Evaluation of the 3rd and 4th UNFPA Country Programme for Kazakhstan (2010-2018) EVALUATION REPORT
November, 2019
EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Kazakhstan Country Map1
Evaluation team Evaluation Team Leader Lyubov Palyvoda Evaluator Baurzhan Zhussupov Evaluator Jamila Asanova
1 https://www.un.org/Depts/Cartographic/map/profile/kazakhst.pdf ii EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Acknowledgements The authors wish to acknowledge with their sincere thanks the numerous staff members from the various Government of Kazakhstan Ministries and related institutions, the UN collaborating agencies, donor agencies and a wide range of CSOs for providing time, resources and materials to permit the development and implementation of this evaluation. We appreciate the participation of members of the Evaluation Reference Group, especially those who took time to attend briefings and provided comments. We are particularly grateful to the United Nations Population Fund (UNFPA) Kazakhstan staff members of country and regional offices who, despite a very heavy load of other pressing commitments, were so responsive to our repeated requests, often on short notice. We would also like to acknowledge the many other Kazakh stakeholders and client/beneficiaries, including experts in P&D, health, youth, gender and the dedicated staff at the visited centers, who helped the implementation of this evaluation despite their busy schedules. It is the team's hope that this evaluation and recommendations presented in this report will positively contribute to building a sound foundation for future UNFPA Kazakhstan supported programs in collaboration with the Government of Kazakhstan.
Disclaimer This evaluation report was prepared by a team of three consultants, namely: Lyubov Palyvoda, Evaluation Team Leader; Jamilya Asanova and Baurzhan Zhussupov, Evaluators. The content, analysis and recommendations of this report do not necessarily reflect the views of the United Nations Population Fund, its Executive Committee or member states.
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Table of contents
EXECUTIVE SUMMARY 1
CHAPTER 1: Introduction 1.1 Purpose and objectives of the country programme evaluation 8 1.2 Scope of the evaluation 8 1.3 Methodology and process 8
CHAPTER 2: Country context 2.1 Development challenges and national strategies 16 2.2 The role of external assistance 18
CHAPTER 3: UNFPA strategic response and country programme 3.1. UNFPA strategic response 20 3.2 UNFPA response through the country programme 22 3.2.1 Brief description of UNFPA previous cycle strategy, goals and achievements 22 3.2.2 Current UNFPA country programme 23 3.2.3 The financial structure of the programme 25
CHAPTER 4: Findings: answers to the evaluation questions Evaluation question 1: Relevance 28 Evaluation question 2: Effectiveness 31 Evaluation question 3: Effectiveness 39 Evaluation question 4: Effectiveness 43 Evaluation question 5: Efficiency 46 Evaluation question 6: Sustainability 49 Evaluation question 7: Sustainability 51 Evaluation question 8: Sustainability 53 Evaluation question 9: Coordination within the UNCT 54 Evaluation question 10: Added value of UNFPA country programme 57
CHAPTER 5: Conclusions 5.1 Strategic level 60 5.2 Programmatic level 61
CHAPTER 6: Recommendations 6.1 Strategic Recommendations 64 6.2 Programmic Recommendations 65
ANNEXES Annex 1. Terms of Reference 68 Annex 2. List of persons/institutions met 79 Annex 3. List of documents consulted 80 Annex 4. The evaluation matrix 83 Annex 5. Abstract of the evaluation report 122 Annex 6. Stakeholders’ mapping 124 Annex 7. UNFPA Intervention logic for 3rd and 4th CPs by programme components 127
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Abbreviations and Acronyms
AIDS Acquired Immune Deficiency Syndrome AWP(s) Annual Work Plan(s) BCC Behaviour Change Communication BOS Business Operation Strategy CA Central Asia CEDAW Convention on the Elimination of all Forms of Discrimination against Women CEMD Confidential Enquiry into Maternal Deaths CEPD Confidential Enquiry into Perinatal Deaths CO Country Office CP Country Programme CPE Country Programme Evaluation CPAP Country Programme Action Plan CPD Country Programme Document CSA Country Situational Analysis CSOs Civil society organizations CSPS Centers for socio-psychological support DVS Domestic violence survey ERG Evaluation reference group ESP Essential service package EQA Evaluation quality assessment FBOs Faith – based organizations GBV Gender-Based Violence GDP Gross domestic products HIV Human Immunodeficiency Virus ICPD International Conference on Population and Development IEC Information, Education and Communication ILO International Labour Organization IP(s) Implementing Partner(s) KZT Kazakh tenge MCH Maternal and Children’s Health MDGs Millennium Development Goals M&E Monitoring and Evaluation MICS Multiple indicator cluster survey MOH Ministry of Health NGO Non-Government Organization NMCR Near-Miss Cases Review ODA Official development assistance OMT Operation management team P&D Population & Development PHC Primary Health Care PSA Population situation analysis QA Quality assessment SDGs Sustainability Development Goals SOP Standard operating procedure SRH Sexual and Reproductive Health STI Sexually Transmitted Infection TOR Term of reference UNAIDS Joint United Nations Programme on HIV/AIDS UNCT UN country team UNDAF UN Development assistance framework UN PFD UN Partnership Framework for Development UNDP United Nations Development Programme UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund VCT Voluntary counseling and testing WHO World Health Organization
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List of tables Table 1. KAZAKHSTAN: Key facts Table 2. Data sources by collection methods Table 3. Sample disaggregation by categories Table 4. The UNFPA financial commitment for 2010-2015 (in USD millions) by priority areas/ outputs Table 5. Expenditure evaluation for the 3rd Country Programme (2010-2015), USD Table 6. The UNFPA financial commitment for 2016-2020 (in USD millions) by outcome /output areas Table 7. Expenditure evaluation for three years of the 4th Country Programme (2016-2020), USD Table 8. Status of achievement of output SRH indicators of the 3rd UNFPA CP, 2010-2015 Table 9. Status of achievement of output SRH indicators of the 4th UNFPA CP, 2016-2020 Table 10. Status of the outcome indicators for SRH area of the 3rd and 4th CPs Table 11. Status of achievement of output Gender indicator of the 3rd UNFPA CP, 2010-2015 Table 12. Status of achievements of outputs Adolescents, youth and gender indicators of the 4rd UNFPA CP, 2016- 2020 Table 13. Status of the outcome indicators for Adolescents, youth and gender area of the 3rd and 4th CPs Table 14. Status of achievement of output P&D indicators of the 3rd UNFPA CP, 2010-2015 Table 15. Status of achievement of output P&D indicators of the 4th UNFPA CP, 2016-2020 Table 16. Status of the outcome indicators for P&D area of the 3rd and 4th CPs Table 17. UNFPA roles and indicative resources by 2016-2020 PFD Results Table 18. The UNFPA participation in UNCT working groups, June 2019
List of Figures Figure 1. UNFPA sites visited during evaluation, June – July of 2019 Figure 2. ODA key statistics: Kazakhstan Figure 3. The 3rd Country Programme (2010-2015) budget utilization by priority areas, in USD Figure 4. Three-year budget utilization of the 4th Country Programme (2016-2020) by priority areas, USD Figure 5. Three-year budget utilization of the 4th Country Programme (2010-2015) as of the UNFPA financial commitment for 2016-2020 by priority areas, USD Figure 6. UNFPA Coordination and Assistance v. Programme Expenditures by 3rd and three years of 4th CPs, % Figure 7. Logic model of SRH Programme, 2010-2015 Figure 8. Logic model of SRH Programme, 2016-2020 Figure 7. Logic model of Gender Programme, 2010-2015 Figure 7. Logic model of Adolescent&Youth and Gender Programmes, 2016-2020 Figure 7. Logic model of P&D Programme, 2010-2015 Figure 7. Logic model of P&D Programme, 2016-2020
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Table 1. KAZAKHSTAN: Key facts Key Facts and Figures Source The Republic of Kazakhstan is a unitary state with the presidential system of government. Covering an area of 2.724 million square kilometers, the country has the ninth largest territory in the world. In the north and the west, the country shares border with Russia (7,591 km), with China in the east (1,783 km), with Kyrgyzstan (1,242 km), with Uzbekistan (2,351 km) and Turkmenistan (426 km) in the south. The total length of land border of Kazakhstan with other states amounts to 13,200 km. Surface area 2,724,902 sq. km World Bank, 2018 Population Population (inhabitants) 18,395,660, 2019 Population as of 1 January 2019 (Committee on Statistics of the Ministry of National Economy of the Republic of Kazakhstan). Urban population 10,638,681, 2019 Urban population as of 1 January 2019. (Committee on Statistics of the Ministry of National Economy). Population growth rate 1.4 (2017) World Bank data Government Type of government The Republic of Kazakhstan is a The Constitution of the Republic of unitary state with a presidential Kazakhstan form of government. Key political events/dates: 1991 - Kazakhstan gained its independence 1992 – Kazakhstan joined the United Nations. 1993 - First Constitution of independent Kazakhstan. 2016 - Kazakhstan’s election as a non-permanent member of the UN Security Council. Seats held by women in the 21.7% (2016) Draft VNR Report national parliament Economy GDP per capita (PPP USD) 9,030.4 (2017) World Bank Data GDP growth rate 4.1 (2017) World Bank Data Main industries: The primary drivers of the country’s economy are ore, manganese, chromite, lead, and zinc among others. Agriculture is also very essential accounting for 5%, industry 35%, and service 60%. The country also produces and exports oil and gas in hundreds of thousands of metric tons. It also produces uranium accounting for 35% of the global production and the second uranium reserves deposits after Australia. Kazakhstan’s vibrant service industries are related to technology and retail. In 2015 the country ranked 13 out of 30 in Global Retail Development Index Social indicators Unemployment 4.8% (2019) Trading Economics Life expectancy at birth 71.1 (2018): World Population Review 65.9 (males)/ (2018) 76 (female) Under-5 mortality (per 1,000 live births) 10.11 Committee on Statistics of the Ministry of National Economy of the Republic of Kazakhstan (2018) Maternal mortality ratio (deaths of women per 100,000 live 14 Ministry of Health of the Republic births) deaths/100,000 of Kazakhstan (2018) live births (2015) Health expenditure (% of GDP) 3.88 (2015) World Bank Data Births attended by skilled health personnel, percentage 99% (2015) World Bank Data Adolescent fertility rate (births per 1,000 women aged 15- 28 (2016) World Bank Data 19) Condom use to overall contraceptive use among currently No data available married women, 15-49 years old, percentage Contraceptive prevalence rate, any method 55.7% World Bank Data, 2015 People living with HIV, 15-49 years old, percentage 0.2% World Bank Data, 2017 total population: Index Mundi, 2015 Adult literacy (% aged 15 and above) 99.8% Total net enrolment ratio in primary education, both sexes 99 (2017) UNESCO Institute for Statistics
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Sustainable Development Goals (SDGs): Progress by Goal (taken from the Voluntary National Review on the implementation of the 2030 Agenda for Sustainable Development)2 Since gaining independence, Kazakhstan has focused on reducing poverty and raising the incomes of the population. To this end, the country has created favorable conditions for employment and business development, increasing the accessibility of public health services, education and infrastructure (clean drinking water, utilities and transport). The 1. No mechanisms for providing targeted social assistance to the socially vulnerable population are being improved on an Poverty ongoing basis. The favorable external economic environment has contributed to the rapid growth of per capita income and a significant reduction in the level of poverty in the country. According to national figures, the proportion of the population with incomes below the subsistence level in 2018 compared with 2001 decreased 11 times, from 46.7% to 4.3%. One of the significant changes in 2019 was the introduction of monthly guaranteed assistance as a part of the TSA for each child from a low-income family. In Kazakhstan, hunger is not an issue and the prevalence of malnutrition remains at a low level in contrast to other comparable countries. Over 80% of the country's food security on major food products is provided through local production. In 2018, Kazakhstan ranked 57th among 113 countries in the Global Food Security Index and continues to 2. Zero actively pursue a policy of improving the competitiveness of the agro-industrial sector (AIC). Work is under way to Hunger digitize the agro-industrial sector: 100% of arable land and 70% of pasture land have been digitized, with the overall goal being to create at least 20 digital and 2,000 advanced farms that will use precision farming technologies (electronic field maps, accurate weather data, sensors, space monitoring and other solutions) by 2021. As a result, Kazakhstan has increased the agricultural labor productivity by 4.4 times; from 2010 to 2018 the agricultural labor productivity increased from KZT 429,000 to almost KZT 1,913,900. The implementation of national health care reforms in Kazakhstan has enabled the country to achieve significant results under this SDG. Over the last 18 years, life expectancy has increased by 7.75 years. A National Screening Program is currently in place to ensure the early detection of diseases that are the main causes of death and disability. In order to reduce maternal and infant mortality, an integrated model of medical care in childbirth and childhood has been introduced. International technologies have also been implemented for perinatal care and the integrated management of childhood illnesses. Here a focus is done only for neonatal mortality. It has to be added that improved 3. Good emergency care and clinical management of severe obstetric complications due to implementation of evidence based Health and clinical protocols, regionalization of perinatal care, confidential audit of maternal morbidity and mortality in routine Well-Being practice of maternities. These all interventions resulted in significant reduction of severe hemorrhages (> 1 liter) which had impact on maternal mortality rate. One of the achievements in maintaining children's health is the development of neonatal highly specialized care. To date, compared with 2010, the survival rate of children with extremely low weight (under 1 kg) has increased by 1.5 times. The national immunization schedule ensures the full immunization coverage of the population, with vaccines administered by qualified health professionals. The work on health-care digitalization continues. In order to increase funding in health care, the introduction of a Compulsory Social Health Insurance (CSHI) scheme by 2020 is under way. Today in Kazakhstan, fully-equipped medical centers that meet international accreditation standards have been established, capable of providing highly specialized care. Kazakhstan is taking measures to increase preschool education coverage in order to prepare children for school and ensure the development of their skills. In 2010, the Balapan Programme, set up to provide children with preschool education, was launched, doubling preschool education coverage. Currently, the preschool coverage of children aged 3–6 years is 95.2%, with 100% coverage planned by 2020. In 2018, an average of 20.1% of kindergartens in the country 4. Quality had created the conditions for inclusive education. Considering the importance of digitalization in the educational Education process, 98.3% of the country's schools now have Internet access and more than 100,000 teachers have completed courses on the use of information and communication technologies. The transition to trilingual (Kazakh, Russian and English) education is under way, with more attention being paid to the development of students´ critical thinking and practical skills. Kazakhstan seeks to create an education system that also offers further training and retraining (if needed) throughout the lifetime of its citizens. The country has also created the necessary conditions for inclusive education. Kazakhstan has made significant progress in establishing the institutional framework for gender equality. Since 1995, the National Commission for Women's Affairs and Family and Demographic Policy has been operating as an advisory body under the President of the Republic of Kazakhstan. In order to address pressing gender issues, measures are being taken to increase women's participation in the economy through equal access to the labor market, financial and other resources. Kazakhstan maintains a steady level of employment for women, similar to that of other countries, 5. Gender including highly developed countries. Women make up 49% of the total labor force. Women's participation in small Equality and medium-sized businesses (SMEs) has increased significantly over the past five years. Among the registered active entrepreneurs, 43.2% are women (as of 1 January 2019). About 28% of the directors of small, medium and large enterprises in Kazakhstan are women. Women are actively involved in the development of civil society. A network of non-governmental women's organizations is rapidly developing. About 300 non-governmental organizations are actively involved in the protection of women's rights and interests. 6. Clean To date, 73% of transboundary water basins are covered by active agreements on cooperation for water usage with Water and these states. At the same time, Kazakhstan has large reserves of underground water (explored and confirmed reserves
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Sanitation at 1 January 2018 of 15.56 3 km ), which contribute to the partial coverage of the water deficit. Despite this, providing the population with access to water, including quality drinking water, remains a significant problem in the country. The existing water management system fully meets the needs of the country. The main water consumers are industry, urban and agriculture and irrigated agriculture. As of 1 January 2019, 94.5% of the urban population and 84.4% of the rural population (or 59.9% rural settlements) have a centralized drinking water supply. To increase the access of the population and economic entities to water, a number of measures are being implemented. These include low taxation of water facilities (providing drinking water - 0,1%), subsidization of services for drinking water supply from no alternative sources of drinking water supply, application of the principles of price ceiling, and others. Maintenance work (deteriorated water supply networks – 52%, and drainage networks – 57%), the repair, reconstruction and construction of water supply and drainage networks are being carried out. Groundwater exploration is also being undertaken to explore the potential of its use for the provision of quality drinking water to rural communities. Today, the Unified Power System of Kazakhstan operates in a sustainable manner; it is fully reliable and able to meet the demand of both the population and the economy. Furthermore, 100% of the population has access to electricity. The western regions of Kazakhstan, which are rich in hydrocarbon resources, use natural and associated gas as a fuel source. However, the level of gasification remains low (49.68% of the population in 2018). To address the problem, 7. plans are under way to construct a 1,061 km main gas pipeline for the gasification of Nur-Sultan, as well as for the Affordable central and northern regions of the country. Thus, by 2030, the level of gasification will reach 56%. and Clean The concept for ‘’Transition to a Green Economy’’ and the law on Renewable Sources of Energy support have been Energy adopted and conditions created to attract investment for the implementation of RSE projects, such as improving the
legal framework for investors in RSE. Specific target indicators of RSE development and steps to achieve them have been adopted. It is planned to increase the share of RSE to 3% of total energy consumption by 2020 and to 10% by 2030 (excluding large HPPs), and in the long term increase the proportion of renewable and alternative sources to 50% of the total energy balance. By the end of 2018, 67 renewable energy facilities were operational in Kazakhstan. Over the years of independence, Kazakhstan has implemented a number of systemic and structural economic reforms and carried out large-scale privatization. As part of the ongoing structural reforms, Kazakhstan consistently implements the policy of diversifying and improving the competitiveness of the economy through the modernization 8. Decent of enterprises and the creation of new nodes of industrial development. In 2010-2014, around 75,000 permanent jobs Work and were created in Kazakhstan as part of the State Programme on Industrial-Innovative Development in Kazakhstan. A Economic single aggregate payment has been introduced in the country in order to transfer informal workers to the formal Growth sector of the economy, and ensure their participation in the system of compulsory medical and social insurance and
pension provision. The State provides training on the basics of entrepreneurship and on issuing loans/microloans for starting a business. Government programs are being implemented on concessional lending, providing financial support to entrepreneurs and subsidizing small and medium-sized business projects. Building resilient infrastructure, industrialization, and fostering innovation are the top priorities of the Republic of Kazakhstan's economic policy. Since independence, Kazakhstan has built or reconstructed more than 12,500 km of roads and 2,500 km of railways, together with a number of seaports. The new network of roadways, railways and airlines is designed to bring together all the regions of Kazakhstan and the capital through a hub-and-spoke service, 9. Industry, thus building a resilient infrastructure framework throughout the country. Kazakhstan's industrialization policy is Innovation implemented through the State Programme for Industrial and Innovative Development. It aims to accelerate the and diversification of the economy and the development of higher value-added industries. In 2018, the GVA of the Infrastruc- manufacturing industry was 10.7% of GDP compared with 2010, and the GVA of the manufacturing industry per capita ture was $1,189.2 (2010 prices). A large-scale national programme, ‘’Digital Kazakhstan’’, is currently under
implementation, which contributes to the digitization of the existing economy and to the establishment of the future digital industry. Three quarters of the adult population has basic digital literacy, and the level of Internet access is growing (the number of subscribers has increased 2.5 times since 2010). However, a gap still exists between urban and rural populations. Kazakhstan has become home to more than 100 ethnic groups and provides inter-ethnic and interreligious harmony in the country. The country is committed to ensuring a decent life for all. Kazakhstan has developed a Strategic Development Plan until 2025 that aims to ensure the social welfare of the citizens of Kazakhstan. This objective is being addressed in an integrated manner through several priority directions of the country's economic policy. The 10. well-being of Kazakhstanis will be provided through the accelerated growth of GDP per capita. Kazakhstan's Concept of Reduced Family and Gender Policy for 2030 establishes the conditions for the successful career building and active participation Inequalitie of modern Kazakhstani women in state and public administration. The competences of local authorities responsible for s the social protection of people with disabilities are being enhanced. Additional measures are being taken to fully integrate people with disabilities into society and to ensure the conditions are in place to allow them to live fuller lives. Kazakhstan's Concept of Migration Policy is currently under implementation. It sets out the strategic goals, objectives and areas of migration policy which are in accord with the expected economic, social and demographic development of the country, its foreign policy, and with the integration processes within the EEU, and with worldwide globalization trends. 11. Today, Kazakhstan is the most urbanized country in Central Asia, at 58.2%. A State development programme for the Sustainable regions of Kazakhstan is currently under implementation, which aims to increase the competitiveness of the regions Cities and through managed urbanization and through improving the quality of life of the population. One of the most important Communi- national objectives is to ensure the affordability of housing for the population. Under the state housing construction ties policy, the amount of commissioned housing increased by 2.5 times from 2005, reaching 12.5 million square meters in
