector 1999-2000. 12 Education data, 1992, 1997, 2000. 15 0ceb5ab4a8fd92af213521db44a8270c.doc

improvement of the repetition rate coupled with the low and stagnant retention rate resulted in high gross enrolment rate (109 percent in 2000), and thus negatively impacts on the efficiency of the primary education. Approximately 20 percent of the primary teachers are unqualified; these could hardly implement the new curriculum and textbooks.

78. The percentage of GDP allocated to the education sector was 2.3 in 1993-94, up to 3.1 in 1996-97 and felt down below 1.4 in 1998-99, the lowest it has ever been in the 1990s. The percentage of education in government budget was 10.9% in 1993-94, 13% in 1995-96 and 7.3% in 1999-2000, the lowest for the period13.

79. The East Asian financial crisis in 1997 has fueled the inflation of the local currency and thus has eroded much of the spending power put into education, the education sector has also getting a smaller share of the total public budget. Given the trend in resource allocation, population structure, reliance on formal educational delivery systems, the end-decade goals for many indicators were not achieved. Achieving these goals will require innovative approaches that go beyond the traditional delivery systems, and will require reaching the hardest to reach children who have remained outside the fold of education system. There are children living in remote and isolated areas, girl minorities’ children, working children and disabled children.

80. Enhancing access to basic education is guided by many policies: (a)-improve the education management in order to provide good and continued service, (b)-expand the access opportunity in line with the socio-economic development, and (c)- decrease the gaps between regions, genders and ethnic groups.

81. In line with these, various foreign aided programs were implemented, including the Education Development Project (IDA, SDC and Norway), the Education Quality Improvement Project (ADB and Norway), the Basic Girl Education Project (ADB and Australia’s AusAids) and the Basic Education Projects (UNICEF), all had major components that were targeting at improving the quality and the access to the primary and lower secondary education.

82. Other initiatives undertaken by the GOL, NGOs and private institutions to enhance access to basic education were programs and projects to support the non-formal education of children and school dropouts.

Quality of education

83. The new primary curriculum and related textbooks and teachers’ guides were developed and disseminated through the orientation courses. A student-centered teaching methodology was provided to 27,592 primary teachers, nation-wide. To assist primary teachers for improving the quality of primary education, the pedagogical advisor system was established for supervising classroom teachers, nation-wide.

13 Report on the AIEP 1996-00 and education plan 2001-05, page 34 and 35. 16 0ceb5ab4a8fd92af213521db44a8270c.doc

84. In 1999-2000, a students learning assessment outcome indicated that the grade 4 pupils learning results averaged fair to good for mathematics, Lao language and world around us. This implied that the quality of primary education was not yet satisfactory.

85. The retention rate of the students from grade 1 to grade 5 of the primary improved from 41.7 percent in 1991-92 to 56.6 percent in 1996-97 and 54.4% in 1999-2000. Given the progress made during the above period, the end decade goal for retention rate of 80 has not been achieved. Substantial disparities were noticed between boys (58.0%) and girls (49.7%). The number of year a student spends from completing the primary education decreased from 11 years in 1991-92 to 9.3 years in 1999- 2000. Even substantial improvement has been made; the quality of basic education was unsatisfactory.

Literacy

86. The adult literacy rate increased from 50.2 percent in 1995 to 74 percent in 1999-2000. Despite this progress, the national aggregate rate masked disparities between rural and urban areas and across gender in regions with low literacy rates. There are pockets of illiteracy in remote and isolated areas populated by ethnic minorities.

87. The functional literacy rate showed a significant improvement year by year. Few districts were able to achieve the universal functional literacy at the primary level for this age group 15-40 years old. There were 135 community-learning centers and 19 non-formal vocational centers, which provided courses on tailoring, weaving, chicken raising and life skills to adults and young people. These were targeting at the poor and disadvantaged group for improving their capacity to engage in self-help and community development activities. Some received revolving fund for developing their home-based economy.

88. The Ministry of Education implemented various local and foreign funded programs to reduce illiteracy of women and children. Among the literacy programs and projects to address girl education conducted are the following:

89. The project on education and the development of ethnic minorities’ people (1995- 2000) for eradicating illiteracy and providing professional skills to women and children through the establishment of community learning centers in 21 villages in Xiangkhouang and Oudomxay for 1,500 targeted groups.

90. The project for the promotion of education for girl child, a joint project of the central LWU, SPC and MOE was implemented in 1998 in Nonghad district, Xiengkhouang province to address school non-attendance of girl child.

91. The project on education for girl child was implemented in 1999 in Sayabuly, Vientiane, and Champassack provinces to address school non-attendance and difficulty in graduation of girl child.

Child protection

Child protection goals

92. The aim is to make the child protection goals the responsibility of all agencies and all citizens in the society. The following paragraphs highlight principal Lao legislation in which special consideration is extended to mother and children protection.

93. Article 20 of the Constitution, promulgated on 15 August 1991, stresses the importance of mothers and children in Lao society, and emphasizes the state’s commitment to favorable policies in their regard. The article places the responsibility for detailing the specific rights and protection of children on the individual government bodies concerned.

94. A Decree of Prime-Minister in 96 required compulsory primary education for all children. An Education law enacted in 2000 adopted Primary Education Compulsory. The Prime-Minister decree and the education law issued on 26 April 2000 as well as the article 8 of the constitution provide the legal and administrative framework for the right to education to the child.