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2018. In 2017, more than 100,000 families had moved into new housing within the framework of the State Housing Construction Programme “Nurly Jer”. The Smart City concept, which focuses on enhancing the quality of life for people working and living in cities, has been developed to improve the efficiency of urban services and to introduce smart technologies in Kazakhstan. Kazakhstan's cultural heritage includes sites representing culture, religion, art and the lives of the Kazakh people. Some of these, such as the exceptional nature sites and areas rich in Kazakh culture, are acknowledged as having outstanding value and are protected by UNESCO. Kazakhstan's commitment to SDG 12 results from the high resource-intensiveness of the country's economy and from the growing volume of waste. Developing a low-waste economy and managing industrial and consumer wastes are two of the country's strategic objectives. The country is in the process of modernizing its waste management system in order to move to sustainable production and consumption patterns. Since 2016, Kazakhstan has maintained the state 12. register of industrial and consumer wastes within the Unified Information System for Environmental Protection. The Responsi- country introduced extended producer (importer) responsibility (EPR) for cars and their components (in 2016), and for ble electrical equipment and packaging (in 2017). As part of Kazakhstan's waste management policy the necessary Consumpti infrastructure continues to be put in place; currently more than 70% of the population has waste collection and on and removal services. Of the 204 cities and regions of the country, 51 now have separate waste collection, while 30 have Production waste sorting systems in place. More than 150 plants are engaged in recycling and the disposal of municipal solid waste (MSW), while another 260 facilities are involved in processing and decontaminating industrial waste. Throughout the 17 regions, local executive authorities, together with experts and civil society, have developed and implemented a 'Set of measures for the modern disposal and recycling of MSW with the wider involvement of business.' Like other nations, Kazakhstan is directing its efforts toward increasing the country's resilience and enhancing its adaptive capacity. Following its voluntary unconditional national commitments under the Paris Agreement, Kazakhstan committed to reduce GHG emissions by 15% relative to the base year level, by 2030. With financial support from external donors, Kazakhstan could increase the reduction to 25% relative to the baseline (289.4 million tones CO2 equivalent). Measures to ensure a sustainable water supply is currently under implementation, including State support for water infrastructure and the introduction of resource-saving technologies in agriculture. Measures are also being 13. Climate taken to preserve the forest fund and to expand forest plantations (sexual forests) to curb desertification. In addition, Action ‘‘A set of measures to prevent and eliminate flood threats for 2017-2020’’ Roadmap has been under implementation since 2017 as part of national obligations under the Sendai Framework. The Roadmap includes 637 practical engineering measures to protect human settlements, transport infrastructure and the economy. In 2017, 107 protective dams were constructed and reinforced, and 71 hydraulic structures, 8 bridges, and 12 highways repaired. These measures have minimized the threats to 692 settlements in the Republic of Kazakhstan (65% of a total 1,055 settlements). Education and information services are being offered to raise public awareness and to prepare an appropriate public response to climate change Kazakhstan has no direct connection with the world's oceans. Nevertheless, the country has two large water bodies, the Aral Sea and the Caspian Sea, thus some of the objectives and indicators of this goal are also relevant for Kazakhstan and can contribute to solving the problems of these ecosystems. In 1993, the countries of Central Asia established the International Fund for Saving the Aral Sea to join efforts to save the Sea and to ensure the prudent use of its resources. Several joint projects are being implemented together with international organizations, including the 14. Life ‘‘Aral Sea Basin Programme’’ and the ‘‘Syr Darya Control and Northern Aral Sea Project’’. To ensure environmental Below monitoring, Kazakhstan continuously measures air quality, seawater quality, soils and sediments, and radiation in the Water sector of the Caspian Sea falling within its territorial borders. The main challenges for the preservation of the ecosystem of the Caspian Sea are finding ways to counteract the systematic acidification of seawater by oil and gas companies, and to preserve coastal marine zones and fish stocks. Because the coastline has shifted, its location is no longer recorded accurately in regulatory documentation, therefore it is no longer protected. Given this situation, Kazakhstan needs the support of the global community to help preserve and restore the ecosystems of the Caspian and Aral Seas. Kazakhstan's terrestrial ecosystems are both unique and vulnerable; the water, land, forests and mountain ranges are influenced by both mankind and nature. Kazakhstan has prioritized the preservation of its terrestrial ecosystems to ensure the welfare of the population. The Government is working to ensure the expansion and fire protection of the country's forest fund. The country has banned the export of timber from its round wood and forests. In addition, in the framework of the global Biodiversity Finance (BIOFIN) Initiative, methodological documents for estimating CO2 15. Life of absorption by forests have been prepared, and work to increase foreign and domestic investment for the expansion of Land forest coverage through carbon emissions compensation is ongoing. Moreover, activities are under way to expand protected areas. Work on the establishment of wildlife corridors for the migration of wild animals is also continuing. Work on the establishment of wildlife corridors for the migration of wild animals is also continuing. Activities within the framework of the BIOFIN global initiative to integrate the ecosystem approach and the valuation of ecosystem services into the draft Environmental Code of the Republic of Kazakhstan are also under way. In 2015, Kazakhstan adopted five institutional reforms, namely: 1. Development of a professional and autonomous 16. Peace, state apparatus; 2. Ensuring the rule of law and openness of the judicial system; 3. Diversified industrialization and Justice and economic growth; 4. Strengthening the 'Nation of a Single Future' identity of Kazakhstan; 5. Transparency and public Strong accountability. Institutions Protection of human rights. The institution of the Commissioner for Human Rights (CHR) has been operating in Kazakhstan since 2002. A striking example of the constructive interaction between public authorities and the non-
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governmental sector is the work of the National Preventive Mechanism (NPM) against Torture. To date, 2,500 preventive visits to various closed institutions have been carried out, with the mechanism proving to be effective in preventing torture Protecting the rights of men and women. Kazakhstan has adopted two important laws: On the State Guarantees of Equal Rights and Opportunities for Men and Women, and On the Prevention of Domestic Violence. The implementation of the gender equality policy is based on the principles of gender mainstreaming, which implies a comprehensive definition of equality. Protection of children's rights. The State has created a legal framework for the protection of children's rights. Children with disabilities and children with HIV and AIDS have the right to receive free medical and pedagogical support in educational and health-care institutions. The number of orphanages in Kazakhstan is being actively reduced, while the number of foster families is increasing. To ensure the protection of children and to improve the national system for the protection of the rights of the child, the institution of the Commissioner for the Rights of the Child was established in 2016. The effectiveness of law enforcement and the judicial system. The Roadmap for Modernization of the Internal Affairs Bodies for 2019-2021 is currently under implementation. As part of the work under the Roadmap, the number of police officers and the staffing level of the penitentiary system was reduced by 11%, and more than 1,000 senior positions were eliminated. Alternative sentences, such as fines, restrictions of liberty, and correctional labor, have become more common. These measures have reduced the prison population from 289 (2014) to 168 (2019) per 100,000 population. Countering corruption. Kazakhstan has developed a unique anticorruption policy model, which is continuously improved in line with national expertise and the best international anti-corruption practices. The UN e-Government Survey placed Kazakhstan in the list of countries with a Very High e-Government Development Index (ranking 39th among 193 countries). Of the 742 services registered on Kazakhstan's public services roster, 531 (71,6%) are available electronically. Contribution to international and regional security. Almaty hosted the first two rounds of negotiations around the Iranian nuclear issue, the outcomes forming the basis of the Joint Comprehensive Action Plan to resolve the situation. Kazakhstan has been active in resolving the Afghan issue and provided mediation during the intensification of Ukrainian-Russian relations. To date, the city of Nur-Sultan (formerly Astana) has held twelve rounds of talks on the peaceful settlement of the Syrian crisis, where interventions by Kazakhstan were highly appreciated by the participating states. Through the prompt response to international trends and timely measures, Kazakhstan has retained its attractiveness for investment capital and consistently strengthens its competitiveness. There is a generally positive trend in attracting foreign direct investment in the Kazakh economy. The Official Development Assistance Concept of the Republic of Kazakhstan has been under implementation since 2013. The Concept is intended to consolidate and align ODA to Kazakhstan's foreign policy priorities; to develop national policy in the provision of financial, technical and other assistance to foreign countries to help their socio-economic development; to coordinate the provision of assistance; and to strengthen the role and reputation of Kazakhstan in the world. The total amount of assistance provided through bilateral and multilateral channels, including humanitarian aid, was $49.4 million (including ODA $42.9 million) in 2015, 17. $38 million (including ODA $30.83 million) in 2016 and $43.3 million (including ODA $35.23 million) in 2017. In general, Partnershi over the period 1996–2017, Kazakhstan allocated about $485.23 million for objectives similar to ODA. At the 70th ps for the session of the UN General Assembly in 2015, Kazakhstan, together with the UNDP, launched a programme to assist 45 Goals countries in Africa in the implementation of the SDGs. Within the framework of regional economic integration, Kazakhstan has progressed from the Customs Union to the Eurasian Economic Union (EAEU), an international economic integration association, of which Armenia, Belarus, Kyrgyzstan and Russia are also members. Kazakhstan pays special attention to youth policy. Since 2015, the Government has expanded the annual funding for the development of volunteer initiatives; the greater integration of the volunteer movement into SDG implementation is being discussed. 2019 was declared the Year of Youth in Kazakhstan. Youth volunteer movements are developing and Kazakhstani youth are actively involved in projects that help vulnerable populations (older people, single mothers, large families and others) and people facing hardship, and in environmental and educational projects
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EXECUTIVE SUMMARY
Overview. The overall purpose of this Country Programme Evaluation (CPE) is to conduct an independent assessment of relevance, performance and sustainability of UNFPA support provided to Kazakhstan during 2010-2018, as well as analysis of various facilitating and constraining factors influencing programme delivery. The overall objective of the evaluation is to assess the extent to which the country programmes achieved intended results and use the findings for the purposes of further programme design and interventions. This report covers results from 2010 to 2018 in four focus areas: 1) Sexual and Reproductive Health (SRH) 2) Adolescent and Youth, 3) Gender, and 4) Population and Development (P&D). The initial budget for the 3rd CP was $7.7 million ($5.9 regular and $1.8 other) and for the 4th CP - $3.75 million ($2.65 regular and $1.1 other).
The overall objectives of the CPE are to provide: (i) an enhanced accountability of UNFPA and its country office for the relevance and performance of its country programme and (ii) a broadened evidence-base for the design of the next programming cycle. The evaluation has three specific objectives: First, To provide an independent assessment of the progress of the country programme towards the expected outputs and outcomes set forth in the results framework of the country programme. Second, to provide an assessment of country office (CO) positioning within the developing community and national partners, in view of its ability to respond to national priority needs while adding value to the country development results. And third, to draw key lessons from the past and current cooperation and provide a set of clear, specific and action-oriented forward-looking strategic recommendations in light of agenda 2030 for the next programming cycle.
The evaluation covers all activities planned and/or implemented during the period 2010-2018 within each programme area (reproductive health, adolescent and youth, gender, and population and development). Since Kazakhstan did only carry out a ‘light evaluation’ in the previous cycle, the period covered include the previous country cycle, i.e. 2010- 2015. Cross-cutting areas include: partnership, resource mobilization and communication. The CPE analyses the achievements of UNFPA against expected results at the output and outcome levels, its compliance with the UNFPA Strategic Plans for 2014-2017 and 2018--2021, the UN Partnership Framework for Development, and national development priorities and needs.
The evaluation reconstructs the programme intervention logic and assesses the extent to which the 3rd and 4th country programmes have chosen the best possible modalities for achieving the planned results in the development context. The evaluation examines the programme for such critical features as relevance, effectiveness, efficiency, sustainability, coordination, and added value, and covers the development interventions. The CPE took place during the period March – August 2019.
Evaluation Approach. The CPE follows the structure provided in the UNFPA Handbook (UNFPA February 2019) to assess the UNFPA CP using two separate components. First, is an analysis of the UNFPA CP Outcomes and Outputs within the four focus areas (SRH, Adolescent and Youth, Gender, and P&D). This component employs four main criteria: relevance, effectiveness, efficiency, and sustainability. The second component assesses the positioning of the UNFPA CP in the country based on two criteria: UNCT coordination, and value added (comparative strengths in the country). The evaluation covers the nine-year CP programme period (2010 - 2018).
Methodology. The evaluation was conducted by a three-person team (team leader and two evaluators). The evaluation is based on non-random samples of respondents with qualitative data collection methods. All interviews followed informed consent procedures as required by the UN ethics guidelines for evaluators. The collection of evaluation data was implemented using three main methods: 1) Desk review; 2) Key informant semi- structured group and individual interviews; and 3) Site visits to CP targeted areas in three regions (Nur-Sultan, Almaty, Turkistan region). The analysis is based on a synthesis and triangulation of information obtained from the above-mentioned three evaluation activities. Limitations of the evaluation include the timing of evaluation falling into holiday season, and the size of the country. All interviews were done without the presence of UNFPA staff.
Key Findings - Overview of Achieved Results Relevance: All programme areas of both 3rd and 4th CPs were found to be of high relevance. Virtually all activities fit well within national priorities and strategies and are consistent with the needs of beneficiaries and implementing partners. There was strong evidence that activities were developed based on sound assessments as well as consultation with partners and beneficiaries. All programme areas of both CPs were/are implemented in a manner that was reflective of UNFPA global strategy, Kazakhstan’s Sustainable Development Goals (SDGs), and the United Nations
1 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Partnership Frameworks (2010 – 2015 and 2016 -2020).
Effectiveness: The UNFPA activity made a good progress in all programme areas. All output and outcome indicators of the 3rd CP were achieved, and there is good progress in achieving output and outcome indicators of the 4th programme areas. However, the output indicators have not been able to correctly reflect the contribution of UNFPA to these achievements. The indicators intending to demonstrate the achievement of the planned outcomes are not also very useable, because most of them are not correctly reflecting advocacy goals.
Efficiency: Overall, the activities implemented toward the achievement of outputs for all programme areas appeared to be reasonable for the amount of resources expended. Most respondents were unable to comment on the question of efficiency in details, but of those who did, most felt that UNFPA has been careful to manage its funds efficiently. The final amount from regular sources received/mobilized for implementation of the 3rd CP constitute only 63,5% from expected regular resources and 77,5% from other resources. As for three years of implementation of the 4th CP, 57,7% from expected $2.65 millions of regular resources and 28,3% of $1.1 millions of other resources were received/mobilized. To achieve planned outcomes, UNFPA has made good use of its human, financial and technical resources. From 20% to 60% of its financial resources UNFPA used to support activities implemented either by its partners or together with partners, including civil society and the government. Also, it should be mentioned that Kazakhstan is an upper-middle-income country where a traditional development assistance model does not apply and traditional donors often cannot support the country. As a result, UNFPA in Kazakhstan operates in a resource- constrained environment. It has also experienced a progressive reduction in its core resources that makes planning more challenging.
Sustainability: There is evidence of both short- and long-term sustainability of programme results from program activities in all programme areas of the 3rd CP and good progress made by the activities of 4th country programme. In addition to establishing an effective policy dialog with national ministries that has resulted in important long-term national strategies and guidelines, there are examples of sustainability of UNFPA activities with the long-term scale up of UNFPA pilot projects and institutionalization of training and technical assistance. UNFPA has consistently made it clear that rather than support services and capacity building, it is more focused on longer-term advocacy and policy development. Through an ongoing constructive dialogue between the UNFPA and its partners, including the Government of Kazakhstan, UNFPA ensures the ownership of results by its partners.
Program Area Findings: UNFPA achieved important results for the SRH focus area as both, the 3rd and 4th CP addressed gaps in SRH identifies in situational analyses – preventable maternal deaths due to avoidable causes, unmet need for Family Planning including modern contraception especially among vulnerable populations, the law restriction to get SRH services for minors without parental consent. Maternal health is the most important priority for healthcare system in Kazakhstan. So, almost all SRH activities are performed under the umbrella of ‘maternity health’. UNFPA has made significant achievements in advocacy for ensuring sexual and reproductive health and rights. Based on CEMD experience and lessons learnt, Confidential Enquiry into Perinatal Deaths (CEPD) methodology, tools, and instructions were developed with UNFPA technical support. The Ministry of Health endorsed CEPD regulations. To ensure the sustainability and to increase the efficiency of CEMD and NMCR, Ministry of Health issued an Order (Prikaz) appointing Republican Centre for Healthcare System Development (RCHD) as a new coordination body. Over the past three years, UNFPA contributed to the development of three strategic documents approved by the government: the Concept of Family and Gender Policy in Kazakhstan until 2030, the Kazakhstan Family Planning National Framework Program 2017- 2021, the Operational action plan to reduce maternal mortality in the Republic of Kazakhstan. The UNFPA comprehensive approach for improving adolescent- and youth-friendly reproductive health services, which focuses on not only programmatic activities of Youth Health Centers but also on measures to make them sustainable, should be considered as best practice of advocacy efforts.
The Adolescent and Youth programmatic area activity was focused on UNFPA promotion of sexuality education among youth through courses in valeology and supported youth initiative in Shymkent, which have been cited as best practice. At the same time, piloting of introduction of sexuality education in colleges along with research in different regions of Kazakhstan allowed to demonstrate lack of sexual knowledge among adolescents and youth and provided evidences on efficiency of sexuality education. These evidences were used by UNFPA to advocate for introduction of sexuality education in schools. As of these efforts the Ministry of Education with support of UNFPA initiating the piloting of sexuality education in several schools, starting from grade 9. Over the years of 3rd and 4th CPs UNFPA support was provided to the Y-PEER network. However, there is no long-term strategy and clear approach on how youth centers can operate without local administration support and develop a sense of ownership among target groups as a place
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that youth will be interested to attend and share the information received with peers. While the 4th country program is still developing, there is no very clear vision of institutionalization of Y-PEER network.
The gender focus area has made important contributions toward support of national gender equality policies according to needs and throughout the 3rd and 4th programs consistently and effectively. Starting with support to the development of the National Women Empowerment Action Plan in the Republic of Kazakhstan, UNFPA then assisted in the implementation of the Gender Equality Strategy, and continues to assist in the development and implementation of the Concept of Family and Gender Policy in the Republic of Kazakhstan until 2030. Kazakhstan has its own way in promotion of gender issues and UNFPA support focuses on establishment of the national system of multi-sectoral response to gender-based violence and preservation of family values. During 4th CP activities of the gender component is mostly focused on implementation of models of MSR to GBV based on ESPs and SOPs and some positive results were achieved in pilot region. UNFPA succeeded in cooperation with faith-based organizations (FBOs) of Islam and Orthodox Christianity in promoting maternal and reproductive health, gender equality, combating GBV and prevention of early/forced marriage.
The P&D component of both country programmes was focused on improving access to goods, services and social safety by vulnerable and key population groups, especially women, young people, migrants, the elderly and people with disabilities, people living with HIV and sex workers and strengthening national policies and international development agendas through integration of evidence-based analysis on population dynamics and their links to sustainable development, sexual and reproductive health and reproductive rights, HIV and gender equality. In the 3rd CP UNFPA assisted policymakers in employing evidence-based data into development of policies on gender equality, young people, sexual and reproductive health, and HIV and AIDS and social-sector stakeholders to better able to plan, implement and monitor social and health services for the elderly, migrants and people with disabilities. In the first three years of the 4th CP UNFPA worked at strengthening national data systems and increased availability and accessibility of evidence - based analysis on population dynamics and their links to sustainable development for the formulation of rights-based policies. UNFPA provided support to MICS (Multiple Indicator Cluster Survey) in 2010 and 2015 that generated numerous indicators for the planning of development programmes to improve quality of life of the population of Kazakhstan as well as for Millennium Development Goals (MDGs) and Sustainability Development Goals (SDGs) progress measurement. Also, UNFPA assisted Kazakhstan in 2009 census data analysis and in country preparation to 2020 census, and implementing the first wave of Generation and Gender survey.
United Nations Country Team Coordination: The both UN Development Assistance Framework (UNDAF) and UN Partnership Framework for Development (UN PFD) reflect the interests, priorities and mandate of the UNFPA in Kazakhstan and spells out the UNFPA contributions to the four out of six key areas of the 2016 – 2020 Partnership Framework. The UNFPA activities clearly contributed to better coordination of the UN agencies in Kazakhstan. The UNFPA participates in activities of several thematic working groups and plays an important role in ensuring outreach to all interested stakeholders. However, in general, coherent work among the UN Agencies remains a challenge in Kazakhstan. Most respondents mentioned competition for government and international donors resources and recognition.
Added value: The value added of the UNFPA country programmes includes both corporate UNFPA comparative advantages, which are part of its mandate and mission, as well as features specific only to the country office. Among them are the UNFPA staff and their attitude to partners, desire to listen and support needs-oriented initiatives proposed by partners, thorough work and technical expertise. The respondents commented on the UNFPA approaches aimed at system changes, targeting cause of problems but not their consequences, persistence in finding allies and/or building support base for introducing new approaches. The respondents appreciated the UNFPA high demand for quality work but also the organization’s transparency and results reporting to stakeholders. The added value of the UNFPA country programme includes new knowledge and skills received by partners, modern approaches to problem solving, attention and support received in all UNFPA programmes’ areas. However, UNFPA visibility remains an issue.