95. Articles 29-33 of the labor code provide protection for women and child workers, they include a list of dangerous activities in which women and children should not be engaged (work at heights of 5 meters or more above the ground, work where high speed machinery is involved, hard work which may have health hazards); provisions for maternity leave (3 months); types of work prohibited during pregnancy (work involving carrying heavy weights or standing long hours); working hours (48 hours per week – six days/week and 8 hours/day, 6 months old: no overtime during pregnancy nor until 12 months after the birth): financial support for delivery costs (60% of the woman’s salary of the amount fixed by the state); special conditions for the recruitment of workers under 18 years of age (maximum of 6 hours/day or 36 hours/week—work prohibited includes mining, jobs which involve exposure to dangerous chemicals, hard labor, urban cleaning, processing of remains for cremation and other difficult work as cited in article 21); minimum working age (15 years); and retirement and pension rights (55 years for women).

96. The family law also contains special provisions for the protection of mothers and children: article 5 places the responsibility for mothers and children of broken households on the state and society; article 9 states the minimum age for marriage (18 years under normal conditions, between 15-18 years in special cases, and in no case less than 15 years); articles 28-36 state the rights and obligation of parents and children; articles 37-42 state the conditions and procedures for adoption of children; and articles 43-46 state the conditions for appointment, the rights and obligations of guardians.

97. Regulations for the adoption of children are further detailed in decree no. 69 of the ministry of justice which includes: the presentation of guarantees from the future foster parents insuring their sound moral, physical and financial dispositions, legal consent by the natural parents when known, heritage rights for the adopted child. 18 0ceb5ab4a8fd92af213521db44a8270c.doc

Justice system for children

98. The Ministry of Justice has cooperated with Save the Children-UK for providing series of training on Convention of the Child Rights with focus on the court and justice proceeding for the offenders who are children. The participants were the judges, attorneys, policemen, district governors, village headmen and Lao women union. They were requested to implement the content of the training in their respective organizations in compliance with the Penal Code. Children under 15 years old are not punishable for their offense; parents are responsible for the damage caused by their children. The latter has to make written statement for non-recidivate. This special measure avoids them to appear at the court. Other similar measures are also in place for providing mind and humanitarian re-education process for the children who have problems with the law.

Children in conflict with laws

99. The Ministry of Justice carried out training of trainers for establishing court committees for dealing with children cases at the provincial and district levels. For this purpose, statistics collection on number of children in conflict with laws was carried out at both levels. Data are not available for this report.

100. The MLSW’s information center on the Convention on the Rights of the Child supported by Save Children Norway was established to collect statistics and information on measures to address the Rights of the Child and to provide information to the public and Child on the Rights of the Child. This has improved the public awareness on and contributes to a better understanding of the Rights of the Child.

Child labor

101. The penal code defines children as all those under 18 years of age, and further subdivides this group into two: those aged 1-15 and 16-18. In the case of the former group, the child is absolved of penal responsibility, and in this case, special provisions are delineated. Articles 17 and 36 of the penal code exempt children (the offender must request pardon from the damaged party, the offense may be publicized, the child may be sent to his/her family, guardian, administrative authorities or social organizations for re-education). Article 37, which lists causes for increased penal responsibility, includes infractions against children. Article 120 provides specific punishment for acts of sexual abuse of children. Several articles also exempt children under 18 and pregnant women from certain punishments i.e. articles 29 (life imprisonment), 34 (house arrest) and 30 (death penalty).

102. Many children aged 15-18 years old were illegally seeking work in neighboring Thailand. Few official figures of children working illegally are available.

103. The LYU has conducted surveys and participatory research projects on child labor and children who illegally cross the border to work in Thailand. The sample survey in 15 villages of Savannakhet province’s Khanthabuly district indicated that 14 percent of the children aged 6 to 18 years old are working in Thailand. A LWU project document14 indicated that over 200,000 Lao nationals work in Thailand, and also no data on child labor. There are 8 Lao provinces which border Thailand and all are known to be areas in which large numbers have gone to Thailand for work, the majority illegally.

104. The MLSW survey in 1997 indicates that there are in Savannakhet province 2,500 people, of which 630 children, in Champassack province 1200 children, and in Khammouane province 1,800 people, of which 302 children, who went to work in Thailand between 1997 and 1999.

105. This figure of children working illegally in Thailand is significant as those who work illegally in Thailand have little knowledge of labor laws both of Lao PDR and Thailand. They are therefore exposed to coercion and exploitation involved in the migration process, or their fate once they arrive in Thailand. Those that were caught by the Thai immigration were sent back through the border immigration checkpoints, 23 in 1997-99 and 83 in 2000. The police took their records and the MLSW and the LYU provided counseling and training for their re-insertion in the society such as tailoring, beauty saloon, hairdresser, repair and construction.

Neglected and abandoned children

106. There were 19,229 orphans of single parents and of both parents in Lao PDR in 1994. This is one of the largest groups of disadvantaged children that the government has to provide support because they came from rural and poor families.

107. The MLSW in collaboration with an NGO (SOS or Save Our Soul) has implemented the project Children Villages in Lao PDR in February 1993. Three children villages were constructed to host 370 orphan children in Vientiane Municipality, Pakse and Xiengkhouang. One is under construction in Luangprabang. The intake age of the new entrants in the children villages is 7 years old or less. The children can stay in the CVL and develop their potential up to the secondary level. Pre-school, primary and lower secondary education were located in the CVL campus for providing education and development for CVL orphans as well as children who came from neighboring communities. As such orphans development is exposed to other children experiences. Four management principles laid the foundation of the children villages: the children and their adopted “mother” form a family, all the children are brothers and sisters, they are part of the same family, and they belong to the same village.

14 Strengthening LWU Project. 20 0ceb5ab4a8fd92af213521db44a8270c.doc

108. A house is provided to one mother per 10 children. The mother takes care of all aspects of the children survival, development, protection and participation. The rights of the child were strictly observed in the children villages by providing means of survival, a new life and a future for the children. The mother is not allowed to beat and to scroll her children. The children villages were a success and were always full of children.

109. Number of orphan children hosted in the CVL was still limited, but the project keeps expanding each year. Orphan children who are really in need of assistance and protection was selected and recruited in the CVL.

110. The Lao government has also established, at its own cost, orphanage boarding schools in Bokeo15, Luangprabang, Oudomxay, Huaphanh, Sayabuly, Vientiane and Savannakhet provinces to host orphans, neglected and abandoned children. The schools provide full accommodation, clothing, life skills learning, and formal education up to lower secondary level, protection and development for children aged 7 and over. The selection criteria was (1)-disadvantaged children of poor families, (2)-children can help themselves for their own daily duties such as wearing cloth, eating, going to toilette and so on. The provincial authorities run these schools and due to poor communication, updated statistics were not available for this report.

111. The number of orphan children intake in the boarding was still limited to those disadvantaged and needed. The majority of those who could not been hosted in the boarding schools did received some counseling and clothing from the MLSW.

Girl children

112. In Lao PDR, three factors prevent girl children from getting equal education and development opportunities like boys. The education service did not have adequate methodology and structure to address girl education; the economic constraint would push poor families to withdraw girls rather than boys from the schools, and the cultural practice of the ethnic minorities favor boys than girls education. To address these limitations, the GOL in cooperation with ADB and the Australia’s AusAid implemented a Girl basic Education project in 1999.

113. The project aims at providing innovative approach in dealing with girls’ education. New materials and teaching methodology were developed for keeping girls in primary school as long as possible. Teaching and learning were specifically developed to teach Lao as a second language to ease the communication and the learning achievement of the ethnic girls and minorities students. The provision of 300 female ethnic teachers to the schools that participated in the project intended to contribute for a better learning environment of girl-friendly schools.

15 Bokeo: 300 children, 2000; data not available for other provinces. 21 0ceb5ab4a8fd92af213521db44a8270c.doc

114. One of the project components is to get the ethnic minorities girls enrolled in the Teachers Training Schools so that, upon their graduation, they could provide more appropriate teaching to their mates, who seldom speak the national language. The ethnic girl trainees were selected in specific areas where they have to return upon their graduation. A foundation class for upgrading the general knowledge was introduced in the TTS to enable the ethnic girls to catch up with the standard level of the curriculum. Teaching and learning materials were specifically developed to address the need of ethnic minorities’ girls and a 3-year “Sandwich” curriculum was introduced, by which the girls learned theory in the TTS in the first semester and practiced teaching in their village school in the second semester. This dual system keeps the trainees close to their native village and was intended to reallocate trainees in their villages upon their graduation. The government supports their accommodation, food, travel, and clothing allowance. The TTS closely monitor to ensure their social integration in the school campus.

Victims of sexual abuse and commercial sexual exploitation of children

115. Child sexual abuse is a sensitive issue in Lao PDR and it’s not easy to protect children from it because of a traditional reluctance to intervene directly with the families. When child sexual abuse takes place, village leaders, including representatives of Lao Women Union, Lao Youth Union and police generally resolve the situation.

116. Few data is available from official sources on child sexual abuse. In 2000, 5 girl children who were sent back to Lao PDR from neighboring country recognized that they were recruited by middlemen for working in factories, but in fact they had been lured into commercial sexual exploitation. These are few cases that got into the hands of the MLSW, numerous cases of children sent through the provincial immigration check points and voluntarily returned to Laos were not recorded. Those who felt under the MLSW responsibility were registered in the police file and were provided with counseling and training, which provided them with professional skills for their re-integration in the society.

117. The MLSW and the LYU surveys on commercial sexual exploitation in 1998 indicated that there were 20 children in Champassack province and 23 children in Khammouane province, with very high-risk of being sexual exploited by serving drink and alcohol in the hotel, guest houses, bar, and night clubs. They were between 14 and 18 years old.

118. The MLSW established the Children’s assistance section that has jurisdiction over the 17 provinces. They also have officers at the local levels that are responsible for collecting information on social problems.

119. The MLSW conducted piloted training program in core skills for working with children in especially difficult circumstances in 1997, provided training on sexual abuse and the Convention on the Rights of the Child to 120 officers in 1999 and

training on the rights of the child for 20 teachers and on sexual abuse control for 24 medical workers in 2000.

120. There have been no programs in Lao PDR that specially address the needs of SEC or SAC. But there have been many projects recently implemented that aim to reduce the risk factors that leave children to all forms of exploitation and abuse. Projects and programs related to sexual abuse and sexual exploitation are research, counseling and educational programs that address HIV/AIDS. These programs are still limited in their capacity to fully address the needs of the population. Few staffs were trained for working with sexually abused or sexually exploited children or adults.

121. The government and mass organizations are developing prevention programs, social services and awareness campaigns for children and youth who are in vulnerable situations or difficult circumstances. The programs have been done in collaboration with international organizations such as UNICEF, Save the Children UK, Church World Service and Save Children Norway.

122. Other organizations that are working on issues related to commercial sexual exploitation include the police, the LWU and the LYU. These organizations have affiliates who are responsible for dissemination of information and training on laws and policy related to women, youth and children. The police are responsible for collecting statistics on children who have been exploited or abused. They are also responsible for law enforcement.

123. There are several law articles in the penal code that protects people against rape, incest, pornography, abortion and prostitution. There are also laws that may be used to punish children for having abortions or being engaged in prostitution. Some of the articles institute more severe punishments for crime committed against children than they do for crimes committed against adults. There are no articles that protect children from other forms of child sexual abuse or sexual exploitation. In the case where the child is an offender, parents are made responsible for their actions. In regard of the specific protection of children, the existing articles lack clear definition regarding types of offenses, ages and gender of the victims. The following paragraphs provide details on the specific legislation.

124. Rape: Punishment under the Rape Article 119 range between 3 to 20 years, life or death penalty depending on the severity of the crime, the age of the victim and whether or not the victim suffer physically or dies (Penal Code, 1997). The law punishes the rape of female child victims between 15 and 18 years more severely than the rape of adult female victims. The law does not specifically mention punishment for the offenders of male rape victims who are 15 years old or older.