CONCLUSIONS Strategic level Conclusion 1. UNFPA Kazakhstan approach in 3rd and 4th CPs to use evidence based data on emerging population issues as well as UNFPA position to raise social issues that often are disturbing and inconvenient contributed to relevance of the national policy designed and promoted by UNFPA along with other UN Agencies. UNFPA strategy of programme interventions is responsive to global challenges and national interests and needs. However, M&E of UNFPA is still remains a challenge as such responsibility assign to Assistant representative
3 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
and programme areas’ managers and there is no solely dedicated person to perform this function within the CO team. Conclusion 2. UNFPA Kazakhstan Country Programme documents lack clearly defined output/outcome indicators and their sources. Annual report format does not reflect output/outcome indicators presented in the CPs that make difficult to monitor achievement of indicators by country programme as well as annually. As results, the output and outcome indicators were not usable to reflect the achievements of UNFPA. First, as it was mentioned, most of them are not always correctly reflecting advocacy goals. Second, the indicators don’t have clear operational definitions to measure and interpret them. Third, it is difficult to monitor progress towards the planned outcomes during the programmes, because the output indicators are measured and reported only at baseline and at the end of the programs, but not annually or bi-annually. Conclusion 3. The 3rd UNFPA Country Programme contributed to several achievements made by Kazakhstan, including a significant reduction in maternal and infant mortality, ratification of the Convention on the Rights of Persons with Disabilities, changes in the state health-care programme to ensure better access to health services and commodities, such as the inclusion of antiretroviral drugs in the basic benefit package for HIV positive persons. Over the past three years of the 4th CP UNFPA contributed to the development of three strategic documents approved by the government: the Concept of Family and Gender Policy in Kazakhstan until 2030, the Kazakhstan Family Planning National Framework Program 2017-2021, the Operational action plan to reduce maternal mortality in the Republic of Kazakhstan. However, the output indicators have not been able to correctly reflect the contribution of UNFPA to these achievements. Conclusion 4. During implementation of the 3rd and 4th CPs UNFPA Kazakhstan made smooth transition from concentrating on capacity building of its partners to policy and advocacy and made important shift in attracting more national government and other development partners resources. As Kazakhstan is an upper- middle-income country where a traditional development assistance model does not apply and traditional donors often cannot support the country, UNFPA operates in a resource constrained environment, further aggravated by decreases in the amount of core resources provided from the corporate level, worsening economic situation and undeveloped corporate social responsibilities of the companies. Given this situation UNCT collaboration and UNFPA partnership with civil society organizations, government and other development partners increased efficient use of limited financial, human and expert resources, including joint efforts in nation-wide and/or pilot initiatives. At the same time, UNFPA has not yet used its leadership position to extend its activity and attract resources from donors like EU, USAID for regional programmes. Conclusion 5. The UNFPA has demonstrated added value in its programmatic areas and the Agency partners recognize it. The value added of the UNFPA country programmes includes both corporate UNFPA comparative advantages, which are part of its mandate and mission as well as features specific only to the country office. Among them new knowledge and skills received by partners, modern approaches to problem solving, attention and support received in all UNFPA programmes’ areas, CO attitude. However, UNFPA visibility and recognition, even by its partners, remains an issue. Conclusion 6. UNFPA ensured sustainability of achieved results by provision of evidence-based support to advocacy and policy work, strengthening capacity through introducing its partners to the best international practices, supporting partners participation in training and conferences, advocating positive results of pilot projects at national level and engaging key ministries in implementation of new concepts. UNFPA plans sustainable results of its interventions at CP design stage with careful revision of achieved results considering challenges in environment and best local and international practices. However, achieved results in some areas (e.g. adolescent & youth – Y-peer) are mixed in term of sustainability. Conclusions 7. The UNFPA activities clearly contributed to better coordination of the UN agencies in Kazakhstan. There are several UN institutions the UNFPA cooperates closely with (UNICEF, UN Women, WHO, UNAIDS) and their joint activities are complementary, create synergies and reflect the interests, priorities and mandate of the UNFPA in Kazakhstan (as it states in the UN-Kazakhstan Partnership Framework). However, despite successes, in general, joint programming and coherent work among the UN Agencies remain a challenge in Kazakhstan as of competition for resources, recognition and visibility. At the same time, all respondents recognized positive and effective leadership of the UNFPA Country Manager.
Programmic level SRH Conclusion 8: UNFPA has made significant achievements to ensure sexual and reproductive health and rights. UNFPA has been supporting the successful government efforts to reduce maternal deaths by improving and expanding CEMD, improving infection control at healthcare facilities, addressing other issues of sexual and reproductive health. Moreover, Ministry of Health developed Road Map on implementation of mentioned in Conclusion 2 the Kazakhstan Family Planning National Framework Program 2017-2021. However, there are still unmet need of population to access family planning / SRH services, including contraceptives.
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SRH Conclusion 9. UNFPA funding for the implementation of the SRH component has been decreasing, fewer funds were available for technical assistance including piloting interventions and conducting research for making evidence-based decisions, especially to ensure access to SRH services for vulnerable populations and the commitment of the government became very important. The government provided funds and resources to continue and expand the models that were introduced by UNFPA. CEMD and NMCR models, trainings on effective perinatal care, sufficient standards and clinical protocols have been implemented nationwide by using resources from the state and local budgets. Moreover, government of Kazakhstan is favorite supporting UNFPA in areas where it has more interests, like maternity and infant mortality when other areas like access to contraceptives, state supports ‘on words’ and has to be still ‘convince’ by UNFPA. This is why UNFPA analysis of economic contribution of certain programs / activities was important to prove their efficiency and was necessary in convincing government to release more funding and should be employed for as a part of advocacy strategy for attraction of the government and development actors resources. Adolescent and youth Conclusion 10. In program 3 and especially 4, UNFPA implemented the pilot projects on sexual education of youth and adolescence in some regions. As a result, UNFPA started with revision of the valeology course, development of the Methodological Guidelines for Teachers, training teachers, and trained teachers taught their students. Studies with control and experimental groups provided evidences on the effectiveness of the course on raising awareness of young people on reproductive health issues, which UNFPA used to convince the Ministry of Education. Strategic approach used by UNFPA in promoting of the valeology course attracted attention of the government and now the Ministry of Education tasked the National Academy of Education and Nazarbayev Intellectual School to work on piloting of integration of sexuality education into school curriculum starting from grade 9. It was only a first important step of introduction of a Comprehensive Sexuality Education into the school curriculum that should be advocate further. Adolescent and youth Conclusion 11: Over the years of the implementation of the 3rd and especially the 4th country programs (where work with young people is singled out as a separate component), UNFPA provided various types of support to the Y-PEER network. However, there is no long-term strategy and comprehensive approach for working with Y-PEER network and with adolescents and youth in general. The Y-PEER network has a good capacity and desire to share the knowledge and continue developing the Y-PEER network because a peer-to-peer technology works best of all. However, network experiences high turnover of staff and volunteers, lacks strong leadership and there is no long-term strategy and comprehensive approach on how Y- PEER centers can operate without local administration support and develop a sense of ownership among target groups as a place that youth will be interested to attend and share the information received with peers. While the 4th country program is still developing, there is no very clear vision of institutionalization of Y-PEER network. Adolescent and youth Conclusion 12. The UNFPA comprehensive approach for improving adolescent- and youth- friendly reproductive health services, which focuses on not only programmatic activities of Youth Health Centres but also on measures to make them sustainable, should be considered as best practice of advocacy efforts. Gender Conclusion 13. The Concept on Family and Gender Policy till 2030 was approved by the Government. However, its implementation in the part related to sexual education and universal access to quality family planning services and counseling for vulnerable groups of population and close monitoring is not sufficient. It is equally important to have a common understanding of all stakeholders of the UNFPA programs, not only at the national level (e.g. The National Commission on Women affairs and Family-Demographic Policy in Kazakhstan), but also in the regions, about the purpose of the Concept of Family and Gender Policy, because models of gender relations have a significant impact on the level of functional stability of the family, especially when Kazakhstan is moving towards preservation of traditional family values. Gender Conclusion 14. In September 2015, Kazakhstan joined the UN Sustainable Development Goals, in which 5 of the 17 goals are gender-sensitive. These goals require national adaptation, localization and accounting within the framework of all strategic directions and tasks of the state that UNFPA in partnership with other UN institutions, such as UN Women, can facilitate and support during implementation and monitoring of the achievement of the SDGs. Gender Conclusion 15. UNFPA, together with the UN Women and its other partners from government, civil society and religious communities has a comprehensive approach to addressing gender-based violence. First, UNFPA supports studies that show the extent of the problem and assist in identification of risk factors. Secondly, UNFPA participated in the development of standards (for the police, medical organizations, crisis centers, etc.) for assisting victims of GBV and piloting these standards in the South Kazakhstan region. Thirdly, the problem of violence against women, in particular its prevention, is included in the training module on SRH for college students. However, despite achieved results, there are lack of institutionalization of the standard operational procedures, specifically, in the health sector; use of SOPs are not introduced into the functional
5 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
responsibilities of staff; CSPS staff lack capacity and competencies to promptly and properly react to the needs of GBV survivors as well as to share already gained experience in working with GBV issues. Gender Conclusion 16. UNFPA Kazakhstan positive experience in working with religious Islam and Christian Orthodox leaders of on sexual and reproductive health, gender and gender-based violence and youth will become increasingly important. However, when UNFPA achieved better support and results with Muslim community more effort in promoting stated above issues are needed in working with Orthodox community (based on EQs 2-4, 6, 8). Gender Conclusion 17: The UNFPA collaborates closely with key youth and women advocate with the national policy frameworks and UN Partnership Framework including UN Women, UNICEF, UNDP, etc. UNFPA is recognized leader in implementing pilot initiatives but sometimes it is difficult to understand which UN agency an initiative is originated from, in particular on youth problems (UNFPA or UNICEF), or gender (UNFPA or UN Women). P&D Conclusion 18. The UNFPA is the only programme in Kazakhstan that works with population data, dynamics and projections issues. The necessity to have updated data, including disaggregated and sectoral data, to monitor population dynamics and the SDGs indicators urged the UNFPA Kazakhstan to stress the importance of P&D among its partners, including government and state institutions of Kazakhstan. However, Kazakhstan does not have comprehensive population policy that is increasingly important considering changes in population dynamics and population aging. In addition, survey and study reports prepared by and/or with UNFPA support should openly accessible, better publicized and data open to researchers. P&D Conclusion 19. Huge challenge to sustainability and long-term effects of the UNFPA work on improvement of demographic statistical data and achievement in Kazakhstan include absence of formal demographic education in the universities along with high turnover of personnel in statistics-related state agencies. Introduction of the demographic-related courses for civil servants in the Public administration Academy under President of Kazakhstan can satisfy high-level demand of such specialists only to certain extent. P&D Conclusion 20: The UNFPA activities were effective since they combined the development of the national policy and programme documents through involvement of different stakeholders, studies important for the informed decision making, capacity building of its partners and their support and proactive engagement in the international processes with practical activities at the national and regional levels. The UNFPA achieved all planned outputs of the 3rd CP and in progress to delivery expected outputs of the 4th country programme. Unfortunately, evaluation cannot say to what extent outcome indicators of the 3rd programme were achieved, as needed data was not found. The evaluation has demonstrated that there is limited access to reports and/or to their reference on conducted by UNFPA or with its support surveys and studies and produced data that is very important for advocacy and policy work. P&D Conclusion 21: UNFPA improves national understanding of demographic and social development of the country and factors behind such development; assists in identification and clarification of reasons behind demographic trends; supports identification of factors influencing demographic behavior of people, including migration. UNFPA was successful in raising and improving Government attention and understanding of importance to social issues along with economic based on evidence-based approach that can bring up issues that are either inconvenient to discuss (family planning, domestic violence, HIV/AIDs, etc.) or are not considered as important (issues connected to disable people, especially women, youth, etc.). The UNFPA contribution was especially important as it provides access to international experts and best practices. However, as of limited knowledge of foreign languages of civil servants, the Russian-speaking countries were selected for study visits that limits public authorities exposure to new trends, methodologies and techniques existed at international level.
RECOMMENDATIONS
Strategic recommendations: Strategic Recommendation 1. Improve M&E planning and reporting to better recognize and promote achieved results. Strategic Recommendation 2. Explore resource mobilization strategy outside of Kazakhstan, precisely at regional level. Strategic Recommendation 3. To increase its advocacy and policy work effectiveness based on evidence UNFPA should provide access to secondary data collected during its survey and studies and better promote and publicize reports of surveys/studies/research conducted by CO to all stakeholders, including Government and Parliament of Kazakhstan. Strategic Recommendation 4. UNFPA has to raise its visibility, particularly among potential donors, private sector and groups of supporters.
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Programmic recommendations: SRH Recommendation 5. UNFPA should assist MOH in implementation of its Road Map for the Kazakhstan Family Planning National Framework Program 2017-2021 in order to support government of Kazakhstan in satisfying unmet needs in assess to family planning services and contraceptives. Moreover, UNFPA can assist government in addressing evolving needs in this area while designing new Health Development programme for 2020-2023. Adolescent and Youth Recommendation 6. UNFPA should continue support of Adolescent & Youth component focusing on: i) continuing advocacy on the integration of sexuality course into the school curricula throughout the country; and 2) developing strategy of institutionalization of the Y-peer network. Gender Recommendation 7. UNFPA should support a proper and adequate understanding and implementation of the new Concept on Family and Gender Policy till 2030 at national and regional levels in the part related to gender equality issues through a prism of family values and institutionalization of SDGs. Gender Recommendation 8. UNFPA should continue its support to combating GBV. P&D Recommendation 9. Develop the Government of Kazakhstan comprehensive population strategy/policy that considers population dynamics, including aging issues.
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CHAPTER 1: INTRODUCTION
1.1 Purpose and objectives of the country programme evaluation The UNFPA Country Office in Kazakhstan, in collaboration with the UNFPA Regional Office for Eastern Europe and Central Asia and UNFPA Evaluation Office, was planning to conduct an independent evaluation of the third and fourth UNFPA Country Programme for Kazakhstan (2010-2018) as part of the Country Office evaluation plan and in accordance with the UNFPA evaluation policy (DP/FPA/2013/5).
The overall objectives of evaluation were: (i) an enhanced accountability of UNFPA and its country office for the relevance and performance of its country programme and (ii) a broadened evidence-base for the design of the next programming cycle.
Towards the achievement of the overall objectives, the evaluation had the following specific objectives: ● To provide an independent assessment of the progress of the country programme towards the expected outputs and outcomes set forth in the results framework of the country programme; ● To provide an assessment of country office (CO) positioning within the developing community and national partners, in view of its ability to respond to national priority needs while adding value to the country development results. ● To draw key lessons from the past and current cooperation and provide a set of clear, specific and action- oriented forward-looking strategic recommendations in light of agenda 2030 for the next programming cycle.
1.2 Scope of the evaluation The evaluation covered all activities planned and/or implemented during the period 2010-2018 within each programme area (reproductive health, adolescents and youth, gender and population and development). Cross-cutting areas included: partnership, resource mobilization and communication. Besides the assessment of the intended effects of the programme, the evaluation also aims at identifying potential unintended effects. The CPE analyzed the achievements of UNFPA against expected results at the output and outcome levels, its compliance with the UNFPA Strategic Plans for 2014-2017 and 2018--2021, the UNDAF and UN PFD, and national development priorities and needs. The evaluation reconstructed the programme intervention logic and assessed the extent to which the ongoing country programme had chosen the best possible modalities for achieving the planned results in the current development context. The evaluation examined the programme for such critical features as relevance, effectiveness, efficiency, sustainability, coordination, and added value, and covered the development interventions.
The main audience and primary users of the evaluation are the decision-makers within the UNFPA country offices and organization as a whole, government counterparts in the country, the UNFPA Executive Board, and other development partners. The UNFPA Regional Office for Eastern Europe and Central Asia and UNFPA Headquarters divisions, branches and offices also will use the evaluation as an objective basis for programme performance review and decision-making.
1.3 Methodology and process
EVALUATION METHODOLOGY
Evaluation criteria and evaluation questions The evaluation was structured around the following evaluation criteria: ● four out of the five standard OECD-DAC criteria: relevance, effectiveness, efficiency and sustainability3; and ● two criteria specific to UNFPA, with a view to assessing: (1) the strategic positioning of UNFPA within the Kazakhstan UN Country Team (UNCT) and coordination with UNCT; and (2) UNFPA Country programme added value. Based on these evaluation criteria, the evaluation team used the following evaluation questions, which guided the data collection and analysis work throughout the evaluation process.
3 The OECD-DAC evaluation criterion, the impact, is not considered in UNFPA country programme evaluations, due to the nature of the interventions of the Fund, which can only be assessed in terms of contribution and not attribution. 8 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Relevance EQ1: To what extent is the UNFPA support: (i) adapted to the needs of the population with emphasis on the most vulnerable population; and (ii) in line with the priorities set by international and national policy frameworks; (iii) aligned with the UN Partnership Framework; and (iv) planned interventions adequately reflect the goals stated in the UNFPA Strategic Plan?
Effectiveness EQ2: To what extent have the intended programme outputs been achieved? EQ3: To what extent did the outputs contribute to the achievement of the planned outcomes (i. increased utilization of integrated SRH Services by those furthest behind, ii. increased the access of young people to quality SRH services and sexuality education, iii. mainstreaming of provisions to advance gender equality, and iv. developing of evidence-based national population policies) and what was the degree of achievement of the outcomes? EQ4: To what extent has UNFPA policy advocacy and capacity building support helped to ensure that sexual and reproductive health (including Family Planning), and the associated concerns for the needs of young people, gender equality, and relevant population dynamics are appropriately integrated into national development instruments and sector policy frameworks in the programme country?
Efficiency EQ5: To what extent has UNFPA made good use of its human, financial and technical resources, and has used an appropriate combination of tools and approaches to pursue the achievement of the Results defined in the UNFPA country programme?
Sustainability EQ6: To what extent has UNFPA been able to support its partners and the beneficiaries in developing capacities and establishing mechanisms to ensure ownership and the durability of effects? EQ7: To what extent have the partnerships established with ministries, agencies and other representatives of the partner government allowed the country office to make use of the comparative strengths of UNFPA, while, at the same time, safeguarding and promoting the national ownership of supported interventions, programmes and policies? EQ8: To what extent have some of the results of pilot projects being used to scale up interventions and/or bring relevant evidence to policy-makers to adopt such approaches?
Coordination EQ9: To what extent has the UNFPA country office contributed to the functioning and consolidation of UNCT coordination mechanisms?
Added Value EQ10: What is the main UNFPA added value in the country context as perceived by UNCT and national stakeholders?
In addition, the evaluation team looked at key lessons and provided a set of clear, specific and action-oriented forward-looking strategic recommendations in light of agenda 2030 for the next programming cycle as well as best practices of the UNFPA activities.
The proposed set of evaluation questions provides a balanced mix of generic and specific questions, and all of them are focused on providing useful information such as information on the changes the intervention sought to achieve, investigating particular intervention characteristics or factors which have / have not worked. Also, the proposed list of evaluation questions was manageable and not too long and was limiting and prevented the analysis from “going where the data leads”. Evaluation sub-questions were developed to help define a particular question or drill down on specific areas. Also, having fewer evaluation questions helped to keep the focus on the evaluation objectives and make the evaluation manageable and cost-effective.
Methods for data collection and analysis
9 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
The evaluation methodology was based primarily on standards and guidance described in How to Design and Conduct a Country Programme Evaluation at UNFPA4 throughout the phases of the evaluation. Suggested and prescribed tools, such as the evaluation matrix, was adapted for the country programmes’ context. Evaluation methods were both quantitative and qualitative, including documentary review, group and individual interviews, focus groups and field visits to programme sites as appropriate. The collection of evaluation data was carried out through a variety of techniques ranging from direct observation to informal and semi-structured interviews and focus/reference groups discussions. The evaluators took into account ethical considerations when collecting information. The team closely adhered to the UN Evaluation Group Code of Conduct and Ethical Guidelines for Evaluations (2008). The evaluation was based on a person-centered approach by emphasizing respect, accountability, fairness and transparency. Preceding fieldwork evaluation team (ET) reviewed cultural and religious sensitivities existing in Kazakhstan and considered potential harm to participants evaluation can make. While setting the interviews the ET considered respondents availability, place of face-to-face meeting. Often the interviews were conducted outside of government offices to make public officials feel more free and relaxed. While meeting vulnerable groups like persons with disabilities, ET came to place where there were necessary conditions (like path, space for wheelchairs) and evaluation participants felt comfortable. Every meeting started with acknowledgement that all received information from respondents will be treated as confidential, respondents’ privacy and anonymity will be guaranteed and information they shared will not be linked to them as well as their participation in evaluation is voluntary and free and they can stop interview at any moment (ET was prepared where deemed necessary, to obtain statements of informed consent).
Taking into consideration the tasks of the evaluation as well as time and budget constraints, a non-experimental design has been used to answer the evaluation questions. This type of design was also most relevant, given that the majority of the evaluation sub-questions were descriptive and normative in nature. Experimental and quasi-experimental designs cannot be applied in this case, as they require creating a control group (not covered by the program) by random (when using an experimental design) or non-random (in the case of a quasi-experimental design) selection and using data collection and analysis methods that are time-consuming and costly. Another reason why these types of design are inapplicable to this case is that to have a control group, the initial indicator values (before the start of the program) should have been established for the groups not covered by the program, which at this point in the implementation is virtually impossible. Considering budget and time constraints and to better answer the evaluation questions, the evaluation used a combination of quantitative and qualitative methods and various groups of stakeholders within the framework of non-experimental design. Moreover, it allowed the Evaluation Team to analyze the relationship between the intervention and its effects, the program’s strategy.
The data collection methods were designed around the assumptions and indicators proposed in the evaluation matrix5 and considered the most effective ways to collect needed information in order to answer EQs in given country and programmes’ context and limited timeframe, including: ● Desk review and analysis. A review, prior to fieldwork, of relevant documents including government and UNFPA policy and strategy documents, the United Nations - Kazakhstan Partnership Framework, the UNFPA 3rd and 4th Country Programmes (2010-2015 and 2016-2020) documents, including the Work Plans, Country Office Annual Reports (COARs), the National MDG Final Report, UNDP Human Development Reports for Kazakhstan, the M&E matrix, monitoring reports and relevant secondary data. The Evaluation matrix was developed during and after the in-country data collection to help evaluators consolidate in a structured manner all collected information corresponding to each evaluation question. The table also makes it easier to identify data gaps in a timely manner, and to collect all outstanding information. ● Key informant interviews, interview guides and interview logs. Separate semi-structured interviews were designed using interview guides for key informants (UNFPA staff, government counterparts, donors, other UN agencies, national and international implementing partners – IPs, civil society partners) in capital city and selected sites in Kazakhstan. The means of interviews were mostly face-to-face, whereas Skype/phone interviews were also used. Interview logs were kept by each evaluator in order to share data and record them effectively. Where it was possible group interviews were conducted to collect key information from beneficiaries and partners in response to the Country Programme intended results. ● Site Visits and on-site observations. The selection of four sites outside of capital city was based on consultations with the UNFPA office in Kazakhstan. As Kazakhstan is an upper middle income country, the UNFPA programme is mainly focused on Advocacy and Policy Dialogue. However, there are several pilot projects supported by the Government and international donor in Almaty city, Shymkent city and Turkestan region (Turkestan city and Saryagash town) that were visited by the Evaluation Team. The Evaluation Team conducted on-site observations
4 Evaluation Handbook: How to Design and Conduct a Country Programme Evaluation at UNFPA, UNFPA Independent Evaluation Office, February 2019. Downloaded from www.unfpa.org/evaluation 5 Evaluation Matrix is presented in the Annex 4 10 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
during field visits to the selected locations. The purpose of those on-site observations was to observe operations in real circumstances (church, hospital and crisis center) and/or to meet programmes’ activities’ participants to talk about UNFPA activities in the city and results achieved to date. With regard to gender issues, on-site observations helped reveal people’s motivations, attitudes, and influences. The Evaluation Team ensured gender consideration while conducting on-site observations.
Table 2. Data sources by collection methods Data collection methods Number of data sources Documents reviewed and analyzed (number of documents) 85 Interviews: • Government officials /experts – national level 8/2 • Government officials – regional level 4 • CSOs 4 • Academia/UNFPA Experts 1/2 • UNFPA, UN Agencies/Institutions 5/5 • Partners/beneficiaries (church, youth, hospital, support centers) 2/2/2/2 Cities visited • Nur-Sultan, • Almaty, • Shymkent, • Turkistan, • Saryagash On-site observations • Almaty youth center; • Shymkent perinatal center; • Saryagash center of social-psychological support
Evaluators assessed the extent to which programme results effects have been already achieved, but also looked into the prospects. By conducting retrospective assessments for the most part, analysing what has happened and the reasons why, evaluators used prospective assessments as well. It is important for the next programme cycle in order to take into account lessons learned from the current situation and understand how the existing knowledge base can be used for the development of the new UN-Kazakhstan development partnership framework and the new UNFPA Country Programme for Kazakhstan for 2020-2025 and to accelerate the implementation of the ICPD Programme of Action.
The evaluators used a variety of methods to ensure the validity of the data collected. Besides a systematic triangulation of data sources and data collection methods and tools, the validation of data was sought through a thorough analysis of primary and secondary documentation and of the findings from the interviews, focus group discussions and on-site observations. To address the EQs, the Evaluation Team used more than one type of informants (including the UNFPA programme staff) to obtain data and, also, triangulate the data. Counterfactual analysis was applied wherever possible to explore the cause-to-effect relationships within the programme being evaluated. The Evaluation Team used the evaluation framework to structure the analysis and findings. Data obtained was also triangulated (several data collection methods were used to gather information on the same subject) to reinforce findings and identify inconsistencies. Agreement between respondents and/or evidence of different types on a given EQ suggested that the underlying data were accurate. Differences indicate either inaccuracies or the possibility that an activity had different results on the different types of respondents. Special attention was given to cross-validation of programmes’ documents.
The evaluation used various data analysis methods in order to develop the findings, conclusions, and recommendations to answer the EQs. The data analysis took place on a continuous basis, i.e. during the desk phase, field phase, and synthesis phase. The following mix of methods (used intertwined) guided the analysis: document analysis; theories of change and contribution analysis, triangulation of analysis of primary and secondary documentation and of the findings from the interviews, group discussions and on-site observations; content analysis; descriptive statistics; process mapping and visualization. The collected data was analyzed with gender dimension in mind to reflect a gender perspective so as to exclude gender bias and to enable the team to map all possible consequences for women and men6 within the UNFPA programmes’ framework, including women’s real situation in
6 Ruzvidzo, T. May 2007. Measuring Gender Equality: Taking Stock – Looking Forward. OECD Development Centre. 11 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
terms of their cultural and social status, gender equality, sexual and reproductive health, gender-based violence, women’s and girl’s empowerment and reproductive rights, etc. While the “genderized” data collection methods were specifically adapted to include gender issues, the primary purpose of these instruments was to collect data on the object of the evaluation and not on women.7
Selection of the sample of stakeholders The UNFPA country programme involves/affects a wide range of stakeholders. The evaluation adopted an inclusive approach, involving a broad range of partners and stakeholders. During the preparation phase the evaluation manager performed a stakeholders mapping (presented in the Annex 6) in order to identify both UNFPA direct and indirect partners (i.e. partners who do not work directly with UNFPA and yet play a key role in a relevant outcome or thematic area in the national context). Those stakeholders include representatives from the government, civil society organizations, and donors. In addition, during field mission stakeholders from other UN organizations operating for/in Kazakhstan (like UNDP, UNICEF, UNV, etc.), other multilateral organizations, bilateral donors, and other direct and indirect stakeholders of the 3rd and 4th programmes were identified. In the event the identified interviewees are not available or interested in participating, the ET utilized snowball sampling. When the ET determined it has an information gap, the ET asked UNFPA CO, key beneficiaries and stakeholders to recommend other key informants to interview.
Based on the stakeholder mapping key informants sample was selected by using the following stakeholder selection criteria8: ● Stakeholders involved in seemingly good performing and poor performing interventions of the country programme. ● All type of stakeholders for each given output / outcome - i.e., implementing partners, execution agencies, other partners, direct and indirect beneficiaries, and donors. ● For each output/outcome, stakeholders associated to on-going activities as well as with activities (AWPs) that have already been completed. ● The sample should include both stakeholders related to parts of the programme implemented in the country capital and other parts implemented in other regions/ provinces/ districts. ● The sample should include both stakeholders associated with financially large and financially modest AWP. ● The sample should include both stakeholders associated to regular actions and pilot interventions. ● Stakeholders involved with the national execution modality and with the direct execution modality. ● Stakeholders associated with soft-aid activities carried out by the country office. ● Stakeholders associated to regional interventions. ● Whenever relevant, stakeholders that have been involved with interagency projects.
The final list of government, NGO and donor interviewed is presented in the Annex 2.
Table 3. Samples disaggregated by categories, N=39 Categories # Male/adult 13 Female/adult 26 Male/youth&adolescent 0 Female/youth&adolescent 2
Site selection. The purposive selection of sites for data collection considered the following factors: • Involvement in UNFPA activities; • Different UNFPA programmes’ areas; • Different types of interventions provided by UNFPA activities; • Consideration of all levels of assistance: national, regional and local; and • Presentation of regions where pilot projects were/are being implemented.
The evaluation considered the geographic distribution of pilot/projects’ activities.
https://www.oecd.org/dev/38640915.pdf. 7 Mensah, S.A. Gender Sensitive Data Gathering Methods. Gratis Foundation. http://www.un.org/esa/sustdev/csd/csd15/lc/gender_method.pdf 8 Handbook on How to Design and Conduct a Country Programme Evaluation at UNFPA, UNFPA Independent Evaluation Office, February 2019 12 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
EVALUATION PROCESS
Process overview The country programme evaluation was implemented in five sequential phases, each of them including several steps, with respective deliverables as follows:
Dissemination Preparation Design Fieldwork Reporting & Follow-Up
1. Preparation This phase, managed by the UNFPA Country Office in Kazakhstan, included: ● Drafting of country programme evaluation (CPE) terms of reference (ToR) ● Establishing an Evaluation Reference Group (ERG) ● Receiving comments from the ERG on the CPE ToR ● Receiving comments on the CPE ToR from the UNFPA EECARO ● Receiving approval of the CPE ToR from the UNFPA Evaluation Office ● Selecting potential evaluators ● Receiving pre-qualification of potential evaluators from the UNFPA Evaluation Office ● Recruiting evaluators and establishing an Evaluation Team chaired by the Evaluation Team Leader ● Preparing the initial set of documentation for the CPE, including list of Atlas projects and stakeholder map
The preparation phase included a communication with the UNFPA Country Office in Kazakhstan to gain a better understanding of the development context, UNFPA programme and partners, refine the evaluation scope, identify UNFPA requirements and potential sites for field visits etc.
2. Design During the design phase, the Evaluation Team performed the following tasks: ● Documentary review of all relevant documents available at the UNFPA Country Office in Kazakhstan, Regional Office and Headquarters levels regarding the UNFPA Country Programmes for Kazakhstan for 2010-2015 and 2016-2020. ● Mapping of stakeholders relevant to the CPE, including state and civil society stakeholders and indicating the relationships between different sets of stakeholders; the stakeholder map was used for stakeholder sampling for data collection. ● Reconstruction of the intervention logic of the programme, i.e. the theory of change meant to lead from planned activities to the intended results of the programme. ● Finalization of the list of evaluation questions and preparation of the evaluation matrix. ● Development of a data collection and analysis strategy, as well as a concrete workplan for the field phase.
Once all the interviewees and field trips were identified by the evaluators, the UNFPA Evaluation Manager (together with the country office staff) set a preliminary agenda for the field phase and run the required logistical arrangements.
3. Fieldwork After the design phase, the Evaluation Team undertook a two-week mission in Kazakhstan to collect and analyse the data required in order to answer the evaluation questions consolidated at the design phase, and to analyze the findings with a view to formulate the preliminary conclusions and recommendations of the evaluation.
During June 24 – July 5, 2019 the Evaluation team visited five cities (Figure 1), namely Nur-Sultan, Almaty, Shymkent, Turkistan, and Saryagash; conducted 31 interviews with 39 people and visited three sites, namely - Almaty youth center, Shymkent perinatal center, and Saryagash center of social-psychological support.
At the end of the field phase, the Evaluation Team provided the UNFPA country office with a debriefing presentation on the preliminary results of the evaluation.
13 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Figure 1. UNFPA sites visited during evaluation, June – July of 2019
4. Reporting During this phase, the Evaluation Team continued the analytical work initiated during the field phase and prepare a first draft of the final evaluation report, taking into account comments made by the country office at the debriefing meeting. This first draft final report was submitted to the Evaluation Reference Group for written comments. Comments made by the ERG and consolidated by the UNFPA Evaluation Manager were then allow the Evaluation Team to prepare a second draft final evaluation report. A formal evaluation quality assessment (EQA) took place at the reporting phase.
5. Dissemination and Follow-Up During this phase, the country and regional offices, as well as relevant divisions at UNFPA headquarters are informed of the CPE results. The evaluation report, accompanied by a document listing all recommendations, are communicated to all relevant units within UNFPA, with an invitation to submit their response. Once filled, this document became the management response to the evaluation. The UNFPA Country Office in Kazakhstan provided the management response within six weeks of the receipt of the final evaluation report.
The evaluation report, along with the CPE ToR and management response, will be published in the UNFPA evaluation database within eight weeks since their finalization. The evaluation report will also be made available to the UNFPA Executive Board and will be widely distributed within and outside the organization.
Team composition and distribution of tasks The evaluation was carried out by a competitively selected independent Evaluation Team consisting of an Evaluation Team Leader and two Evaluators who are external to UNFPA. The team members combined knowledge and experience in evaluation with technical knowledge and expertise in areas related to the UNFPA development and programmes. The allocation of responsibilities and distribution of work included, at least, two aspects: (i) allocation of responsibilities by area of work; (ii) allocation of responsibilities for sections of the final evaluation report.
Evaluation limitations The following challenges/limitations were considered and mitigated to obtain reliable data: • The timing of the evaluation. The timing of the evaluation falls into summer/ holiday period when many stakeholders were out of reach. This limitation was mitigated by careful planning and good logistical support and division of labour among the evaluation team members as well. To support a balanced approach to the review of activities, the team purposefully sampled sites, respondents, and direct observation opportunities during fieldwork to ensure exposure to a wide scope and variety of activity locations, beneficiaries/stakeholders, and
14 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
components. • The access to sources of information (both documentary sources and stakeholders) as of government restructuring during almost 10-year period of Country programmes implementation and Presidential election in June of 2019. Changes of key personnel in some national counterpart institutions (Ministry of Health, State Statistics Agency) affected institutional memory and made it sometimes difficult to obtain accurate and representative data for the period under evaluation. In order to mitigate these limitations the evaluation team used secondary data and purposive sampling approach to identify ‘right’ key informants (some of them retired or moved to other institutions). • Recall bias. Some of the activities within the 3rd CP have already been completed. Respondents found it difficult to accurately recall efforts related to these particular activities or changes over time. A challenge of qualitative data is that results rely on the interviewee’s recollection or perspectives. The team overcame this challenge by incorporating best practices for qualitative data collection when recall was required, such as framing questions to anchor activities to memorable points in time to ease recall, by asking questions that rely less on recall of specific activities and more on the current perceived implications of those activities, and by triangulating the results. Data were triangulated with other respondent categories and sources, using different methods, to help verify where respondents might have been biased due to recall limitations. • Limitation of data sources. Many study and survey reports supported by UNFPA are not publicly available and their data are not available to secondary use of researcher and all interested. To overcome this limitation, the evaluation team asked the UNFPA CO to provide reports. • Size of the country. UNFPA activities were and are conducted in various regions of Kazakhstan. Evaluation Team was not able to visit all sites and only sites that are of higher interest of CO were selected to visit.
15 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
CHAPTER 2: COUNTRY CONTEXT
2.1 Development challenges and national strategies UNFPA commenced its operations in Kazakhstan in 1992 after collapse of the Soviet Union. Until 1999, the assistance to the country was provided in the framework of the regional program for the Central Asia and essentially as an emergency aid to improve mother health through delivery of medical equipment and medicines to perinatal centers and maternity hospitals, contraceptives for population, and training of healthcare personnel. UNFPA operated mostly in Kyzylorda and South-Kazakhstan Oblasts. Besides, UNFPA jointly with the UN Statistics Division assisted Kazakhstan in the first census of the independent Kazakhstan in 1999 by providing necessary technical and advisory support to preparation and delivery of the census, training of personnel and data processing.
The first UNFPA CP in Kazakhstan in 2000-2004 strengthened national capacity in policy design on safe motherhood and reproductive health and improved access to appropriate information and services in pilot regions. The pilot regions included South Kazakhstan, East Kazakhstan, mainly Semipalatinsk region, Karaganda, Akmola (now Astana) and Almaty. The support was provided on the national level to data collection, processing and analysis and recommendations were prepared on data use in social development planning.
The second UNFPA CP (2005-2009) addressed linkages between population, sustainable development and poverty in order to raise efficiency of government policy on improving welfare of residents of the country; dissemination of pilot safe motherhood program, creation of critical mass of healthcare professionals trained on efficient perinatal technologies and family planning. A special focus was turned to control over spread of HIV-infection and violence against women. In the framework of the second CP technical assistance was provided to preparation and delivery of census of 2009; obtainment of information and preparation of analytical reports on vital population issues, including crude mortality, family status, ageing and migration; it helped to develop a youth movement to deliver peer-to-peer training on SRH, prevention of unwanted pregnancy, STI transmission, including HIV; training of healthcare personnel and improvement of quality of reproductive health services to youths. The impact of the program was largely determined by successful pilot project in South-Kazakhstan Oblast as a model replicated in the former Semipalatinsk nuclear test site.
The third UNFPA CP (2010-2015) addressed quality of mother care services, improved access to services and information on sexual and reproductive health care, prevention of gender-based violence, and provision of evidence on vital population issues, promotion of needs of vulnerable population in the regional and national development programs.
The fourth UNFPA CP (2016 – 2020) aims to: improve equal access to comprehensive high-quality social services (health, education, social security, rights, etc.) for people of Kazakhstan, including socially vulnerable and disadvantaged persons and groups; foster human rights by involving rights holders into decision-making; establish the national system of multi-sectoral response to gender-based violence; support fair, responsible, accountable and available to all judicial and legal systems and government institutes; and contribute to the achievement of SDGs in the region jointly with the Government and partners.
Kazakhstan is a country with abundant natural resources; the economy is successfully developing and coping with problems owing to reasonable governance. However, now the economy of Kazakhstan is strongly exposed to the pressure of dropping prices of oil and other natural resources, crisis in China and Russia, as well as other external factors.
The population of the country is quite young; the median age is 29 years. The proportion of young people aged 14-28 in total population is 25%. The Government recognizes that such a high proportion of youths lays a background for economic development and it undertakes certain measures on the national level to improve capacities of youths.
Maternal, infant mortality and life expectancy have significantly improved. The infant and maternal mortality has dropped 4.5 times versus 1990. Infant mortality dropped from 45.8 per 1,000 live births in 1990 to 8.9 in 2017, while maternal mortality dropped from 55 per 100,000 live births in 1990 to 12.6 in 2017. In Kazakhstan, the life expectancy at birth grew by 4 years from 67.6 in 1991 to 72.9 in 2017. The Government set the task to reduce maternal mortality to Western European level (4-5 per 100,000 live births) and increase life expectancy to 80 by 2050. The progress achieved in maternal mortality in the last 5 years results from implementation of efficient perinatal technologies recommended by WHO. From 2011 on, these technologies were implemented as pilot models and then disseminated countrywide covering 16 regions using public resources and technical assistance of UN agencies. Besides, introduction
16 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
of confidential enquiries into maternal deaths Beyond the numbers along with the above interventions has significantly improved quality of emergency care in obstetric conditions with a positive impact on maternal mortality. In the last few years, the deaths caused by obstetric hemorrhage have significantly dropped from 11.2 in 2009 to 4.3 per 100,000 live births in 2014. However, the risk of death from obstetrical hemorrhage in Kazakhstan remains quite high and is almost 5 times higher than in OECD countries (e.g., 0.7 in the UK). Inadequate availability of contraception encourages artificial termination of unintended pregnancy. Abortion remains quite a prevalent way of birth control in Kazakhstan with every fifth pregnancy ending with abortion.
Official statistics demonstrates decline in sexually transmitted disease morbidity; however, sentinel surveillance finds that prevalence of STIs is more than it is officially reported. One of the existing problems includes the absence of guidelines for STI syndrome management in PHC settings coupled with the existing health care monopoly of specialized STI dispensaries that provide care only when requested by patients. Consequently, the absence of early detection mechanisms and complicated patient pathways lead to the spread of infections and the scope is difficult to measure due to the lack of reliable statistics.
Despite significant proportion of active age population, the use of contraception in Kazakhstan remains limited. It should be noted that the income level influences contraception coverage, as well as choice of contraception. 55% richest and only 45% poorest women use advanced contraception, while 90% poorest and 55% richest women use intrauterine devices.
According to the existing legislation, the government ensures access to family planning services and does not restrict the rights of people to selection of contraception method; on the other hand, it does not assume responsibility for the provision of contraception. Contraception for vulnerable groups is not included into the guaranteed healthcare benefit package. The only chance to get contraceptives for free is financing from local (oblast) budgets subject to availability of resources. This effort is not systemic; it is difficult to assess these activities due to the absence of official monitoring.
The national survey of reproductive health of adolescents and young people aged 15-19 supported by UNFPA (2018) found that 42.5% youths had first sexual intercourse at school age before attaining majority; 2.5% youths had first sexual experience before the age of 15, and 20.9% by the age of 18. Quite a lot of adolescents are not concerned about uncontrolled sexual behavior with higher risk. Use of contraceptives by adolescents and youths is not peculiar to their reproductive behavior. In addition, adolescents are not well informed of preventive behavior and safe sex.
Youths are in the group of high risk of HIV infection, because very often they do not have access to information and family planning services. According to the above-mentioned survey of 2018, only 9% of youth aged 15-19 years had a comprehensive knowledge about HIV prevention. Moreover, 66% of youth aged 15-19 years are not informed of HIV prevention and prophylaxis. 85% of young people 15–19 years old said that they receive certain information about sexual and reproductive health, including STIs and HIV. But the fact that young people receive this information from the Internet, social networks, i.e. a question arises about the quality and reliability of the information received. Information from unreliable sources misinforms young people, hence the low rates of young people’s awareness of sexual and reproductive health 15–19.
The rate of coverage with voluntary counseling and testing for HIV (VCT) is only 8.4%, which is unacceptably low. Given the increase in the sexual spread of HIV, and against the background of a low level of awareness of HIV among young people aged 15–19 years, the low level of VCT coverage is a warning signal. 73.5% do not know where to go for an anonymous HIV test. Low awareness is more common among young people living in rural areas, among girls and among 15–17 year olds. Furthermore, 47% of young people do not know the consequences of unsafe abortions, and 46% do not know the consequences of STI infection. In Kazakhstan, HIV-infection is concentrated. As of 01 January 2015, total number of HIV-infected citizens of Kazakhstan from the inception of HIV reporting (1987) is 22,474 people. HIV prevalence is 0.09%.
In the last 7 years, Kazakhstan has achieved some progress in human rights protection and promotion of gender equality. Key legislative documents were adopted to address prevention of domestic violence and counteraction to human trafficking, pension coverage, as well as gender equality strategy during the period 2006–2016. Kazakhstan improved policy mechanisms in order to eliminate discrimination against women and facilitate gender equality, including engagement of women to political and social life, achievement of 30% representation of women in decision- making process in the elected or appointed authorities.
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The Government continues to emphasize the need to increase population of the country, leverage distribution of population by regions and support birth rate. At the same time, demographic development, population flow projection and its linkage to sustainable development, reproductive health and reproductive rights, as well as enhancement of gender equality, support to family and vulnerable population have not been systematized into the uniform demographic policy yet.
Recently, Kazakhstan has been demonstrating impressive economic growth, though the health and social development rates were behind economic growth; this may worsen the status of socially vulnerable groups in the context of crisis and devaluation. Public health and social expenditures remain relatively low; in mid-2015, the public health expenditures amounted to 2.4% and 4.1% of GDP respectively and may go down as a result of budget sequestration, especially with regard to capital expenditures in these sectors.
These challenges are recognized by the government and it makes appropriate steps. Therefore, the above assessment clearly demonstrates significant progress of the Government of Kazakhstan and non-governmental sector in the last ten years. However, in the context of strong pressure of crisis it is necessary to retain these achievements and continue progress in order to ensure continued decline of maternal mortality, increase of life expectancy, prevention of STI outbreaks, including HIV-infection, reduction of unsafe abortion rate, improved knowledge of young people and adolescents of sexual and reproductive health care, efficient response to gender-based violence, development of gender and demographic policy, and other indicators. Resolution of the above issues will raise quality of life. And in these particular areas the Country Office of UNFPA in Kazakhstan is ready to provide support and assistance
2.2 The role of external assistance In 2016, Kazakhstan’s net official development assistance (ODA) amounted to $31 million, compared to USD 43 million in 2015, a decrease of 43% in real terms. The ratio of ODA as a share of gross national income [GNI] was 0.03% in 2016, compared to 0.04% in 2015.
The Foreign Policy Concept of Kazakhstan 2014-2020 guides Kazakhstan’s contribution to the international community’s development co-operation efforts. The ODA Concept of Kazakhstan (April 2013) sets out a roadmap for becoming a provider of development co-operation. Law No. 263-V on Official Development Assistance (December 2014) describes the main objectives, principles, competences and sectoral priorities of Kazakhstan’s ODA. In accordance with Article 6 of this law, Presidential Decree No. 415 “On approval of the main directions of the state policy in the sphere of ODA for 2017-2020” (January 2017) identifies the geographic and sectoral priorities, forms and mechanisms of financing, key parameters and tools for practical activities of Kazakhstan in the field of official development assistance for the period up to 2020.