125. Under the child Rape article 120, punishment for having sexual relations with a male or female child below the age of 15 is imprisonment between 1 to 5 years (Penal Code, 1997). Rape is the only form of sexual abuse addressed in this article.

126. Pornography: A person can be punished with fines between 5,000 and 50,00016 Kips under article 127, for making, distributing or using pornographic or other materials offensive to the nation. There are no specific laws that protect children from being used in pornographic production or from being exposed to pornographic materials (Penal Code, 1997).

127. Prostitution: The laws protect minors from being prostituted. The prostitution Article 122 punishes by imprisonment between 3 months and one year, any person who engages in commercial sexual relation as a form of income and punishes any person who assists the person in engaging in prostitution.

128. Also, Article 123 punishes by imprisonment for 6 months to 3 years anyone who obtains an income by procuring persons for prostitution. If the person who is procured for prostitution is below 18 years old or is under the offender’s responsibility and is forced to be prostituted the punishment is more severe by imprisonment of 3 to 5 years (Penal Code, 1997). There is no mention of gender of the victims in this article.

129. Trade and abduction of person: To protect children from being trafficked, article 92, punishes a perpetrator by imprisonment from five to fifteen years for the trade and abduction for the purposes of receiving a ransom of persons. Under this article there is no specific protection for children.

130. Incest: Article 124 punishes the act of sexual relations with a close family member, including children, by imprisonment of six months to one year (penal code, 1997).

131. Parental responsibility: Under the family law article 33, both parents are the representatives of their children and they take responsibilities for their actions in cases where the children need to have their civil rights and benefits protected in places such as the court of law, at work, in school and other places.

132. In cases where the parents neglect their children, the children may be removed from the custody and representation of the parents (family law, 1997). Cases of juvenile delinquency where children are between 15 and 18 years of age are put under the discretion of the court.

133. Conditions for marriage: The family law does not specify an age of consent for engaging in sexual relations. However, article 9 regarding conditions for marriage states that men and women have the right to marry when they are at least 18 years of age. In special cases, where it is seen as necessary, the age of marriage may be below 18 years but no less than 15 years old. In the event of marriage the man and woman must both agree on marriage and there must not be any force from either party to marry.

134. The Labor Law stipulates that children under 18 years of age should not work more than 6 hours per day and 36 hours per week. They should not work past 10:00 PM

16 Official exchange rate as-of March 2001: US$1=Kip 8,230.00 24 0ceb5ab4a8fd92af213521db44a8270c.doc

and before 5:00 AM. The children must also have 11 hours of rest before they begin work again and they should not work with dangerous substance. Another part of the child labor law article states that children under 15 years of age are not allowed to work. Also, children are not allowed to work with hazardous substances. Alcohol is not noted as a hazardous substance.

135. Abortion: Anyone who performs an illegal abortion may be punished by imprisonment between two and five years. A more severe punishment of five to ten years’ imprisonment is allowed if illegal abortions are being performed on a regular basis or in the case that the wrongdoers make the health of a woman worse or she dies. A woman who performs or tries to perform an abortion on herself or has someone else perform the abortion for her will be punished with imprisonment between three months and one year.

136. Policy: The government signed the convention on the rights of the child (CRC) in 1991. This document calls for the protection of children’s rights in the four categories of participation, development, protection and survival. Since the signing of the convention the government has begun to develop policy and projects aimed to protect and advocate for the rights of Lao children. The National Commission for Mothers and Children NCMC is a body of representatives from several ministries that was established to develop policy and monitor progress of the country’s commitment to child rights under the CRC. Each province has a provincial commission for Mother and Children office, such offices are existing down to the District and Village level.

137. The government of Lao PDR also signed the Convention on the Elimination of all forms of Discrimination Against Women in 1990, which has articles that related specifically to suppression of trafficking and prostitution, the best interest of children, and legal rights of children.

138. The Government of Lao PDR has made strong commitment to improve the lives of women and girls. Over the past decade, there has been increased access to education and professional opportunities for Lao women. The LWU in particular has played a major part of advancing the education and professional opportunity for women.

Children and HIV/AIDS

139. While the number of children affected by HIV/AIDS remains very low, the reported cumulative HIV positive cases dramatically increased from 1 in 1990 to 86 in 1995 to 717 in December 2000. The reported cumulative AIDS cases increased from 1 in 1992 to 8 in 1995 and to 190 in 2000.

140. There were 213 new HIV infections recorded in 2000, 30 cases progressed to AIDS and 18 people died of AIDS-related causes. Overall 72 people are known to have died.

141. The reported cumulative cases of children under 13 years old were 2 for HIV positive and 2 for AIDS infection, all through mother. For those between 13-19 years old, 4 cases of HIV and 3 cases of AIDS infection, all through sexual transmission

142. The spread of HIV/AIDS is of growing concern for Lao PDR. Because of the high rate of AIDS in neighboring countries there are great concern that Lao people working in Thailand are at high risk of contacting the virus and bringing it back to Laos. There are also many migrant laborers from foreign countries who come in Laos, mostly on road and dam construction projects.

143. Common high-risk behaviors for contacting STDs and HIV/AIDS, in Lao PDR, include condom misuse and excessive alcohol use. The major mode of HIV/AIDS transmission is 90% heterosexual intercourse. Other infections have been through mother to child transmission, and transfusion of infected blood. There are 3 cases of peri-natal transmission. Male and female ratio of the HIV/AIDS infections is 1.3 to 1. Of the known cases, 20-29 year old age group appears to be the most vulnerable.