The ODA Law provides the legal basis for establishing an agency under the Ministry of Foreign Affairs, provisionally known as the Kazakhstan Agency for International Development Assistance (KAZAID), to implement development co- operation activities. For the moment, the Ministry of Foreign Affairs is the designated authority to implement the main lines of Kazakhstan’s ODA policy, including ODA activities.
In 2016, the main sectors for Kazakhstan’s bilateral development co-operation were government and civil society, economic infrastructure, and other social infrastructure (Kazakhstan did not report details on recipient countries).
Multilateral ODA accounted for 64% of Kazakhstan’s net disbursements in 2016, provided primarily through the United Nations (accounting for 91% of its multilateral ODA in 2016), as well as through other multilateral organizations.
Kazakhstan has been a Development Assistance Committee Invitee since 20159. “ODA shall be provided with the aim to facilitate: 1) further integration of Kazakhstan into the regional and international relations system; 2) establishment of external conditions favourable to the successful implementation of Kazakhstan’s development strategies and programs; 3) peace- building, regional and global security; 4) promotion of the social and economic development of a partner country and the well-being of its citizens; and 5) gradual transition of a partner country to address environmental protection and climate change.” Article 3. Goals and Objectives of Official Development Assistance Law of the Republic of Kazakhstan on Official Development Assistance (10 December 2014, No. 263-V)
9 An Invitee may be invited, on a case-by-case basis, to participate in formal meetings of the DAC or its subsidiary bodies. An Invitee may take part in discussions but does not take part in decision-making processes, nor is it bound by the DAC’s conclusions, proposals or decisions. 18 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Figure 2. ODA key statistics: Kazakhstan10
UNFPA is operating in Kazakhstan since 1992 and the bilateral cooperation is currently based on the fourth Country Programme (2016-2020) within the collective UN Partnership Framework for Development for 2016-2020. The Country Programme is aligned with national development priorities, including the Kazakhstan 2050 strategy, the new economic policy (Nurly Zhol), and the state health programme for 2016-2020.
Today, UNFPA provides expert advice and helps the Government and CSOs develop capacities to ensure that motherhood is safe, that family planning is available, and that all women and young people can access high-quality sexual and reproductive health care. With more births and fewer deaths, Kazakhstan has achieved stable population growth after a period of decline. Maternal mortality has fallen dramatically and there is nearly universal skilled attendance at births. Gaps in access to contraceptives remain, however, and young people lack adequate sexual and reproductive health services.
UNFPA contributes to four out of six outcomes of the United Nations Partnership Framework for Development, 2016- 2020. UNFPA mainstreams humanitarian response and preparedness throughout the programme, and the key beneficiaries of the programme are women and young people, particularly those most in need. The main UN partners include WHO, ILO, UNICEF, UNDP, UNESCO and UNAIDS. UNFPA achieves results through complementary and well- coordinated activities with these UN agencies, concentrating on: ● Improving access of people to quality and integrated services in sexual and reproductive health; ● Strengthening national legislation, policies and programmes which take account of the needs of adolescent and young people; ● Promoting gender equality and prevent gender-based violence; ● Strengthening national data system and improving accessibility and availability of evidence-based population dynamics analysis.
UNFPA contributes to Sustainable Development Goals no. 3, 5, 10, 16 and 17.
Kazakhstan has made considerable progress in the last 25 years in the area of Reproductive Health11 as one of the countries who adopted the ICPD Programme of Action in 1994. One of its greatest achievements has been the
10 OECD (2018), “Kazakhstan’s Official Development Assistance (ODA)”, webpage, (accessed 10 May 2018), http://www. oecd.org/dac/dac-global-relations/kazakhstan-official-development-assistance.htm. 19 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
reduction by 75% of the Maternal Mortality Ratio (MMR) since the early 1990s where it was estimated at 62 per 100,000 live births in 1990 to 12.6 per 100,000 live births in 2017.
Committee on Economic, Social and Cultural Rights12 noted the following achievements of internationally agreed development goals as per the Second Periodic Report of States Parties submitted by Kazakhstan in 201513 under articles 16 and 17 of the International Covenant on Economic, Social and Cultural Rights: ● Child/infant mortality - according to the estimates of the Inter-Agency Group for Child Mortality Estimation, as included in its 2015 report on child mortality, the infant mortality rate in Kazakhstan was 13 per 1,000 live births and the child mortality rate was 14 per 1,000 in 2014. Information on these achievements was included in the official Word Bank database in 2015, and Kazakhstan climbed 20 places (from 98th to 78th) in the ranking of countries by infant mortality rate in the 2014/15 Global Competitiveness Index. ● Maternal mortality - in November 2014 report of the Inter-agency Group for Maternal Mortality Estimation indicated that the maternal mortality rate was 12. Thus, according to United Nations estimates, maternal mortality has fallen by 85 per cent.
CEDAW Fifth periodic report14 acknowledged the following achievements: ● 61 per cent of the targets of the SDGs have been incorporated into national and sectoral plans and strategies in Kazakhstan; ● Demographic changes in Kazakhstan were observed between censuses of 1999 and 2009, namely: the birth rate increased, mortality declined, life expectancy rose, and the migration balance was positive. As a result, the population increased by more than 1 million; ● by 2018, life expectancy had increased by 3.7 years to 73.15 years, including by 3 years for women (to 77.19 years), and by 4.1 years for men (to 68.84 years); ● At the end of 2017, in the Global Gender Gap Index of the World Economic Forum (WEF), Kazakhstan was ranked 52nd out of 144 countries. For the indicator “economic participation and opportunity”, Kazakhstan was in 30th place, “educational attainment” — 48th place, “health and survival” — 36th place and “political empowerment” — 93rd place”; ● Since 2010 the level of domestic crime has declined by an average of 10 per cent. While in 2010, 745 cases were registered, in 2016, the figure had fallen to 484 cases, or 35 per cent. The number of murders committed in the context of family and domestic relations has fallen by almost two thirds (from 268 to 93).
CHAPTER 3: UNFPA STRATEGIC RESPONSE AND PROGRAMME
3.1 UNFPA strategic response UNFPA is the lead United Nations agency for delivering a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled. UNFPA expands the possibilities for women and young people to lead healthy and productive lives. The strategic goal of UNFPA is to achieve universal access to sexual and reproductive health care, realize reproductive rights and reduce maternal mortality to improve the lives of women, adolescents and youth, enabled by profound analysis of population dynamics, observance and protection of human rights, and promotion of gender equality. In pursuing its goal, UNFPA has been guided by the International Conference on Population and Development (ICPD) Programme of Action (1994), the Millennium Development Goals (2000) and the 2030 Agenda for Sustainable Development (2015) as well as other global frameworks underpinning the 2030 Agenda, including the Sendai Framework for Disaster Risk Reduction 2015-2030 of the Third United Nations World Conference on Disaster Risk Reduction, the 2015 Paris Agreement on climate change and the 2015 Addis Ababa Action Agenda of the Third International Conference on Financing for Development.
UNFPA is committed to the Delivering as one approach and the system-wide coherence principles contained in the Standard Operating Procedures. UNFPA country programmes are fully aligned with the United Nations Development Assistance Frameworks and implemented to enhance country, regional and global policy coherence, joint programmes, monitoring, and reporting for results. UNFPA is one of three United Nations organizations that chairs the largest number of United Nations country team inter-agency groups and participates in the largest number of joint programmes. As such, it is uniquely positioned to further advance coherence in programme delivery.
11 UNECE Regional Conference on ICPD+25, 1 - 2 October 2018: Mr. Olzhas Toguzbayev, Deputy Director of the Department on Multilateral Cooperation, Ministry of Foreign Affairs 12 E/C.12/KAZ/2, 13 September 2017 13 ibid 14 Fifth periodic report submitted by Kazakhstan under article 18 of the Convention, due in 2018, 11 July 2018 20 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
UNFPA commits to working with the United Nations Development Programme (UNDP), the United Nations Children’s Fund (UNICEF), and the United Nations Entity for Gender Equality and the Empowerment of Women (UN-Women), the United National Education, Science and Culture Organization (UNESCO) to support implementation of the 2030 Agenda. UNFPA key areas of collaboration include: (a) Eradicating poverty; b) Addressing climate change; c) Improving adolescent and maternal health; d) Achieving gender equality and the empowerment of women and girls; e) Ensuring greater availability and use of disaggregated data for sustainable development; and (f) Emphasizing that development is a central goal in itself, and that in countries in conflict and post-conflict situations, the development work of the entities of the United Nations development system can contribute to peacebuilding and sustaining peace, in accordance with national plans, needs and priorities, and respecting national ownership.
Since 1992 UNFPA in Kazakhstan focused its work mainly on emergency response to strengthen maternal health care through the supply of medical equipment, contraceptives and provision of basic training for service providers as well as on improvement of reproductive health, building capacity of national institutions, knowledge sharing and development of evidence-based reproductive health care standards. In its second and third country programmes UNFPA made a gradual shift toward a technical assistance programme focused on sexual and reproductive health rights and on linkages between health, population, gender and sustainable development for evidence-based policy formulation. In addition the third country program aimed at high-quality maternal health services, improved access to sexual and reproductive health services and information, preventing and responding to gender-based violence, and provision of evidence- based data on emerging population issues, including reaching and addressing the needs of vulnerable and other key populations. The Fourth UNFPA country program focuses on four key areas, namely: sexual and reproductive health, adolescents and youth, gender equality and women’s empowerment, and population dynamics. The programme will contribute to four out of six outcomes of the United Nations Partnership Framework for Development, 2016-2020.
UNFPA recognizes the strategic plan as the key tool for directing the work of UNFPA in supporting countries in implementing the ICPD Programme of Action and the Key Actions for the Further Implementation of the ICPD Programme of Action (ICPD+5) and in advancing the Millennium Development Goals. The UNFPA Strategic Plan for 2008-2013 has been approved by the Executive Board in 2007. Following the mid-term review (2011) of the UNFPA Strategic Plan (DP/FPA/2011/11), UNFPA globally adopted a set of seven interrelated outcomes no longer strictly associated with the three previous programmatic areas.
The new UNFPA Strategic Plan for 2014-2017 reaffirmed the strategic direction set out in the midterm review of the 2008 - 2013 strategic plan, and presented a set of organizational changes that support its attainment. It sets out a vision for the changes in the lives of women, adolescents, and youth.
The UNFPA Strategic Plan 2014-2017, which was formally approved at the Executive Board Second Regular Session 2013, is focused squarely on addressing the unfinished agenda of Cairo, with a particular concentration on sexual and reproductive health and reproductive rights. The starting point for this is the substantive strategic direction set out in the Mid Term Review, which has been retained and reaffirmed in the 2014-2017 Strategic Plan and which is represented by the bull's eye. The bull’s eye is the goal of UNFPA: the achievement of universal access to sexual and reproductive health, the realization of reproductive rights, and the reduction in maternal mortality. The work of the organization is centred on attaining this goal, particularly through an enhanced focus on family planning, maternal health, and HIV/AIDS. Reaching this goal would bring enormous benefits to people across the world by accelerating progress on the ICPD agenda, and would make a major contribution to the MDGs. MDG 5a and 5b on maternal mortality and reproductive health are the central focus of the Fund’s work, but it is important to recognize that improving maternal health has a number of broader developmental impacts for the other MDGs. Women, adolescents and youth are the key beneficiaries of UNFPA work. The organization will prioritize the most vulnerable and marginalized, particularly adolescent girls and also indigenous people, ethnic minorities, migrants, sex workers, persons living with HIV, and persons with disabilities. UNFPA will work to improve their health and their ability to participate in the decision-making process on the issues that affect their lives, whether those decisions are made at the individual, familial, community, or national levels. The outer ring of the bull’s eye contains the key factors that enable
21 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
the attainment of the goal. Respect for human rights is a principle that underpins all of the Fund’s work. A human rights-based approach can be seen in how UNFPA operates, such as in the emphasis on ensuring that family planning services are free of coercion or that HIV/AIDS interventions are stigma-free.
The 2018-2021 UNFPA strategic plan reaffirms the relevance of the current strategic direction of UNFPA, the goal of which is universal access to sexual and reproductive health and reproductive rights, focusing on women, adolescents and youth. In accordance with the strategic direction of UNFPA and in line with General Assembly resolution 70/1 on the 2030 Agenda for Sustainable Development, the strategic plan seeks to ensure that no one will be left behind and that the furthest behind will be reached first. Current strategic plan is the first of three UNFPA strategic plans leading to 2030. It describes the transformative results that will contribute to the achievement of the Sustainable Development Goals, and, in particular, to good health and well- being, the advancement of gender equality, and the empowerment of women and adolescent girls, with a focus on eradicating poverty. UNFPA has prioritized 17 Sustainable Development Goal indicators to align the UNFPA strategic plan to SDGs.
The strategies introduced in the strategic plan are evidence-based and take into account the lessons learned from previous plan cycles. They are designed to further enhance organizational effectiveness and efficiency and United Nations system-wide coherence, as well as strengthen the UNFPA integrated results and resources framework and the UNFPA business model.
As requested by the Executive Board in decision 2017/7, a chapter outlining a common approach with UNDP, UNICEF and UN-Women, Working together to support implementation of the 2030 Agenda, prefaces the report.
3.2 UNFPA response through the country programme UNFPA implements its strategic plan at headquarters, regional, multi-country and country levels. Country programmes are at the forefront of implementing the strategic plan. They respond to country needs and priorities, and to the achievement of the Sustainable Development Goals. Country programmes are aligned with the outcomes and outputs of the strategic plan. UNFPA country programmes address the four outcomes of its strategic plan in an integrated manner, and are guided by country priorities, the United Nations Development Assistance Framework, and the revised business model and UNFPA modes of engagement.
3.2.1 Brief description of UNFPA previous cycle strategy, goals and achievements The 3rd UNFPA Country Programme Document for Kazakhstan (DP/FPA/DCP/KAZ/3) was approved by the UNDP/UNFPA Executive Board in July 2009. The programme covered the period from 2010 to 2015. UNFPA third country programme is integrated into the United Nations Development Assistance Framework (UNDAF) and contributes to its two outcomes: (a) by 2015, the population of Kazakhstan and vulnerable groups in particular will enjoy improved social, economic and health status; and (b) by 2015, national institutions at all levels and civil society are more capable of, and accountable for, ensuring the rights and needs of the population, particularly vulnerable groups. The programme was based on the recommendations of the 2008 Executive Board field visit to Kazakhstan, which recommended a focus on: (a) advocacy; (b) awareness-raising; (c) expanding national and international best practices; (d) strengthening national capacity; and (e) promoting national ownership and leadership in the three UNFPA core programme areas.
22 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
The programme was aligned with the UNFPA strategic plan, 2008-2011, and the provisions of the Millennium Declaration and other relevant international instruments. The programme aimed to contribute to government priorities outlined in national development plans, including Strategy 2030 and the long-term programme of health-care development to 2020, emphasizing universal access to sexual and reproductive health. The programme focused on: (a) policy advocacy; (b) the dissemination of strategic information; (c) technical assistance and the strengthening of technical and institutional capacity in population and development; (d) reproductive health and rights; and (e) gender equality. Support to emergency preparedness through technical assistance, coordination and resource mobilization had been mainstreamed in the programme. In particular, the programme supported data collection and analysis, reproductive health commodity security and the prevention of gender-based violence in emergencies.
The 3rd Country Programme Document (CPD) for Kazakhstan included three broad programmatic areas: reproductive health and rights, population and development, and gender equality.
Implementation of the 3rd UNFPA program contributed to the achievement of two 2010-2015 UNDAF goals, namely: by 2015 (1) the population of Kazakhstan, and vulnerable groups in particular, will enjoy improved social, economic and health status; and (2) government institutions at all levels and civil society are capable of and accountable for ensuring the rights and needs of the population, particularly vulnerable groups. Outcomes of UNFPA CP contribute into joint programme outcomes of the United Nations at the country level.
The third country programme (2010-2015) made good progress in: (a) implementing effective perinatal technologies; (b) improving maternal mortality monitoring; (c) advocating for ensuring access to family planning services and commodities; (d) expanding the Y-peer network for youth; (e) advocating for comprehensive sexuality education; (f) providing evidence of vulnerable and key populations’ access to maternal and reproductive health; (g) engaging faith- based organizations in advocacy for maternal and reproductive health and in preventing gender- based violence; and (h) building the capacity of policymakers to address population and development issues. UNFPA contributed to a significant reduction in maternal and infant mortality, ratification of the Convention on the Rights of Persons with Disabilities, changes in the state health-care programme to ensure better access to health services and commodities, such as the inclusion of antiretroviral drugs in the basic benefit package for HIV positive persons.
However, the independent review of the country programme has provided several recommendations for the next programme: (a) strengthen national ownership and accountability for results; (b) explore strategies for diversifying the sources for programme funding; (c) improve programme monitoring and evaluation; (d) ensure universal access to quality sexual and reproductive health services and information; (e) ensure comprehensive sexuality education; (f) strengthen partnerships with civil society and religious organizations; (g) increase national capacity on population and development for the formulation of human rights-based policies, with a special focus on vulnerable populations.
3.2.2. Current UNFPA country programme The 4th Country programme for Kazakhstan (DP/FPA/KAZ/4) was approved by the Executive Board of UNFPA and UNDP on 30 June 2015. The programme covered the period from 2016 to 2020.
The fourth country programme (2016-2020) is aligned with national development priorities, including the Kazakhstan 2050 strategy, the new economic policy (Nurly Zhol), and the state health programme for 2016-2020. Guided by a rights-based approach and results-based management principles, the programme is also aligned with the post-2015 development agenda, the UNFPA strategic plan, 2014-2017, and the UNFPA business model. The programme contributes to four out of six outcomes of the United Nations Partnership Framework for Development (UN PFD), 2016-2020. Humanitarian response and preparedness are mainstreamed throughout the programme, and the key beneficiaries of the programme are be women and young people, particularly those most in need.
UNFPA CP 2016-2020 uses the following strategies and is focused on: a) advocacy and policy dialogue to ensure reproductive rights and universal access to integrated mother, reproductive and sexual health care services with a focus on more vulnerable groups; b) empowerment of young people and access to comprehensive sexuality education; c) strengthened policy and institutional mechanisms to promote gender equality and prevent gender-based violence and damaging practices/habits; d) supported data collection, access and analysis to inform policy-making in the field of population flow and its linkage with reproductive and sexual health and reproductive rights.
23 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Country Programme Document (CPD) for Kazakhstan for 2016-2020 includes four broad programmatic areas: sexual and reproductive health; adolescents and youth; gender equality and women’s empowerment; and population dynamics.
Sexual and reproductive health The outcome of this component is: Increased availability and use of integrated sexual and reproductive health services (including family planning, maternal health and HIV) that are gender-responsive and meet human rights standards for quality of care and equity in access. Output 1: Strengthened policy framework and institutional mechanisms to deliver integrated sexual and reproductive health services, with particular focus on the most vulnerable and key populations. The UNFPA efforts included policy dialogue and advocacy of interests of vulnerable population, as well capacity of the country for the development and implementation of national strategies and action plans in the field of reproductive health care and family planning.
Adolescents and youth The outcome of this component is: Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education and sexual and reproductive health. Output 2: Strengthened national laws, policies and programmes that include adolescent and youth and their human rights and needs. Activities under this component contributed to achievement of PFD output 1.1: Improved equal access to comprehensive high-quality social services (healthcare, education, social security, rights, etc.), including for socially vulnerable and disadvantaged persons and groups.
Gender equality and women’s empowerment The outcome of this component is: Advanced gender equality, women’s and girls’ empowerment, and reproductive rights, including for the most vulnerable and marginalized women, adolescents and youth. Output 3: Strengthened national policies and institutional mechanisms to promote gender equality, and to prevent gender-based violence and harmful practices. This component facilitated achievement of PFD outcome: Judicial and legal systems and government institutes are fair, responsible, accountable and available to all in the framework of the national development priority to prevent gender discrimination and ensure gender equality and equal opportunities for women and men. To achieve the CP output the UNFPA planned to deliver active evidence-based policy dialogue, know-how transfer and technical assistance to the country.
Population dynamics The outcome of this component is: Strengthened national policies and international development agendas through integration of evidence-based analysis on population dynamics and their links to sustainable development, sexual and reproductive health and reproductive rights, HIV and gender equality. Output 4: Strengthened national data systems and increased availability and accessibility of evidence-based analysis on population dynamics and their links to sustainable development for the formulation of rights-based policies. UNFPA’s activities under this outcome contributed to achievement of PFD outcome: Holders of rights are involved into decision-making and implementation on the national and local levels resulting in facilitation of human rights. In this area UNFPA planned to actively employ evidence-based policy dialogue and provide technical assistance to the country and strategic information.
CPAP is developed in accordance with the UN Partnership Framework for Development (UN PFD) for the Republic of Kazakhstan, 2016-2020, in the course of consultations with the government organizations, non-government sector, UN agencies and donor organizations. The CPAP is fully aligned with the UNFPA Strategic Plan, 2014–2017.
Implementation of the 4th UNFPA program contributes to the achievement of four out of six Partnership Framework for Development outcomes in 2016-2020, such as: (1) improved and equal access to comprehensive high-quality social services (health, education, social security, rights, etc.) for people of Kazakhstan, including socially vulnerable and disadvantaged persons and groups, (2) holders of rights are involved into decision-making and implementation on the national and local levels to foster human rights, 3) judicial and legal systems and government institutes are fair, responsible, accountable and available to all; and 4) the Government jointly with partners contribute to the achievement of SDGs in the region and is the leader in promotion and implementation of the United Nations
24 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
principles, standards and conventions. The outputs of UNFPA CP will contribute to joint program outcomes of the UN on the country level.
3.2.3 The financial structure of the programmes The UNFPA Executive Board approved15 funding of the 2010-2015 Country program in amount of $5,9 millions from UNFPA Regular Sources and approximately $1,8 million to be mobilized from other sources. Distribution of funds among three priority directions and outputs is presented in the Table 4.
Table 4. The UNFPA financial commitment for 2010-2015 (in USD millions) by priority areas/ outputs
RR Other Total % of Overal Budget Reproductive health and rights 3.2 1.0 4.2 54.5% Output 1: Maternal health strategies are approved and action plans are developed and implemented Output 2: Health-care providers have the capacity to expand the delivery of high-quality family planning and reproductive health services, with a focus on vulnerable groups, including rural populations and the poor laws, policies and programmes that include adolescent and youth and their human rights and needs Output 3: Women and young people have improved access to high-quality sexual and reproductive health and services to prevent HIV and AIDS Output 4: Women and young people are equipped with high-quality information to prevent and reduce the risk of unwanted pregnancies and HIV transmission Population and development 1.6 0.6 2.2 28.7% Output 5: Policymakers employ evidence-based data to develop policies on gender equality, young people, sexual and reproductive health, and HIV and AIDS Output 6: Social-sector stakeholders are better able to plan, implement and monitor social and health services for the elderly, migrants and people with disabilities Gender equality 0.4 0.2 0.6 7.8% Output 7: The action plan of the gender equality strategy reaches a greater number of women and is fully implemented Programme coordination and assistance 0.7 – 0.7 9.0% Total 5.9 1.8 7.7 100%
Financial structure of the 2010-2015 Country Programme is presented in Results and Resources Framework for Kazakhstan16. The total expenditure evolution table (see Table 5) and Figure 3 depicts the cumulative total budget versus expenditure distribution in the CP for the 2010-2015 period. It should be noticed that budget from regular resources was implemented by 63.5% when budget of other resources was completed by 81%. The overall actual allocations of expenditures for Reproductive health within the whole period consisted of 61,65%, 3,78% for the Gender, and 28,3% and 6,27% for P&D and programme coordination and assistance components respectively.
Table 5. Expenditure evaluation for the 3rd Country Programme (2010-2015) (in USD) OR RR Total Programme Budget Expenditure Budget Expenditure Budget Expenditure Gender equality 12284,88 12281,88 167146 165091,06 179430,88 177372,94 Population and development 48439 47817,93 1312449,44 1281083,86 1360888,44 1328901.79 Programme coordination and assistance 320717 294480,79 320717,00 294480,79 Reproductive health and rights 1396334 1043524,77 1946974 1850890,88 3343308,00 2894415,65 TOTAL 1457057,88 1103624,58 3747286,44 3591546,56 5204344,32 4695171,17
15 Approved by the Executive Board of the UNDP and UNFPA on 9 July 2009 16 results and resources framework for Kazakhstan. DP/FPA/CPD/KAZ/3 25 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Figure 3. The 3rd Country Programme (2010-2015) budget utilization by priority areas, in USD
For the 2016-2020 the UNFPA Executive Board approved17 funding in amount of $2.65 millions from UNFPA Regular Sources and approximately $1.1 million to be mobilized through co-financing modalities and/or other resources, including regular sources. Distribution of funds among four outcome and outputs areas is presented in the Table 6.
Table 6. The UNFPA financial commitment for 2016-2020 (in USD millions) by outcome /output areas
RR Other Total % of Overall Budget Outcome 1. Sexual and reproductive health 1.00 0.20 1.20 32% Output 1: Strengthened policy framework and institutional mechanisms to deliver integrated sexual and reproductive health services, with particular focus on the most vulnerable and key populations Outcome 2. Adolescents and youth 0.45 0.40 0.85 22.67% Output 2: Strengthened national laws, policies and programmes that include adolescent and youth and their human rights and needs Outcome 3. Gender equality and women's empowerment 0.35 0.30 0.65 17,33% Output 3: Strengthened national policies and institutional mechanisms to promote gender equality, and to prevent gender-based violence and harmful practices Outcome 4. Population dynamics 0.45 0.20 0.65 17,33% Output 4: Strengthened national data systems and increased availability and accessibility of evidence- based analysis on population dynamics and their links to sustainable development for the formulation of rights-based policies Programme coordination and assistance 0.40 - 0.40 10,67% Total 2.65 1.10 3.75 100% Financial structure of the 2016-2020 Country Programme is presented in Results and Resources Framework for Kazakhstan18.
Preliminary financial data for three years (2016-2018) of the 4th country programme presented in the Table 7 and Figure 4 below. So far, 57,8% out of committed 3,75 millions are allocated to three components and Programme coordination and assistance including 22,77% for Adolescents and youth component, 38,98% for Reproductive health and rights, 12,03% for the Gender, and 18,3% and 7,82% for P&D and programme coordination and assistance components respectively. Table 7. Expenditure evaluation for three years of the 4th Country Programme (2016-2020), USD OR RR Total % of overall Programme Budget Expenditure Budget Expenditure Budget expenditure Adolescents and youth 233457,71 196471,57 260187,43 258077,58 493645,14 22,77% Gender equality 56971,52 45176,4 203727,09 190858,5 260698,61 12,03% Population and development 42536,19 39890,94 356243,76 356713,57 398779,95 18,40% Programme coordination and 169637,32 7,82% assistance 169637,32 166965,05 Reproductive health and rights 311248,25 280483,36 533520,74 530121,36 844768,99 38,98% TOTAL 644213,67 562022,27 1523316,34 1502736,06 2167530,01 100%
17 Endorsed on 30 June 2015 by Government and adopted by the Executive Board of UNDP and UNFPA 18 Results and resources framework for Kazakhstan. DP/FPA/CPD/KAZ/4 26 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Level of utilization of regular and other financial resources for three years of 2016-2020 Country programme is presented in Figure 6 below.
Figure 4. Three-year budget utilization of the 4th Country Programme (2016-2020) by priority areas, $
Figure 5 presents level of utilization of three-year expenditures according to the UNFPA financial commitment for 2016-2020 by priority areas as well as total planned budget.
Figure 5. Three-year budget utilization of the 4th Country Programme (2010-2015) as of the UNFPA financial commitment for 2016-2020 by priority areas, USD
Analysis of programme and management expenditures for 3rd and 4th Country programmes shows that expenses for programme coordination and assistance constitute 6.27% for the 3rd CP and 7.82% for three years of the 4th CP (Figure 6).
Figure 6. UNFPA Coordination and Assistance v. Programme Expenditures by CPs, %
27 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
CHAPTER 4: FINDINGS: ANSWERS TO THE EVALUATION QUESTIONS
3rd and 4th UNFPA Country programmes derived from the national development priorities (for example for 4th CP they are specified in Kazakhstan 2050 strategy, the new economic policy and the state health programme for 2016-2020), aligned with the UNFPA strategic plans for 2008-2011 and 2014-2017, integrated into UNDAF and UN PFD, and are guided by a right-based approach and result-based principles and the UNFPA business model. National development priority and either UNDAF (3rd CP) or UN PFD (4th CP) outcomes guide UNFPA strategic outcomes and country programme areas and outcomes. For example, implementation of the 3rd UNFPA program contributes to the achievement of two 2010-2015 UNDAF goals, its CP outcomes contribute into joint programme outcomes of the United Nations at the country level. The 4th UNFPA CP contributes to four out of six outcomes of the United Nations Partnership Framework for Development (UN PFD), 2016-2020.
In defining its outcomes UNFPA rely on theory of change formulated in the UN PDF, 2016-202 that is flexible to accommodate various national priorities and mandate of the UN agencies and underpins key objectives of the partnership between the UN and the Government of Kazakhstan19. To develop relevant country programmes the UNFPA CO employs several steps. First, relative to the UNFPA activities existing national documents, programs and materials on priority areas are collected and analyzed along with other UNFPA related programmes of international and local organizations. Second, country staff meets with local partners to discuss areas and directions of potential activities. Then UNFPA draft strategy is reviewed by regional peer review groups. The UNFPA Executive Board signs final strategy and Government of Kazakhstan approves the Action Plan. In addition it should be mentioned there are several other factors that the UNFPA CO considers during strategy and annual planning processes, including: priority areas are evidence-based, adjusted with UNDAF strategy, and continuing addressing country needs and priorities; advocacy activity should prevail capacity building as Kazakhstan rated as middle-income or ‘pink’ country; sustainability of implemented activity; piloting activity first and when it proves effectiveness multiply to either other regions or areas of activities; in case if there are interesting proposals from partners with no funding to support them, the UNFPA put them on resource mobilization list.
Analysis of UNFPA intervention logic for both CPs shows that its outputs derive from Results and Resources Framework for Kazakhstan and AWP and are based on outcomes developed for each of the programme areas and presented in these documents. Logic models for each programme components of 3rd and 4th CPs are presented in Annex 7. Analysis of quality of output and outcome indicators for each programme components and their availability are presented under Effectiveness EQs.
RELEVANCE EQ1: To what extent is the UNFPA support: (i) adapted to the needs of the population with emphasis on the most vulnerable population; and (ii) in line with the priorities set by international and national policy frameworks; (iii) aligned with the UN Partnership Framework; and (iv) planned interventions adequately reflect the goals stated in the UNFPA Strategic Plan?
The analysis of the UNFPA’s documents20 and meetings with the key stakeholders21 showed that the work of the UNFPA in Kazakhstan was and is still relevant to the existing situation in country; it addressed/ing pressing needs of the population with emphasis on the most vulnerable population (women, youth, elderly, people with disabilities, migrants, refugees) and was/is based on research/study results of the pressing issues of most vulnerable groups. Both CPs are built upon the experiences of the previous programmes, integrating previous findings and lessons learnt into their design and implementation.
The SRH outcomes of the 3rd and 4th CPs were/are specified and focused on SRH services, sexuality education for adolescents, and access to sexual and reproductive health and reproductive rights, in all contexts. Situational analyses were performed for the third and fourth CPs. The third CP situational analysis highlighted a number of problems in SRH area, including high maternal mortality, unmet need for modern contraception, and high prevalent risky sexual behavior, which led to high syphilis and abortion rates. Most young people aged 15-24 did not have HIV comprehensive correct knowledge. The third UNFPA country program was aimed to provide help in solving these problems. The fourth CP situation analysis showed many positive changes, in particular a significant reduction in
19 Gurbo, M. (2019). Final evaluation of the PFD Kazakhstan, 2016-2020 20 Annex 3: 3, 13-15, 17-18, 59-66, 71-73, 80 21 Key Informants interviews, June 24-28, 2019 28 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
maternal mortality. However, confidential enquiries revealed that only 16% of maternal deaths were unavoidable. In addition, despite the decline in abortion rate, it remained high, especially among vulnerable groups, including adolescent and youth (that was an argument to make it as a separate component in the 4th CP). Modern contraceptive method utilization was not changed, mainly due to their high prices. Sex workers, young migrants, as well as rural youth were identified as vulnerable groups. In spite of the existence of youth-friendly centers, their number was limited and availability of reproductive health services for youths, especially in rural area, remained low. In addition, there was no specific policy on the provision of SRH services for vulnerable groups, in particular persons with disabilities, adolescents and migrants. In Kazakhstan, before treating a patient under the age of 18, consent must be obtained from the patient’s parent or legal guardian. Legally requiring parental consent for prevention and treatment services of adolescents would likely decrease utilization these services overall, leading to significant negative health outcomes. Decreasing the age of voluntary agreement for healthcare services without parental consent from the age of 18 to 16 years of old is needed, especially for SRH services. Kazakhstan’s economy has suffered from global oil prices fallen sharply since mid-2014. Therefore, it was important to support the government to retain positive trends in SRH, particularly in maternal mortality reduction and fill the gap identified in the 4th CP situational analysis.
Kazakhstan promotes gender issues through family values that with support of UNFPA are addressed in the Concept of Family and Gender Policy of the Republic of Kazakhstan until 2030. Such approach helps to target stereotypical thinking in the society, especially at the local level, implying that gender is an antipode to male. Moreover, UNFPA was involved in developing the Gender Equality Strategy for 2006-2016. In gender-based violence prevention, UNFPA provided important assistance to the Government in creating a system of multi-sectoral coordinated response of the key public health, psycho-social support and police sectors to GBV survivors through identifying, keeping record and referral of gender-based violence survivors; developing and adapting the Basic Services and Standard Operating Procedures (SOPs) that should be provided for women and girls subjected to violence; and in preventing practices that cause harm to the health and welfare of women and girls such as early and forced marriage through evidence-based advocacy and engagement of religious leaders of Islam and Orthodox Christianity.
The results of studies performed during 2005-2009 within P&D component, aimed at identifying the real needs of the target groups with emphasis on the most vulnerable groups, addressed by UNFPA, were taken into consideration when defining the fourth country programme. Results of the 2009 census helped the development of a database on, and the analysis of, emerging population issues, such as mortality, family status, ageing and migration. It also increased the skills and knowledge of civil servants and legislators on population and development issues. The 4th UNFPA CP 2016- 2020 was built on progress made by the 3rd CP in providing evidence of vulnerable and key populations’ access to maternal and reproductive health and in building the capacity of policymakers to address population and development issues as well as recommendation to increase national capacity on population and development for the formulation of human rights-based policies, with a special focus on vulnerable populations. In order to assess needs of population, UNFPA assisted in analysis of data collected by Multiple Indicator Cluster Survey (MICS) and National Domestic Violence Survey (NDVS) to be used in policy and government decision-making. Collected data on physical, economic, sexual, psychological violence by NDVS provided Committee on statistics with important information necessary to measure SDGs and for policy design. As both the UNFPA CPs and the studies used for planning the national and sectorial strategies involved partners and population in assessing the situation, needs and gaps, there are good reasons to consider that 3rd and 4th country programmes are relevant and consistent with the needs and expectations of the stakeholders.
Both UNFPA country programmes are in line with the priorities set by international and national policy frameworks. The UNFPA CP 2010-2015 was developed in cooperation with the Government of Kazakhstan, taking into consideration the general framework provided by the UNDAF 2010-2015, document elaborated on the basis of 2008 Kazakhstan Common Country Analysis. The components of the CP were designed to contribute to the priorities defined in the Kazakhstan 2030 National Strategy and sectorial strategic documents such as Strategic Plan for the development of the Republic of Kazakhstan till 2020 and Health Development Strategy of Kazakhstan with focus on universal access to sexual and reproductive health services. The third country programme covered two UNFPA Strategic Plans (2008-2011, extended to 2013, and 2014-2017). The midterm review of the 2008-2011 Strategic Plan resulted in adoption of new key principles in the approach of the Agency. The CO managed to align the CP to these new coordinates in a short period of time, ensuring the correlation to the global UNFPA strategy.
The SRH component of the 3rd CP were designed to contribute to the national priorities defined in the State Healthcare Development Programs of Kazakhstan for 2005-2010 and 2011-2015, and the Program to reduce maternal and child mortality for 2008 - 2010 with focus on decreasing maternity deaths through universal access to health services and improving reproductive health. The 4th CP was in-line with the State Healthcare Development Program of Kazakhstan
29 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
for 2016-2019 that includes maternity mortality ratio, STI incidence among 15-17 and HIV prevalence among 15-49 as target indicators. The SRH components of the both country programs directed to achieve Millennium Development Goals (to improve maternal health; to combat HIV/AIDS, malaria, and other diseases) and Sustainable Development Goals (Good Health and Well-being, Target 3.7: ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes by 2030).
Within adolescent&youth component of the 4th CP UNFPA supported the Nazarbayev Intellectual Schools (NIS) and National Academy of Education to develop and test a training course for college students aimed at delivery correct information about sexual and reproductive health and reproductive rights. UNFPA first supported development/revision of the Valeology course with strengthened SRH component. This course was piloted in different colleges of Eastern Kazakhstan Oblast, then in Mangystau, Kyzylorda, Aktobe and South Kazakhstan regions. Then UNFPA supported testing relevance of the course to provide evidences that this knowledge is highly demanded and efficient in raising awareness of students about SRH. Received evidences were used as advocacy tool to convince the Ministry of Education to look into a need of introduction of sexuality education into existing school curriculum throughout the country.
Within gender component, UNFPA assisted: the National Commission on Women Affairs and Family-Demographic Policy under the President of the Republic of Kazakhstan in the development of conceptual documents on a family- demographic policy in line with the commitments assumed by the country at the International Conference on Population and Development; in improvement of the status of disabled persons for subsequent ratification by Kazakhstan of the Convention on the Rights of Persons with Disabilities; in design of the National Action Plan on improvement of the status of elderly people in Kazakhstan in accordance with the principles of Madrid International Plan of Action on Ageing and in the development of the Concept of Family and Gender Policy in the Republic of Kazakhstan until 2030.
The P&D activities were focused on improved access to goods, services and social safety nets by vulnerable groups, especially women, migrants, refugees, young people, the elderly and people with disabilities. The fourth UNFPA country programme 2016-2020 is aligned with national development priorities, including the Kazakhstan 2050 strategy, the new economic policy Nurly Zhol. Guided by a rights-based approach and results-based management principles, the programme is also aligned with the post-2015 development agenda, the UNFPA strategic plan, 2014- 2017, and the UNFPA business model. P&D area of the 4th CP concentrates on supporting data collection, access and analysis to inform policies in the area of population dynamics and their links with sexual and reproductive health and reproductive rights.
Both UNFPA country programmes are aligned with the UN Partnership Framework. The 3rd CP contributed to achievement of two 2010-2015 UNDAF goals and at the country level and the 4th UNFPA country programme contributes to four out of six outcomes of the 2016-2020 UN PFD (Table 15). The first and main Strategic Pillar ‘Reduced disparities and improved human development’ of the 2016-2020 PDF for Kazakhstan includes an Outcome: Improved equitable access to integrated quality social services (health, education, social protection, legal et al.) for the population, including for socially vulnerable and disadvantaged individuals and groups. SRH services are an important part of efficient, integrated, people-centered health services that are advised to create under the PFD. UN PDF specified two crosscutting issues such as youth involvement and gender equality for six outcomes of the three strategic pillars. Achievement of the stated strategic goals in the PFD relies on the Kazakhstan ambition to ‘own’ and lead its development programmes as well as on the collective strength of all United Nations agencies working in the country. UNFPA collaboration with key youth and women actors such as UN Women, UNICEF, UNDP makes an important contribution to reaching out the most vulnerable population groups and assisting the country in meeting its international Conventions and frameworks, including gender equity. It is relevant to mention a programme that UN Women starts in 2019 in cooperation with UNICEF, UNFPA and UNDP and with support of the Ministry of Labour and Social Protection of the Republic of Kazakhstan to enhance effective implementation of the Family and Gender Policy in Kazakhstan, Women’s Economic Empowerment and Ending Violence against Women and Girls. The programme includes as one of the directions of work a full-fledged support to comprehensive governmental approach to GBV and integration of multi-sectoral response to prevention of violence against women in Kazakhstan, which should promote sustainability of the achievements, mentioned above and strengthen cooperation that is more inter-sectoral.
So, the 3rd and 4th Country Programs are completely aligned with the goals of UNFPA 2014–2017 and 2018-2021 Strategic Plans. The 4th CP has more focused on achieving its outcomes through advocacy and policy dialogue. The 4th CP was developed and approved before UNFPA 2018-2021 Strategic Plan. The country office verified that the current
30 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
4th CP is inline with the new UNFPA Strategic Plan. Because Kazakhstan is classified by UNFPA as a country with the lowest need and highest ability to finance its own programmatic interventions, UNFPA funds are allowed to be allocated mostly for advocacy, policy dialogue and advice. As a result, some population groups including migrants, disabled persons, and refugees that were defined in the 3rd CP as vulnerable and key populations are not mentioned in the 4th CP. In addition, the evaluation has demonstrated that the UNFPA activities in the P&D area are important to the national, regional and sectoral development, policymaking, decision-making, programming and public use. Therefore strengthening statistics and ensuring greater availability of data (especially disaggregated by population groups, sectors of economy, territory etc.) is essential and that improvements are needed in several statistical domains, including demographic statistics.
EFFECTIVENESS EQ2: To what extent have the intended programme outputs been achieved?
SRH Component The third UNFPA Country Programme, 2010-2015. Status of achievement of output SRH indicators of the 3rd UNFPA CP, 2010-2015 is presented in the Table 8.
Table 8. Status of achievement of output SRH indicators of the 3rd UNFPA CP, 2010-2015 Indicators Baseline Target/ Actual result Remarks Output 1. Maternal health strategies are approved and action plans are developed and implemented Indicator: Percentage of health- - In line with the long-term We could not find data to measure this indicator in care institutions implementing programme of health-care 2015. However, effective perinatal technologies by effective perinatal technologies. development in Kazakhstan proposed by WHO was implemented in all health- up to 2020/All health-care care organizations in 2017. institutions in 2017 Output 2. Health-care providers have the capacity to expand the delivery of high-quality family planning and reproductive health services, with a focus on vulnerable groups, including rural populations and the poor Indicator: Number of trained - at least three persons in It was difficult to measure due to the uncertain base: health-care providers each health-care in order to determine if the indicator is achieved, institution/Data not found there is a need to determine what healthcare institutions have to be considered Indicator: Training programme is - Programme incorporated/ There is no evidence that training programme has incorporated into the curricula Data not found been incorporated into the curricula of ALL tertiary of all tertiary and secondary and secondary medical schools, especially because medical schools. of autonomy given to educational institutions. Output 3. Women and young people have improved access to high-quality sexual and reproductive health and services to prevent HIV and AIDS Indicator: Percentage of services 0 75/Data not found Limited information is available regarding the certified as youth-friendly certification process (definition of the "services", definition of ‘youth-friendly’, certification body etc.) Output 4. Women and young people are equipped with high-quality information to prevent and reduce the risk of unwanted pregnancies and HIV transmission Indicator: Percentage of young 19 50/Data not found The definition and source of data to measure the people aged 15-24 who are indicator are unclear. In addition, the target is very aware of sexual and ambitious, because it supposes a dramatic reproductive health and HIV improvement of the knowledge. prevention issues. Indicator: Percentage of regions 12 75/Data not found It was difficult to measure because Y-peer doesn’t of the country involved in youth have any formal registration in any region of peer network Kazakhstan.