144. Even thought the incidence of HIV/AIDS is increasingly high, but the prevalence rate is very low in comparison with the neighboring countries. These figures may be misleadingly low, as reporting comes from only ten of Laos’ 18 provinces and testing is extremely limited and often non-random even where it is available.

145. These figures are contrasting with the high risk-risk behaviors of young people aged 14 to 18 years old who are working in nightclubs, resort, guesthouses, hotels, and bar-restaurants and have high risk behavior for commercial sexual exploitation. The MLSW survey in December 1998 indicated high rate of sexually transmitted diseases (STDs) in the young population of Lao PDR. There is evidence that some children working in these above establishment lack of knowledge about condoms and birth control, they were at high risk of contracting HIV/AIDS and/or becoming pregnant. Alcohol served in establishments where sexual exploitation also occurred encourages certain high-risk behaviors including unsafe sex.

146. The Trust’s provincial and sectoral partners have identified the groups at highest risk, and are the focus of the HIV efforts. They are (1)-service girls, such as bar and hospitality workers, (2)-young people, including students and out of work and out of school youth, (3)-mobile population, (4)-men and women with multiple sex partners, and (5)-wife as she can’t negotiate sex and condom use, even with a husband. The Trust and its partners conducted awareness campaign in schools and entertainment establishments.

147. To combat the HIV/AIDS epidemic, the Lao government established the National Committee for the Control of AIDS since 1988. The NCCA have affiliates in the provinces (Provincial Committees for the Control of AIDS or PCCA) and districts (District Committees for the Control of AIDS or DCCAs). The NCCAs and affiliates mandate is coordinate with concern institutions and provide technical assistance for the control of HIV/AIDS.

148. In July 1998, the Lao government in collaboration with UNDP and UN AIDS launched the Lao PDR HIV/AIDS Trust to mobilize and co-ordinate resources for the most effective support of the National HIV/AIDS/STD Plan. Its serves as a resource management mechanism that offers benefits to both implementers and supporters of the national response.

149. National efforts have increased the awareness of the general population about HIV/AIDS however; this is not always resulting in changed behavior, which remains our largest challenge. However condoms are now increasingly available, and the high profile condom promotion campaign is encouraging more people to be open in discussing sex, condoms and HIV/AIDS, which is a first step to changing behavior.

150. The Trust strategy is to strengthen the government’s HIV/AIDS related policies and mobilize districts and villages to reach the general public. Through targeted interventions to the most vulnerable groups, combined with raising general awareness and sensitivity, it is possible for low-prevalence countries such as Lao PDR, to avoid an advanced epidemic.

Children in especially difficult circumstances

151. In 1996, the MLSW in collaboration with UNICEF, SC-UK and CWS implemented a project for children in especially difficult circumstances (CEDC), the first of this kind, in Vientiane Municipality, Savannakhet and Bokeo provinces. The project objectives were (1)-to assist CEDCs, (2)-to find ways to protect them from dangers, (3)-to promote the enforcement of the child rights, and (4)-to maintain peaceful order.

152. Various consultations and meeting at the central, provincial and district levels were held with LYU, LWU and concerned line agencies on CEDCs definition and status as well as on the promotion of the Child Rights among participants. Other aspects of the CEDC that were disseminated to the CEDC targets are the high-risk of sexually exploited children in Lao and those who were been lured to go to Thailand, children that illegally cross-over the border to work in Thailand.

153. The line ministries and provinces held cascade of meeting on the similar content in their respective organizations.

Children with disabilities

154. In 1994, there were 5,570 children, of which 2131 girls with general disabilities, and 5,610 children with hearing-vision-olfaction-speaking disabilities, nationwide. Out of the children with general disabilities, 1118 children, of which 442 girls were limbed handicaps.

155. In 1992, under the cooperation of the Ministry of Education and the National Rehabilitation Center, Ministry of Health, a special school in the National

Rehabilitation Center was opened for the first time for the blind and deaf children. There were only 25 pupils attending the school and there are now over 120 pupils. Blind children only attend the special school for sometime until they have basic Braille knowledge and then move on to an Inclusive Education school. This decision is up to the child and the family.

156. In the academic year 1993-1994, with the support of UNESCO and Save the Children UK, the Inclusive Education Project was piloted in one primary school in Vientiane Municipality. The project objective was to integrate children with mental and physical disabilities in the formal education setting. It also aimed to improve the quality of education in order to lower failure, repetition and dropout rates by ensuring that schools took an active role in recruitment and retention. It also required the improvement of working processes in schools and classrooms to help children to learn more successfully.

157. The school accepted 13 children with mental and physical disabilities in 1993-94. While implementing the pilot project for 2 years, there were lots of difficulties faced; however, it was proven feasible to expand the project applying all gained experiences. At the same time, the new way of working was introduced, which emphasised capacity building of personnel implementing the project, and so, in academic year 1995-1996, an expansion was made to – primary schools and 3 kindergartens. Each year, since then, expansion to new provinces, districts and schools has taken place.

158. The children with disabilities inside the project increased from 13 in 1993-94 to 610 in 1999-2000. Twelve provinces, 28 districts, 28 pre-schools, 47 primary schools and 3 secondary schools were involved in the project.

159. Most children are doing well in school, communities and families are active and supportive, and the general quality of education has been improved to a satisfactory level. There was a significant reduction in failure, repetition and dropout rate in Inclusive Education schools.

160. These were steps we have taken over the past years. There is still a long way to go before all children, especially the disabled, have access to education and to make all schools feel that having children with special education needs in schools is normal. The project keeps expanding and its continuity is ensured with the support of the international organisations, such as Save the Children UK, SIDA, UNESCO and others.

Children and substance abuse

161. The LYU survey in 6 northern provinces, namely Oudomxay, Luangprabang, Bokeo, Phongsaly, Luangnamtha and Sayabuly indicated that youngsters aged 8 to 18 years old or below were increasingly addicted to substance abuse, especially meth-amphetamine and opium. The majority of the addicts were boys. In some districts, youngsters represented 20 to 50 percent of all the surveyed addicts. While opium abuse was confined to the traditional poppy cultivation areas, meth-

amphetamine addiction was spreading to urban areas and cities. Children addicted to meth-amphetamine outnumber those addicted to opium. Few addicted were gone through the treatment and rehabilitation centers.

162. Even though the prevalence rate of those addicted to the two above-mentioned drugs are very low; the incidence rate of meth-amphetamine abuse and addiction among youngsters was increasing during the past 2 years.

163. The Lao National Commission for Drug Control and Supervision mandated a school survey on drug abuse among youth in collaboration with the MOE and UNDCP on 12 November 1999. Thirteen schools in Vientiane Prefecture were the targets of the survey. Overall, the most popular drug use (lifetime use) by youths in the age group of 12 to 21 year old were solvents (5.4%), ATS or “Yabaa” (4.8%) and abuse of prescribed drugs (4.7%)17. The data shows that the most susceptible age group is between 12 to 19 years old. Males (25.1%) reported a higher percentage of drug use at some point during their lifetime compared to females (9.85%). Boys in the 17 years old age group have extremely high lifetime prevalence rates of ATS use (14.1%) and solvents (11.4%). Drug abuse seems to be on the increase in schools in Vientiane.

164. Facing with this menace, in 1999 the GOL seriously tackled the problems at the beginning by establishing ad-hoc committees to combat drug abuse at the central level (government and ministries) to the provincial, district and grassroots levels (schools and communities) with short and long-term objectives.

165. The short-term objective was the establishment of school and community-based anti-drug abuse task forces whose mandate was investigating in and out-of-school children drug abuse-related behavior and providing counseling and mitigated measures in connection with peers pressure, parents, community leaders, grassroots mass organizations and security networks. In 1999, anti-drug abuse curriculum and related recreational activities for children were piloted in primary and lower secondary schools in 10 provinces, out of the 18 provinces. Community-based drug abuse prevention activities were also introduced and integrated in poppy reduction and rural development programs in areas of high prevalence rate of drug abuse. These measures created positive impact on parents and community awareness against drug abuse.

166. The long-term objective of the task forces is to develop a full-range of measures, including mandate, revised legislation, means and mobilizes fund to combat drug addiction among in and out of school youngsters. The ad-hoc committees to combat drug addiction were established at the central, provincial, district and grassroots levels, especially in the government structure and communities to monitor and raise awareness of target groups, provide gateways and alternative solutions to drug addiction.

17 LNDC/UNDCP Report on drug abuse among youth in Vientiane, school survey, page 4. 29 0ceb5ab4a8fd92af213521db44a8270c.doc

Children and unexploded ordnance

167. Lao PDR was heavily bombed during the Indo-Chinese war, especially between 1964-1973. More than 3 million tons of bombs were dropped onto Laos, and 30 percent of the ordnance dropped did not explode. After 25 years of peace, these bombs still maim and kill Lao multi-ethnic people in their efforts for the peaceful reconstruction and safeguard of the country.

168. In 1995, the Lao PDR in collaboration with UNDP and UNICEF established a Trust Fund for advocacy and removal of the unexploded ordnance. In 1996, with the support of the government of Sweden and the technical support of NGOs, a survey on the impacts of unexploded ordnance on Lao PDR socio-economic development was carried out. Fifteen provinces out of 18, 86 districts out of 142, and 7,675 villages out of 11,000 were severely to moderately affected by the unexploded ordnance. Among the surveyed provinces, 10 have heavy load of unexploded ordnance, 5 have one or more than one of its districts affected by unexploded ordnance. Unexploded ordnance are found in the center of the village (32%), plain (13%), road construction areas (7%), forest and areas near the village (7%), grass land for animals (5%), and river banks and other (3%). Agricultural land is the second most affected area by the unexploded ordnance.

169. The survey collected data on nearly 10,649 UXO related accidents, which have occurred since 1973. More than 20 years after the end of the war, there is still one UXO accident occurring, on average, at least every two days. Of the accident victims, 4 percent are girls and 27 percent are boys. The percentage of young children involved in recent accident is increasing. Villagers often expressed concern regarding their children’s lack of awareness regarding the risks of handling or playing with UXO.

170. Given the country’s rapid population growth of 2.5 percent and the pressure on land for agriculture, UXO contamination acts as a major constraint to development and contributes to endemic poverty by limiting expansion of agricultural production. UXO-related accidents are not likely to decrease significantly over the next several years unless clearance and community awareness activities are initiated in affected areas.

171. The strategy to address the unexploded ordnance includes (1)-community awareness, especially focus on children for reducing risk behavior that lead to accidents among children through intensive community-based activities and school curriculum and teaching activities, (2)-training and capacity building, (3)-survey for developing integrated UXO database, and (4)-mine clearance.

Ethnic minorities children

172. Lao PDR is composed of 47 ethnic minorities who have achieved different socio- economic development. Support for multi-ethnic groups and their children was the backbone policy of the GOL. As the ethnic minorities groups are poor and live in

small villages that are scattered in large area, in some cases, their children could not attend school that are located far away from their villages. Besides, due to cultural difference and social development status, formal schooling and curriculum for the primary education could not meet their requirement.

173. To address the above-mentioned constraints, the GOL constructed and funded 17 ethnic boarding schools in predominantly ethnic areas such as Luangprabang, Oudomxay, Huaphanh and Champassack provinces. There were 8,121 ethnic children in 1997-98 and 5,186 ethnic children (1,417 girls) in those boarding schools. The number of girls’ attendance attests the difficulty in changing ethnic minorities’ tradition.

174. The schools provided full accommodation, formal education, protection and development for children between 7 to 14 years old. These children after their graduation could continue on their study at the upper secondary schools and other vocational schools and become equal members of Lao citizenship.