Achievement of the 3rd CP output indicators was analyzed by an external consultant and presented in the Evaluative evidence report22. The ET verified consultant’s conclusions on status of achievement of output SRH indicators. Except the indicator of the Output 1, where sufficient evidence was found that the target was achieved, the ET has been convinced of consultant's opinion that most indicators are not well defined. The main problem with output indicators is that they do not meet SMART criteria that are originally proposed to set goals and objectives but now are well accepted in M&E: Specific; Measurable; Achievable and Attributable; Relevant and Realistic; Time-bound, Timely, Traceable, and Targeted.
22 Bonis S. (2015), Evaluative evidence using light methodology of UNFPA Kazakhstan Country Programme 2010-2015 31 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Document analysis23 and key informants’ interviews24 shows the following achievements of 3rd UNFPA Country Program, 2010-2015: ● National Healthcare Development Program 2011-2015 «Salamatty Kazakhstan» was issued. ● An Action Plan on introduction of Minimum initial service package for SRH in disasters (MISP) into the National Emergency Preparedness Plan was developed and agreed with respective stakeholders. ● Reports on government’s response to the population needs in family planning and access of law enforcement officers to reproductive health were developed, discussed, and passed to the government ● Postpartum/post abortion clinical protocols and National Guideline on Family Planning were developed. ● Findings of Confidential Enquiry into Maternal Deaths were recognized by the Ministry of Health as an effective and useful tool for improvement of quality of care that lead to a decision in initiation of perinatal deaths auditing (Confidential Enquiry into Perinatal Deaths – CEPD) in 2016. ● A Contraceptive market segmentation analysis was conducted and its results were submitted to the Ministry of Health. ● Baseline assessment and follow up assessment on progress of effective perinatal technologies implementation was conducted and disseminated. Republican Centre for Obstetrics, Gynecology and Perinatology was identified as an organization that took accountability for implementation of effective perinatal and antenatal technologies in the country. Effective perinatal technologies were implemented in five regions of the country through replication of effective pilot experience earlier received in Southern Kazakhstan Oblast. A model of perinatal care quality management at the facility levels was piloted in Mother and Child Centre of Ust-Kamenogorsk and Perinatal Centre of Semey City. Austrian certifying body confirmed ISO 9001 certification of these centres. ● After quality assessment, the hospital-based near-miss case review developed by WHO and supported by UNFPA was recommended to scale-up to all regional perinatal centres. ● Training tools on effective perinatal technologies were developed and incorporated into curricula of Medical University and Medical College of Semey. Training package materials for Family Planning services at the primary health care levels were developed and piloted. The training package utilized the advanced teaching technology for effective adults learning and contained the latest WHO recommendations on Family Planning. ● In 2013, national survey of sex workers and people living with HIV supported by UNFPA was conducted to measure access to SRH and family planning services by these population groups. ● Partnership between UNFPA and leading faith-based organizations (Sunni Islam and Orthodox Christianity) on issues of reproductive health and family planning was established. FBOs’ representatives were educated on human rights, maternal and reproductive health, prevention of GBV and harmful practices. They recognized importance of these issues for their parishioners and wished to introduce a special teaching course into the educational curricula in madrassas and seminaries.
The fourth UNFPA Country Programme, 2016-2020. Status of achievement of output SRH indicators of the 4th UNFPA CP, 2016-2020 as of the end of 2018 is presented in the Table 9.
Table 9. Status of achievement of output SRH indicators of the 4th UNFPA CP, 2016-2020 Indicators Baseline Target/ Current Remarks status Output 1 of Outcome 1: Strengthened policy framework and institutional mechanisms to deliver integrated sexual and reproductive health services, with particular focus on the most vulnerable and key populations Indicator 1: Percentage of health service 0 60/in It’s unclear which health organizations should be providers at primary health care and hospital progress considered as health service providers and what levels practicing the newly adopted clinical are newly adopted clinical protocols and protocols and standards standards. Indicator 2: Contraceptives included in the list No Yes /No Next 2020 year Obligatory Social Medical of basic benefit package for vulnerable and Insurance (OSMI) will be fully implanted in key populations Kazakhstan. The basic benefit package will only include emergency and treatment of urgent conditions. Contraceptive expenses will be able to be compensated only by OSMI. Further, vulnerable and key populations are not defined. Indicator 3: Number of key facilities in all 16 11 32/In Definition of key facilities is not provided. regions of Kazakhstan that use in their routine progress work the ‘near-miss cases’ review approach of confidential audit ‘beyond the numbers’
23 Annex 3: 3, 13-15, 17-18, 59-66, 71-73, 80 24 Key Informants interviews, June 24-28, 2019 32 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Because the 4th CP is ongoing, it is too early to evaluate whether output SRH indicators have been achieved or not. Nevertheless, it should be noted that many indicators do not have clear definitions.
Document analysis25 and key informants’ interviews26 shows the following achievements of 4th UNFPA Country Program 2016-2020 are made during three years of the programme implementation: ● Based on CEMD experience and lessons learnt, Confidential Enquiry into Perinatal Deaths (CEPD) methodology, tools, and instructions were developed with UNFPA technical support. CEPD regulations were endorsed by the Ministry of Health. ● To ensure the sustainability and to increase the efficiency of CEMD and NMCR, Ministry of Health issued an Order (Prikaz) appointing Republican Centre for Healthcare System Development as a new coordination body and introduced two supporting mechanisms, namely 1) financial stimulation of national experts who conduct reviews and 2) implementations of CEMD and NMCR as facility accreditation requirements. ● National working group developed Kazakhstan Family Planning National Framework Program for 2017-2021 with UNFPA technical support. Respective Action Plan was integrated into the Road Map of the State Healthcare Development Programme. ● National standards for maternal and neonatal care in health facilities starting from the first level of care (PHC and first-level hospitals) were developed based on European standards for maternity care recommended by UNFPA. The Standards cover the spectrum: from pre-pregnancy services to postnatal services including care of newborns. ● National experts assisted by UNFPA conducted perinatal care assessments in three regions of Kazakhstan. The results leaded to adjustment of the effective perinatal care training course. ● Economic Analyses for Governmental Investment in Oral Contraceptives (OC) in Kazakhstan were conducted in 2016 and 2017. The latter analysis was focused on youth aged 15-19. It was demonstrated that an intervention to increase uptake of oral contraceptives among girls aged 15-19 by providing oral contraception free of charge could generate direct benefits for the state budget by decreasing expenses associated with abortions and unintended pregnancies. ● Virtual Contraceptive Consultation (VIC), a distance-learning platform on Family Planning, was translated into Kazakh. VIC courses were integrated into curricula of post-graduate training at the Kazakh Medical Post-Graduate University. ● National Guideline on Quality Assurance (QA) and Monitoring and Evaluation (M&E) tools for Youth Friendly Services (YFS) was developed, piloted and revised. ● A youth-friendly health centre opened in Almaty. The centre, supported by the Ministry of Healthcare, the Almaty city administration and UNFPA, offers the services of gynecologist, and urologist, psychologist, social worker and other experts. It is positioned as a centre of excellence on adolescent and youth health. ● CEMD revealed that the proportion of maternity deaths due to the two main causes, obstetric hemorrhages and severe pre-eclampsia, significantly declined because of improved perinatal care. Under these circumstances, sepsis caused by hospital-acquired infections (HAI) became an urgent issue. UNFPA was requested by MoH to address HAI at perinatal care facilities. UNFPA (a) mobilized international expertise, (b) conducted infection control assessment, (c) conducted training for multidisciplinary teams (clinicians, epidemiologists, microbiologists) to respond to identified gaps, (d) supported the development of Action Plan. This methodological approach demonstrated high effectiveness and is planned to be expanded by MoH on the national level.
Adolescent and youth There was not separate Adolescents and youth component in 3rd CP. However, there were two output indicators mentioned young people (Output 3&4) in context of reproductive health and rights. Findings were presented above (SHR section).
The forth UNFPA Country Programme, 2016-2020. Status of achievement of output adolescent & youth indicators of the 4th UNFPA CP, 2016-2020 as of the end of 2018 is presented in the Table 10.
Table 10. Status of achievements of outputs Adolescents and youth indicators of the 4rd UNFPA CP, 2016-2020 Indicators Baseline Target/ Actual Remarks result Adolescents, youth: Output 2. Strengthened national laws, policies and programmes that include adolescent and youth and their human rights and needs Indicator 1: United Nations Educational, Scientific and Cultural No Yes/No as of As of UNFPA advocacy efforts the
25 Annex 3: 3, 13-15, 17-18, 59-66, 71-73, 80 26 Key Informants interviews, June 24-28, 2019 33 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Organization standards on comprehensive sexuality education 2018 education authorities is are integrated into national standard curricula becoming more open to introduce sexuality education. Indicator 2: Percentage of regions of Kazakhstan with Y-peer 25% 60% / 47% (8 2018 target value was 44% presence out of 17 regions as of 2018) Indicator 3. Existing legislation is revised to decrease age from No Yes/ in progress In progress 18 years to 16 years in receiving sexual and reproductive health services without parental consent
Document analysis27 and key informants’ interviews28 shows the following achievements of 4th UNFPA Country Program 2016-2020 within adolescents and youth component.
Within the Indicator 1 the following results were achieved: ● Developed with UNFPA methodological support valeology course demonstrated high effectiveness of sexuality education in raising awareness on SRH issues among students. Now the valeology Course is integrated into the curricula of all colleges in Eastern Kazakhstan; ● Successful experience on piloting of sexuality education in Eastern Kazakhstan was presented to government and policy and decision makers during several national and regional advocacy events and workshops for secondary schools’ directors and parents' associations, training for journalists and colleges’ students as well as through other communication channels. The researches with control and experimental groups provided evidences on the effectiveness of the valeology course on raising awareness of young people on reproductive health issues, which UNFPA used to convince the Ministry of Education. Now the Ministry of Education is looking for an opportunity to collaborate with UNFPA, and gave a task to the National Academy of Education and Nazarbayev Intellectual School to collaborate with UNFPA on integration of sexuality education into school.
The following results were achieved within Indicator 2, including: ● After UNFPA supported two ToT and training for young activists, two of newly trained Y-PEER activists were certified as International trainers by PETRI School in Sofia, Bulgaria; 30 young people had been certified as Y-peer trainers and conducted adolescents and young people in regions with quality information on Reproductive health issues; ● As of UNFPA support through a Y-Peer Summer School in Aktau for volunteers from all parts of the country and 2018 Y-PEER Annual Summer Leadership School for youth and adolescents in Turkestan region as well as other events the Y-PEER network was expanded to Mangystau region; three resource centers are fully furnished and equipped in Aktau and Zhanaozen cities’ colleges and in Beineu youth center; Y-PEER activities were reestablished in Astana ● The events ranged from providing trainings courses, organizing public events dedicated to UN celebrations, such as World Population Day, World AIDS Day, International Volunteer Day up to holding a special event during the EXPO-2017 Youth and the Energy of the Future were conducted with the UNFPA support. In the frameworks of 16 days of activism against gender based violence campaign, Y-peer volunteers jointly with local authorities and CSO Women’s league for creative initiatives conducted mini sessions on gender issues and prevention of violence for 10 secondary schools. In total more than 500 students were sensitized.
As achievement of Indicator 3 is in progress UNFPA supports various interventions within its mandate, including: ● UNFPA used the platform of an International Conference Child Friendly Kazakhstan organized by the National Child Ombudsman and UNICEF to bring to policy and decision makers' attention which problems adolescents face and how often these relate to their RH status and what adults should do to ensure the realization of their Reproductive Rights; ● Decreasing the age of voluntary agreement for healthcare services without parental consent from the age of 18 to the 16 years of old was included in the Health Code on Health of the Population and the Healthcare System of the Republic of Kazakhstan that was agreed within the Ministry of Health for further public discussion before sending to the Parliament for approval before end of 2019.
27 Annex 3: 3, 13-15, 17-18, 59-66 28 Key Informants interviews, June 24-26 & July 4, 2019 34 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Despite UNFPA concentrated important efforts within the adolescents and youth component, some planned outputs were not fully achieved yet. In 2018, as shown by findings of a study29 conducted with the UNFPA technical support, there is still limited access of teenagers and young people to reproductive health services and low level of literacy in sexual and reproductive health protection issues, prevention of unwanted pregnancy and STI/HIV. As results there are growth of a number of abortions, STIs and reproductive health violation, in particular, infertility.
The CP intention was to extent the Y-peer network to a stage when it covers 60% of the country’s regions. Until 2019 it reached only 47% (8 out of 17 regions) of the target value and Y-peer was established in Akmola, Aktobe, East Kazakhstan, Kyzylorda, Mangystau, Turkestan, Almaty Oblast, Almaty and Astana. In addition there are challenges faced by Y-peer in terms of ownership and leadership in the network.
Evaluation shows that even if some initiatives are translated in the national legislation, further efforts are needed to advocate for their application. For example, even if Salamatty Kazakhstan Programme contains as a goal the introduction of sexuality education in the educational process of youngsters, little has been done on national level for its application. Nevertheless, the intervention of UNFPA can capitalize on the evidences obtained from Valeology course - with sexual and reproductive health component developed in line with UNESCO standards on sexuality education - and in coordination with the local authorities in EKO, which can be used for further advocacy at national level.
Gender equality and women empowerment The third UNFPA Country Programme, 2010-2015. Status of achievement of output gender indicator of the 3rd UNFPA CP, 2010-2015 is presented in the Table 11.
Table 11. Status of achievement of output Gender indicator of the 3rd UNFPA CP, 2010-2015 Indicators Baseline Target/ Actual Remarks result Output 1. The action plan of the gender equality strategy reaches a greater number of women and is fully implemented Indicator 1: Gender equality law and domestic violence Not Adopted Adopted law are adopted. adopted
Based on the document analysis30 and key informants’ interviews31 it can be noted that results of the UNFPA interventions in the gender component started to be visible after 2013. They include: ● More responsible attitude towards the gender equality issues observed at the highest level of the state apparatus of Kazakhstan became more visible after adoption of two important laws, namely: the Law on State Guarantees of Equal Rights and Opportunities of Men and Women, the Law on Prevention of Domestic Violence in 2009, and the National Strategy for Gender Equality for 2006 –2016 resulted in increased participation of women in the socio-political life of Kazakhstan; ● With UNFPA support representatives of Kazakhstan government and civil society strengthened their capacity on issues related to prevention of violence against adolescent girls, early and forced marriages and protection of human rights in the course of ICPD PA and MDGs progress in CA countries; ● UNFPA initiated and supported, both technically and financially, a survey on Gender Based Violence prevalence in Kazakhstan and its impact on Sexual and Reproductive Health of GBV victims, which results were presented in the beginning of 2016 at a National Event. ● UNFPA supported the National Commission on Women Affairs and Family-Demographic Policy under the President of the Republic of Kazakhstan jointly with other donors to conduct the International Conference on Prevention of Violence against Adolescent Girls, Early and Forced Marriages in countries of Central Asian and Caucasus within Millennium Development Goals in 2013. The conference participants developed and agreed on Recommendation to the countries of Central Asia and Caucasus on activities to prevent such harmful practices32. ● UNFPA provided support to preparation and presentation of the Report on implementation of CEDAW in Kazakhstan that was presented at the 57th CEDAW session in 2014 by the Government and national NGO; ● UNFPA together with the Statistics Committee conducted the first in Kazakhstan national research on prevalence of violence against women in 2015. Collected and analyzed data was used by the Government of Kazakhstan for the development of effective policies on gender-based violence prevention and response;
29 A sociological study on the state of reproductive health of adolescents and youth 15-19 years old. Public Opinion Research Center under the Ministry of Health in Kazakhstan with UNFPA support. 2018 30 Annex 3: 1, 5, 12, 17-18, 33, 59-67, 78, 80 31 Key Informants interviews, June 24-26 & July 1-4, 2019 32 http://ru.soros.kz/press_center/press_releases/child_marriage 35 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
● UNFPA started dialogue with religious communities and faith-based organizations to target GBV issues.
The main challenge that UNFPA faced during this CP was a low capacity of national institutions in applying opportunities of equal rights for men and women and protection of rights of women guaranteed by legislation of Kazakhstan. It was much needed for higher commitment of health care sector to fight gender-based violence and not just leave it to social and law enforcement sector. Moreover, UNFPA understood that such skills were very important in policy dialogue and advocacy work. As results, UNFPA was seen as the agency that strongly stands for rights of women and one that should be present at all events concerning gender equality issues.
The forth UNFPA Country Programme, 2016-2020. Status of achievement of output gender indicators33 of the 4th UNFPA CP, 2016-2020 as of the end of 2018 is presented in the Table 12.
Table 12. Status of achievements of outputs gender indicators of the 4rd UNFPA CP, 2016-2020 Indicators Baseline Target/ Actual Remarks result Gender: Output 3. Strengthened national laws, policies and programmes to prevent gender-based violence and harmful practices Indicator 1: New long-term national policy document on gender No Developed and See explanation below equality that integrates UPR recommendations and obligations approved/achie related to sexual and reproductive rights, prevention of gender- ved based violence and early marriages Indicator 2: Regional UNFPA guidelines are integrated into the No Yes/In progress See explanation below national health system response to gender-based violence Indicator 3. Number of civil society and faith-based 4 10/in progress Sunni Islam and Orthodox organizations that have supported the institutionalization of (2017: 7 CSOs Christianity communities, Centre programmes to engage men and boys on gender equality and faith-based for Civil Initiatives, KMPA, (including gender-based violence), sexual and reproductive org-s) Women's League for Creative health and reproductive rights Initiatives, Urpak Next of Mangystau region, Orkenietty Kazakhstan of Kyzylorda region.
Within the Indicator 1 the following results were achieved: ● The Concept of Family and Gender Policy till 2030 was developed, discussed and approved be the Government Degree on December 2016. UPR recommendations and obligations on SRHR and prevention of GBV as well as early/forced marriage were reflected in the final document and its Action Plan; ● Within the framework of the global campaign of 16 days without violence, UNFPA supported TEDxAbayStWomen conference devoted to Gender issues and where UNFPA advocated issues of early/forced marriage among 150 participants. Challenge that UNFPA concerns with is proper implementation and funding the Concept of Family and Gender Policy till 2030 at national/regional levels.
UNFPA implemented the following activities within Indicator 2: ● Models of multi-sectoral response to gender-based violence (MSR to GBV) based on the Global Essential Services Package (ESPs) and Standard Operating Procedures for frontline services in health, psychosocial and police areas were shared with the key government Ministries (Ministry of Health and Social Development, the Ministry of Interior, the General Prosecutor Office) and reflected in the Concept of Family and Gender till 2030 and approved by the Government. As a result the General Prosecutor Office initiated and developed a new National Programme Kazakhstan Without Violence in a Family where one of the main priorities is the establishment of MSR to GBV was included in the National Road Map of the Programme. Furthermore, UNFPA provides technical support to the Government of Kazakhstan in developing mechanisms of interdepartmental response to gender-based violence. ● UNFPA supported the piloting of the system of multi-sectoral response to domestic violence in the South Kazakhstan region and the testing and adapting of standard operating procedures (SOPs) and the Essential Package of MSR to GBV on provision of basic services to GBV survivors by specialists of health, social support and police sectors. In addition, the GPO established Centers for Psycho-Social Support (CPSS) to GBV survivors as coordinating body at regional level for health, social and enforcement sectors. UNFPA supported strengthening of institutional capacity of 14 CPSSs on application of Essential service package and newly adjusted SOPs; ● As result of piloting of and advocating for the Essential service package and SOPs in 2017 they were adapted in 2018 in line with national frameworks and three key ministries (health, social and interior) agreed to their implementation throughout country. In addition, the Ministry of Internal Affairs forwarded the adapted SOPs for
33 Annex 3: 1, 5, 12, 17-18, 33, 59-67, 78, 80 & Key Informants interviews, June 24-26 & July 1-4, 2019 36 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
police sector to the Academy of the Ministry for their integration into teaching programme (e.g. institutionalization of the SOPs in the education institution). There are several challenges for further integration of the national health system response to gender-based violence that need UNFPA advocacy attention and efforts, including: • Institutionalization of SOPs in health sector as there is lack of capacity of staff to perform such services; • Poorly equipped CPSS and low capacity of their staff to provide proper response to GBV victims, especially first aid;
Within Indicator 3 technical assistance activities conducted by UNFPA to FBOs resulted in: • The development and further integration of educational course on MH, SRH and GBV to curricula of theological institutions of Orthodox Christianity and Islam communities in Kazakhstan; • Closer and productive collaboration of regional FBOs of Islam and Orthodox Christianity with government on the promotion of maternal and reproductive health, gender equality, combating GBV and prevention of early/forced marriages; • Increased confidentiality of Islam and Orthodox Christianity leaders’ and communities’ roles and influence on their congregations’ wellbeing. There is one challenge that UNFPA faces in working with Orthodox Christianity that is its high subordination to the Russian Orthodox Church resulted in less openness to protected sex.
It should be noted that besides existing challenges all outputs of the gender component for 4th CP are being achieved even there are two more years of the programme. UNFPA technical assistance and advocacy efforts proved to be effective in achieving planned results.
Population dynamics The third UNFPA Country Programme, 2010-2015. Status of achievement of output P&D indicators of the 3rd UNFPA CP, 2010-2015 is presented in the Table 13.