Children participation

175. The pioneer organization was institutionalized in the schools since 1975. It is a national organization specific targeting at the children aged 6 to 14 years old. It main mandate is to foster children participation and mutual assistance, respect of the rules, improve hygiene and awareness of the four aspects of child right through activities and games. Its organizational structure comprises battalions, groups and cells. The selection process for entering the pioneer organization is based on learning achievement, morality, and willingness to assist schoolmates and the society. They are under the national pioneer organization with committees in each school.

176. Pioneer members increased from 66,786 in 1995 to 136,667 (up 100%) in 2000, of which 51 percent are girls. Battalions, groups and cells held quarterly, monthly and weekly meeting. The rights of the child, among other pioneer activities, were developed into activities and games and disseminated during the meeting. The messages on child’s rights were transmitted via the children to their parents. The pioneer organization becomes an integral part of the LYU and the LWU for educating the mass and its members was increasing at 5 percent yearly.

Chapter 5: Best practices and lessons learned

177. The lessons learned from various programs provide for significant insights on law, policy and program reform. The NCMC has identified 3 programs/projects that could be considered as best practices, or practices worth sustaining. The criteria used are (1)-it has been implemented, (2) innovative approach in addressing the issues, (3)-can be duplicated or has been scaled up, (4)-it has impact on disadvantaged group of children or has national impact, and (5)-it has been monitored, evaluated and documented.

Polio free program

178. The WHO resolution dated May 1988 of universal eradication of polio by 2000 was supported by UNICEF and included in the Convention of the Rights of the Child. The EPI was tasked by the MOH to implement it by initiating the first anti-polio vaccine campaign in Vientiane Prefecture’s Hadxaiphong district in 1990, and gradually expanded to the whole country thereafter.

179. The strategy adopted for polio eradication campaign was the organization of National Immunization Days, which also provided other vaccines for the 6 immunizable diseases for children. The National Immunization Day increased the coverage rate step-by step, from 79% in 24 districts within 17 provinces in January 1992, to 82% coverage in 132 districts within 18 provinces in 1995 and 90% in 142 districts within 18 provinces in 1998, and Lao PDR was declared polio free on November 18, 2000.

180. A coordinated program was established with WHO, UNICEF, JICA, AusAid and NGOs in term of geographical coverage and intensity of intervention. An extensive implementation network established with the government line agencies and the mass organizations.

181. The reasons that led to the success include strong political commitment from the GOL, an effective coordination across sectors to respond and address problems on time, and the decentralization of NCMC’s affiliates to the village levels for expanding EPI and polio immunization in their respective areas. Mothers positively responded to the LWU advocacy campaign, which required that children were immunized against polio.

182. The polio eradication program contributed to the development of the community health service for the far-reaching children at the remote and isolated areas.

183. Polio free day was seen as the major achievement for a better health of the Lao children, but we should not lower our guard because polio disease is till common in the neighboring countries and the wild polio virus could well be imported into Lao PDR in the future. Regular surveillance system and provision of anti-polio drop should continue on until the global polio eradication is achieved.

Inclusive education for children with disabilities

184. In Lao PDR, there are 5610 children with hearing-vision-olfaction-speaking disabilities and 5570 children with general disabilities, of which 2131 girls and 1118 children were limbed handicaps.

185. The Lao PDR could not provide high-cost special education to disabled children due to limited fund and human resources. The Inclusive Education project started in 1992 with the objective to integrate children with mild to moderate level of mental and physical disabilities in the formal education setting. It also aims at improving the quality of education and the internal efficiency for all children.

186. In 1999-2000, 610 studenst from 12 provinces, 28 districts, 28 pre-schools, 47 primary schools and 3 secondary schools were enrolled in the project. Most children are doing well in school, communities and families are active and supportive, and the general quality of education has been improved to a satisfactory level. There was a significant reduction in failure, repetition and dropout rate in Inclusive Education schools.

187. Our success is based on the following ideas and principles: 1-training alone will not produce sufficient change-only supported experiences can turn teachers into flexible creative professionals able to respond to children’s special learning needs, 2-support from the education sector and partners must continue until teachers are able to resolve problems, 3-provide clear directions for improving teaching and helping the children with specific problems, 4-professional development of teachers will continue through debate, exchanges, study tours with colleagues and schools, 5- Wherever good work is being carried out, the experiences and skills should be shared and applied in other places, 6-high levels monitoring is a process of help and not a process of inspection and implementation teams can arrange additional training and visits to facilitate exchange of experiences, 7-use a variety of teaching methods and make small changes to activities, 8-wherever possible disabled children enter pre-scchool before attending primary school alongside their peer group, 9-the best training materials come from our own experiences e.g. management guidelines and manuals for basic training, 10-cooperation is needed at all levels, between children, schools, families and communities, across sectors, ministries and international organizations.

Unexploded ordnance

188. During the Indo-chinese war, especially between 1964-1973, more than 3 million tons of bombs were dropped onto Laos, and 30 percent of the ordnance dropped did not explode on impact. Fifteen of Laos’ 18 provinces, of which 10 provinces were heavily affected and 5 were moderately affected by unexploded ordnance. Since 1973, more than 2 decades after the war, there were nearly 10,649 UXO related accidents, on average, at least one every two days. Of the accident victims, 4 percent are girls and 27 percent are boys. The percentage of young children involved in recent accident is increasing. 189. The UXO negatively impacted on the agricultural sector, irrigation projects, and community development program and infrastructure construction. Agricultural land was the most affected after the village center. Local people reported problems with UXO in agricultural land and clearance operation of the agricultural land. 190. The task of the Lao national UXO programme is to support the overall development goals of Lao PDR and to reduce casualties and clearing lands for development. Progress in meeting the goals has been good, and the foundation systems in place for the longer term are encouraging. These achievements have been made possible due to the following approaches. 1-The UXO programme develops a simple planning process by asking the community to identify their needs for risk reduction and areas clearance; these needs are directly linked to the broader socio-economic development requirement of their villages and districts, 2-the ‘needs’ are in excess of the available resources, therefore determining priorities for work is paramount, 3- the prioritization is carried out at district and then provincial levels. 191. The strategy to address the unexploded ordnance includes (1)-community awareness, especially focus on reducing risk behaviors that lead to accidents among children through intensive community-based activities, school curriculum and teaching activities, (2)-training and capacity building, (3)-survey for developing integrated UXO database, and (4)-mine clearance. 192. To highlight the tantamount work that has been achieved during the decade, from 1996 to 1999, 417,423 population briefed, 1695 community awareness villages visited, 205,545 UXO destroyed, 1097 hectares cleared from UXO, and 3802 roving clearance teams established to visit villages. The UXO clearance is also part of the overall national quest to alleviate poverty, and deliver social welfare to all members of the communities, and provide basic right to the child, the right to live and to live and peace.

Annex 1: List of organisations and persons involved in the preparation of the End- Decade Report

1. National Commission for Mothers and Children 2. Ministry of education, Department of General Education 3. Ministry of Foreign Affairs, Department of International organisations 4. State Planning Committee, Department of Planning 5. Ministry of Justice, Department of Laws 6. Ministry of Labour and Social Welfare, Division of Children Protection 7. Ministry of Health, Center for Mother and Child Health 8. Lao Women’s Union, Department of Women Rights-Benefit, development and external relation 9. Lao Youth Union, Department of Pioneer 10. Lao national commission for drug control and supervision 11. Lao UXO 12. Handicap International 13. Aids Trust Fund 14. UNICEF 15. Dr. Chantharavady Choulamany, UNDCP local consultant for assisting the survey of drug abuse among youth in Vientiane Prefecture.

16. Mr. Daovong Vongsay was contracted as local consultant for developing this report.

Annex 2: Indicators

Goals Between 1990 and 2000, reduction of infant and under five mortality rates by one-third or to 50 and 70 per 1000, whichever is less. Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Infant mortality rate 117 82 85 MICS II Under-5 mortality 170 102 127 MICS II

Goal Between 1990 and 2000, reduction of maternal mortality rate by half (per 100,000). Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Maternal mortality rate 653 530 490 MICS II

Goal Between 1990 and 2000, reduction of low birth weight rate of under 5 from 39 to 10. Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Low birth weight rate 39 12.9 10 MICS II

Between 1990 and 2000, reduction of percentage of under 5 below 2 standard deviations from median weight for age from 50 to 25.

Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Stunting rate 50 20.3 25 MICS II

Between 1990 and 2000, reduction of percentage of under 5 below 3 standard deviation from median weight of age from 2 to 0.

Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Waste rate 2 3 0 MICS II

Goal Between 1990 and 2000, reduction of iodine deficiency rate for children aged 6-12 with endemic goitre from 20 to 0.

Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Percentage of children aged 20 9 0 MICS II 6-12 with endemic goitre.

Goal Between 1990 and 2000, reduction of iron deficiency anaemia rate of women from 35 to 12. Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Percentage of women with 35 00.2%: 4gr/dl 12 NHS hemoglobin levels below 1.33%: 4-4.7gr/dl 10grams/100ml 30.06%:7-11gr/dl

Goal Between 1990 and 2000, reduction of vitamin A deficiency from 20 to 0. Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Percentage of under-6 with serum 20 1.95 0 vitamin A below 10 microgram/100ml

Goal Between 1990 and 2000, reduction of measles from 20 to 0. Indicators in NPA Status 1992 Status 2000* Goal 2000 Source of data Percentage of death by measles 20 332 0 *in 2000, outbreak occurred. Goals Between 1992 and 2000, increase EPI coverage as follow: Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data OPV for under 2 22 81.2%: 1st dose, 57.1%: 90 MICS II 3rd dose Measles for under 2 52 41.8% 90 MICS II DTP for under 2 22 52.8% for 3rd dose 90 MICS II BCG for under 2 40 69.3% 90 MICS II TT2 pregnant women 46 No data 90 MICS II

Goal Between 1992 and 2000, reduce neonatal tetanus from 8 to 0. Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Number of cases per 1000 8 22* 0 MICS II live birth * in 2000, 45.0% of children protected against neonatal tetanus. More cases recorded because of better system of data collection.

Goal Between 1992 and 2000, reduce number of under 5 death per 1000LB caused by diarrhoea from 7 to 3.5. Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Under 5 death per 7 No data 3.5 1000LB caused by diarrhoea

Goal Between 1992 and 2000, reduce number of under 5 death per 1000LB caused by pneumonia from 219to 72. Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data Under 5 death per 219 No data 72 1000LB caused by pneumonia

Goal Between 1992 and 2000, increase access to safe drinking water of rural population from 15 to 80 for rural population. Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data urban population with 15 75.5 universal NHS access to safe drinking access* water rural population with 48 37,6 80 NHS access to safe drinking water * world summit goal.

Goal Between 1992 and 2000, increase access to sanitary mean of excreta disposal. Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data urban population with 45 67.1 75 NHS access to sanitary mean of

Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data excreta disposal rural population with 15 19.0 45 NHS access to sanitary mean of excreta disposal

Goal Between 1992 and 2000, increase access to basic education as follows: Indicators in NPA Status 1992 Status 2000 Goal 2000 Source of data NER 63 77.3 80 AIEP 1996-2000 repetition rate 21 19.9 4 AIEP 1996-2000 retention rate 41.7 56.6 (1996-97) 80 AIEP 1996-2000 literacy rate 60 (1996) 74 80 AIEP 1996-2000 * 1996-97