Table 13. Status of achievement of output P&D indicators of the 3rd UNFPA CP, 2010-2015 Indicators Baseline Target/ Actual Remarks result Output 1. Policymakers employ evidence-based data to develop policies on gender equality, young people, sexual and reproductive health, and HIV and AIDS Indicator 1: Number of social policy documents 0 5/6 See list of social policy documents below that accurately reflect population issues. Output 2. Social-sector stakeholders are better able to plan, implement and monitor social and health services for the elderly, migrants and people with disabilities Indicator 2: Number of comprehensive analytical 0 3/7 See list of comprehensive analytical studies studies on emerging population issues. on emerging population issues below
The activities under this component were effectively implemented and the proposed results were achieved in full. The following outputs indicators for the 3rd country programme were achieved. Out of five social policy documents34 that accurately reflect population issues the following were developed, namely: 1. Through conducted rapid assessment of demographic situation in former nuclear testing site of Semipalatinsk region, data on population analyzed and used to develop Joint UN-Government of Kazakhstan programme on raising competitiveness of the Semipalatinsk region through innovative approaches to regional planning and social services (2010); 2. The National Plan of Actions addressing challenges of the aged population was drafted in compliance with ICPD commitments and Madrid International Plan of Action on Ageing and in line with adapted national requirements and regulations. The document discussed and agreed by the high level meeting with national stakeholders to present to the Government (2010); 3. UNFPA assisted the National Commission on Women affairs and Family-demographic policy in data collection of the status of disabled people that contributed to formulating National plan of action on supporting disabled person. 4. Poverty linked issues of vulnerable population groups: women-labor migrants, aged people, people with disabilities, were indicated in 1-st chapter of MDG-2010 report. Development of chapter on Goal 1 of MDG-2010 and 2014 reports is supported by P&D component of UNFPA Kazakhstan (2010, 2014). 5. In 2011 UNFPA supported the Agency on Statistics on 2009 census data analysis and dissemination of census
34 Annex 3: 10, 24, 59-66; Key Informants interviews July 24-27, 2019 37 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
results through the technical assistance provided to the Agency on development of Analytical report on 2009 census data. 6. In 2012 UNFPA participated in drafting and providing technical assistance to development of the State Programme of Development of Healthcare in the Republic of Kazakhstan for 2011-2015.
Out of three comprehensive analytical studies on emerging population issues the following were conducted35, namely: 1. The 2010 second national Multi-indicator cluster survey included indicators on reproductive health, unmet needs in family planning, the rate of abortions and module on Gender based Violence; 2. The 2010 rapid assessment of demographic situation in Semipalatinsk region and needs on improvement of region’s population statistics; 3. 2010 UNFPA provided the technical support to government to conduct desk-review on status of sight-disabled, hard of hearing people, persons with locomotors and mental disabilities. 4. In 2012 the first sociological survey on the SRH status of adolescents and young people of 15-19 years was conducted with UNFPA technical support. 5. For the Country Programme document on 2016-2020, UNFPA CO conducted the Country Situation Analysis (CSA) that includes data on population dynamics, maternal health, SRH of adolescents, young people and vulnerable and key population groups, HIV, gender equality and GBV issues to identify priorities for policies and development programmes. The document was employed by UNCT while working on PFD formulation. 6. In 2015 the first national survey on domestic violence was conducted by the Committee on Statistics with the UNFPA technical assistance. 7. In 2015 the access of migrants in Kazakhstan to maternal, sexual and reproductive health, family planning and prevention of STI/HIV services and information assessed and findings presented to the Government.
The initially planned P&D output indicators of the 3rd CP were achieved.
The fourth UNFPA Country Programme, 2016-2020 (ongoing). Status of achievement of output P&D indicators of the 4th UNFPA CP, 2016-2020 as of end of 2018 is presented in the Table 14.
Table 14. Status of achievement of output P&D indicators of the 4th UNFPA CP, 2016-2020 Indicators Baseline Target/ Actual Remarks result Output 4: Strengthened national data systems and increased availability and accessibility of evidence-based analysis on population dynamics and their links to sustainable development for the formulation of rights-based policies Indicator 1: 2016: Multiple indicator cluster survey is completed; No Yes/ MICS –Yes; 2020: Preparation of data are available and accessible; 2020: Population and housing 2020 census - population and housing census is completed; data are available and accessible No census is in progress Indicator 2: National integrated system of population registers is in No Yes/ No In progress place which provides inter-alia information on vulnerable population groups Indicator 3: National family and demographic policy document that No Yes/ Yes - Concept of Family and integrates population projections, reproductive health and rights, Gender Policy of and gender equality is developed Kazakhstan until 2030
The status of the achievement of three output indicators36 for the 4th country programme is as follows.
Indicator 1: 2016 Multiple indicator cluster survey is completed and data are available and accessible. National data on SRH, FP, HIV, early marriage collected through 2015 Multiple Indicator Cluster Survey (MICS) was presented in the final MICS report. The reports was produced in Russian and translated into English and Kazakh. The MICS findings were presented to the Government on 23 November 2016. 2020 Population and housing census is not completed yet, but the following preparation activities were conducted, including: i) an assessment of the Committee on Statistics needs for the use of Geographic Information System (GIS) in the 2020 Population Census; ii) training of professionals of the Committee on methodological issues of population and housing census and on theoretical and practical aspects of GIS application for electronic/digital mapping for census and geo-referral Population register; and iii) pilot census was completed and results analyzed.
35 Annex 3: 10, 24, 59-66; Key Informants interviews July 24-27, 2019 36 ibid 38 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Indicator 2: So far, national integrated system of population registers that provides inter-alia information on vulnerable population groups is not in place. However, within this output first national survey on domestic violence (DVS) in Kazakhstan was conducted in 2016. Data on domestic violence prevalence was collected, processed and analyzed. UNFPA provided technical support to the Committee on Statistics on analysis of the data and dissemination of the survey results. Preliminary Report was presented to Government on 29 November 2016.
Indicator 3: National family and demographic policy document that integrates population projections, reproductive health and rights, and gender equality is not developed yet, but the following steps were made. First, in 2018 Concept of Family and Gender was approved. Second, the report on 2016 national survey on Domestic Violence is finalized and its results presented to Government for formulation of policies addressing GBV. Third, the Population Situation Analysis (PSA) on South Kazakhstan Oblast was conducted. And, finally, the first wave of Generations and Gender Survey is conducted and data collected in 2018.
EQ3: To what extent did the outputs contribute to the achievement of the planned outcomes (i. increased utilization of integrated SRH Services by those furthest behind, ii. increased the access of young people to quality SRH services and sexuality education, iii. mainstreaming of provisions to advance gender equality, and iv. developing of evidence-based national population policies) and what was the degree of achievement of the outcomes?
SRH Evaluation found that the indicators intending to demonstrate the achievement of the planned outcomes are not very useable, because they are either too narrow to characterize an outcome (e.g. use of contraceptives is a part of the integrated sexual and reproductive health services) or very ambitious to be achieved even with efficient UNFPA contribution (e.g. usage of modern contraceptive methods is planned to increase from 49 per cent to 75 per cent).
Table 15. Status of the outcome indicators for SRH area of the 3rd and 4th CPs CP/ Outcome/ Indicators Baseline Target/ Remarks Actual result The third UNFPA Country Programme, 2010-2015: Outcome 1: Women and young people, especially those in rural areas and from high-risk groups, have improved access to health-care services Indicator 1: Percentage of - 25% against We can’t find any data in annual and other reports allowing rural and urban population the calculating the baseline and follow-up values of the target. Also the covered by high-quality baseline/ definition is not stated to measure the indicator. maternal and child health Data not services found Indicator 2: Percentage of 49 75/54 This indicator is measured among women aged 15-49 who are sexually active women aged currently married/in union. The data source for the base-line value is 15-49 using modern MICS conducted in 2010. MICS 2015 demonstrated positive dynamic: contraceptive methods from 49% in 2010 to 54% in 2015. However, the target was not achieved. Outcome 2: Universal access to high-quality sexual and reproductive health services and services to prevent HIV and sexually transmitted infections is ensured for everyone in need, with a focus on vulnerable population groups Indicator 1: Births by girls 22 15/Data not We can only find data that can approximate the birth rate among girls aged 16-18. found aged 16-18. Demographic reports produced by Committee of Statistics contain birth rates among girls aged 15-19 (2010 – 28.3 per 1,000; 2015 – 30.83 per 1,000). So, we can conclude with high level of confidence the target was not achieved. The fourth UNFPA Country Programme, 2016-2020 (ongoing): Outcome 1: Increased availability and use of integrated sexual and reproductive health services (including family planning, maternal health and HIV) that are gender-responsive and meet human rights standards for quality of care and equity in access Indicator 1: Contraceptive 51 70/56 This indicator is measured among women aged 15-49 who are prevalence rate (total) currently married/in union. The data source for the base-line value is MICS conducted in 2010. MICS 2015 demonstrated positive dynamic: from 51% in 2010 to 56% in 2015. The selection of the indicator and the target are questionable, because it considers all contraceptive methods including non-modern ones. In addition, it’s difficult to expect a significant improvement because that depends on many factors including behavioral changes. Outcome 2: Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education and sexual and reproductive health
39 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Indicator 1: Percentage of 36.2 70/In The data source for the indicator is MICS. The base-line value was young women aged 15-24 progress taken from MICS 2010, because the MICS 2015 report became years who correctly identify available in 2017. The most recent value from MICS 2015 is 26.7%, i.e. ways of preventing sexual the percentage of girls with comprehensive knowledge was actually transmission of HIV and who decreasing. reject major misconceptions about HIV transmission
However, interviews with key informants37 and UNFPA documents/reports38 demonstrated that the outputs contributed to the achievement of the outcomes formulated in CPs despite the fact that it is difficult to evaluate extent of contribution of different outputs. Maternal health is the most important priority for healthcare system in Kazakhstan. So, almost all SRH activities are performed under the umbrella of ‘maternity health’. Taking this into account, UNFPA contributed to the development of the Operational action plan to reduce maternal mortality in the Republic of Kazakhstan approved by Minister of Health on 29th January 2019. The plan includes many novel approaches promoted by UNFPA, including: teaching 90% of hospital epidemiologists on infection control; ensuring the implementation of a hand hygiene program in each medical organization; treatment of disease detected during screenings to adolescent girls under 17; needs assessment for modern contraception for women of reproductive age with social and medical risk factors to provide them with modern methods of contraception; introduction of a mobile application for prenatal monitoring of pregnant women; development of standards for Youth Health Centers and ensuring that Center location is accessible to adolescents and youth; etc. UNFPA provides support to government partners for successfully embodying some activities of the operational plan.
At the same time respondents39 identified the following challenges: ● 3rd and 4th CPs do not have clear and feasible monitoring and evaluation plans. The 3rd UNFPA CP has element of an M&E plan - outcome and output indicators. However, reaching the specific values of targets depended not only on UNFPA, but on other stakeholders, especially the government, i.e. the indicators were not enough specific to show the UNFPA performance. In addition, there are not precise definitions of the indicators, how and when they should be measured, who collect data, and what resources needed for M&E activities. The 4th UNFPA CP contains output indicators that aim to measure the UNFPA performance rather than partners’ achievements. Yet these indicators still have similar limitations. ● Effectiveness of advocacy, policy dialogue and advice largely depends on willingness and readiness of the government to make changes in specific areas. The government is keen to reduce maternal mortality. Therefore, UNFPA suggestions and initiatives are met very positive and supporting feedback from the government. UNFPA was successful in advocating for changing age of access to health services without parental consent from 18 to 16. The new National Health Code has adopted this change and hopefully will be approved by the Government and Parliament by end of the current year. ● UNFPA and UNICEF have supported effective youth-friendly services with focus on SRH and suicide prevention and piloted in different facilities but for the same target group – adolescents and youth. It would be reasonable to explore possibility to create and test one comprehensive model of youth-friendly services. ● Not all UNFPA advocacy efforts were based on economical analysis (like cost-benefit or cost-effectiveness analysis) to speed up government’s decisions to embody innovations proposed by the Agency. However, findings of the 2017 and 2018 Budget Impact Analysis of providing free contraceptives to different groups were used as advocacy tool.
Adolescent and youth As there was not such component in the 3rd CP, the achievement of the stated outcome in the 4th CP was analyzed in the SRH section above.
Gender equality and women empowerment Document analysis40 and key informants’ interviews41 shows that received outputs of the 3rd CP contributed to the achievement of the stated outcomes but it is too early to assess contribution of the outputs to the outcomes of the 4th country programme as only three years passed. The following information on achievements of outcomes was received from key informant interviews and analysis of available documents.
37 Key Informants interviews, June 24-28 & July 1-4, 2019 38 Annex 3: 3, 13-15, 17-18, 36-37, 49-51, 59-66, 71-73, 80, 82 39 Key Informants interviews July 24-26 & July 1-4, 2019 40 Annex 3: 1, 5, 12, 17-18, 33, 36-37, 59-67, 78, 81 41 Key Informants interviews, June 24-26 & July 1-4, 2019 40 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Table 16. Status of the outcome indicators for gender area of the 3rd and 4th CPs CP/ Outcome/ Indicators Baseli Target/ Remarks ne Actual result The third UNFPA Country Programme, 2010-2015: Gender Outcome: National institutions have improved capacity to protect human rights and ensure access to justice for women Indicator 1: Number of legal acts and normative No No/Yes Normative instruments ratified; laws instruments adjusted in line with international developed and passed standards The fourth UNFPA Country Programme, 2016-2020 (ongoing): Gender Outcome 3: Advanced gender equality, women’s and girls’ empowerment, and reproductive rights, including for the most vulnerable and marginalized adolescents and youth Indicator 1: Percentage of the accepted Universal 77% 92%/ n/a Unfortunately, no exact percentage of the Periodic Review (UPR) recommendations on gender accepted UPR recommendations was found equality and reproductive rights from the previous either in annual reports or in available surveys reporting cycle that are implemented
Third Country Program, 2010-2015: UNFPA achieved its goals related to Gender component of the CP 2010-2015. The Parliament of Kazakhstan adopted the Law to counteract domestic violence and by 2012 ratified the ILO Convention concerning Equal Treatment and Equal Opportunities for Men and Women Workers: Workers with family responsibilities. In 2011 UNFPA supported government on data collection and assessment of emerging population issues and advocacy through conduction of desk-reviews and sociological quantitative national surveys on challenges of people with disabilities for improvement of policies for disabled persons. In 2014 the Report on implementation of CEDAW in Kazakhstan was prepared and presented at the 57th CEDAW session in Switzerland where UNFPA provided technical and financial support to one of the Kazakh NGO delegate.
The Fourth Country Program, 2016-2020 As it was mentioned in the analysis of EQ2 the UPR recommendations were integrated into approved in 2016 Concept of Family and Gender policy till 2030. However no documents and data was found to confirm percentage of the accepted Universal Periodic Review recommendations on gender equality and reproductive rights from the previous reporting cycle that are implemented. Moreover, it should be noted that outcome indicators should be defined and explained to be better understood and measured. Also, Annual reports should present better explanation on achievement of outcome indicators as they do for output indicators.
Population dynamics Document analysis42 and key informant interviews43 shows that received outputs contributed to the achievement of the stated outcomes, however it is difficult to evaluate extent of contribution of different outputs as no data or reports were found to support indicators values. At the same time, the following information to confirm achievements of outcomes was received from key informant interviews and analysis of available documents.
Table 17. Status of the outcome indicators for P&D area of the 3rd and 4th CPs CP/ Outcome/ Indicators Baseline Target/ Actual Remarks result The third UNFPA Country Programme, 2010-2015: Outcome: vulnerable groups, especially women, migrants, refugees, young people, the elderly and people with disabilities, have improved access to goods, services and social safety nets. Indicator 1: Percentage of the population aged 60 and 60% 75%/ not found Unfortunately, no data was found above who report having good access to medical and either in annual reports or in social services available surveys Indicator 2: Percentage of migrants who report having TBD 25% increase to Unfortunately, no data was found good access to education, medical and social services baseline/ not either in annual reports or in found available surveys Indicator 3: Conformity of status of disabled persons No Status is aligned Unfortunately, no data was found with international standards and rules on equalizing conform with the either in annual reports or in opportunities for persons with disabilities (United ity requirements of available surveys Nations General Assembly resolution 48/96) the Convention on the Rights of Persons with Disabilities/ not
42 Annex 3: 6, 10, 13-15, 24, 36-37, 59-66, 68-69 43 Key Informants interviews July 24-27, 2019 41 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
found The fourth UNFPA Country Programme, 2016-2020 (ongoing): Outcome: Strengthened national policies and international development agendas through integration of evidence-based analysis on population dynamics and their links to sustainable development, sexual and reproductive health and reproductive rights, HIV and gender equality Indicator 1: National development programmes None All national In progress integrate population dynamics by accounting for programmes/ population trends and projections in setting development targets
Census of 2009 was important to receive important data and serve as base for production of analytical report. However, many key informants44 noticed low validity of data as used approached and techniques were outdated and produced missed data during scanning and reading paper questionnaires. Also, it was mentioned that data analysis took too long45. Preparation of 2020 census proceeding successfully and is based on lessons learnt from 2009 census and best international practices46.
UNFPA support the second 2010 national MICS to ensure its compliance with the ICPD Programme of Action47. Received data is being used by the Government, CSOs, UN Agencies, international organizations in discussion of existing problems and issues in the country and in the planning of development programmes and projects to improve quality of life of the population in Kazakhstan48. In 2015 UNFPA / UNICEF support allowed the Committee on Statistics of Kazakhstan collect appropriate data on key UNFPA indicators disaggregated by age, regions and residence place (urban or rural) including indicators on fertility’s, mother and newborn health, unmet needs of family planning, use of modern contraceptives, attitudes toward domestic violence, sexual behavior, and HIV/AIDS and early marriages. However, 2016 MICS report does not contain any data on P&D outcome indicators either for 3rd or 4th CPs.
In addition to mentioned above, separate surveys/study on issues data for which is not available in state statistics allowed to produce important for policy work information49. They include: i) 2014 Y-Peer Assessment to review the previous experience of Y-Peer activities in different regions of Kazakhstan since its establishment back in 2003, the existing legislation and experience of nation-wide non-governmental organizations and provided recommendations to the Y-Peer member on possible modalities of legal registration in Kazakhstan; and ii) strengthening capacities of Eastern Kazakhstan regional government agencies on effective planning and budgeting, with the aim to support evidence-based approach to decision-making and monitoring achievement in Eastern Kazakhstan region (EKO) within the 2011-2015 joint UNDP/UNICEF/UNFPA/UNV project “Raising competitiveness of the region through innovative approaches to regional planning and social services (using Semey as an example)”50.
It should be mentioned that very few reports on the conducted surveys are available at the UNFPA Kazakhstan website51. Some reports (for example, 2015 MICS) were found in either on Committee of Statistics of Kazakhstan website or Internet52.
Other outputs that contributed to the outcomes include53: ● Population and Development course was developed and piloted for civil servants in the Academy of Public Administration under the President of the Republic of Kazakhstan to build institutional capacity for formulation of Demographic Policy and conduction of demographic analysis and population projections. ● Methodical teaching materials for Demographic analysis and Projections were developed to introduce the course into the graduate training plan for civil servants of the Academy of Public Administration. ● Around 30 civil servants of central and regional governments were trained on demographic analysis, population projections and formulation and monitoring policies and regional development plans, taking into account the linkages between population dynamics and sustainable development. ● Parliamentarian received knowledge on how to consider aging issues in demographic policy. ● The initiative on development of regional databases and population registers, such as register on people with disabilities and adaptation of DevInfo database at regional level was launched.
44 Key Informants interviews July 26, 2019 45 Key Informants interviews July 24-26, 2019 46 Key Informants interviews July 24-25, 2019 47 Key Informants interviews July 24-25, 2019 48 Key Informants interviews July 24-28 & July 1-2, 2019 49 Key Informants interviews July 24-25, 2019 & Annex 3: 59-66 50 Annex 3: 16 51 Annex 3: 85 52 Annex 3: 6, 24 53 Annex 3: 60 & Key Informants interviews July 24-26, 2019 42 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
● Join efforts and expertise of UN agencies for supporting the government on national data collection (MICS – UNFPA and UNICEF, Survey on domestic violence – UNFPA and UN Women)54 makes the process much more effective and results - extensively grounded. ● Strengthened capacity of the Committee of Statistics, national and local governments on P&D data use in policy formulation and integration of demographic data in planning and monitoring of development programs.
At the same time during interviews with key informants55 the following challenges were identified: ● Lack of human resources in public administration. There is still a high turnover of the staff of Committee of statistics trained through national and international trainings supported by UNFPA; ● At present, the country misses demographic center that would coordinate development of indicators, data collection and analysis, researches and broadcasting in the area of population and keep the organizational memory about mobilization of skills, knowledge and abilities when settling different population problems; ● No education institutions/departments on demography exists in Kazakhstan that train specialists in demography; ● No state policy on demography exists and questionable readiness of state to support demography and no state body responsible for demography as now Committee of Statistics is part of Ministry of economy; ● Lack of data to explain population aging when from 2015 to 2030 it is expected increase from 1,882 thousands to 2,889 thousands or from 10.7% to 14.4% of population age over 60 in Kazakhstan56; ● There is an urgent need for survey results verification as most results are based on quantitative surveys and there is a need for more qualitative evidence. This resulted in low analytical nature of reports; ● No common qualifier for public organizations and statistics to joint data and lack of data bases integration: there is no one place where databases of raw data of all surveys/researchers are collected and can be used as secondary data for researchers. Moreover, in absence of education institution unified and agreed approached to databases exists; ● Different level of data details for city and villages; ● As staff of Committee of Statistics and P&D consultants primarily learn from /visit mostly Russian speaking countries – Belarus, Russia, Moldova, Ukraine as of lack English language knowledge there is limited exposure of key P&D experts to international expertise that differs from soviet ‘school’ of demography and statistics; ● There are still gaps exist in the area of statistics. Reliability and sufficiency of statistical indicators in the area of demography and reproductive health is still poor. The national statistics is to be enriched with essential but currently missing data on reproductive rights, reproductive health, family planning and gender equality. The quality of migration statistics is still need improvement; ● The evidence-based development of national programmes and policies for people with disabilities lacks reliable profiles of persons with disabilities and challenges they experience as well as more full and properly disaggregated (like by categories of disability and types of diseases) statistical and administrative data on people with disabilities to be used in the policy formulation. Data on access of disabled people to the reproductive health and family planning services are not covered by the national statistical system; ● Limited national capacities to collect, analyze and utilize population-based data on the linkages between population dynamics and development to promote the sustainability of regional and national development strategies, as well as respond to the changing characteristics and needs of different populations. In addition, there is still no strong national technical capacity in the development of sampling frames for the national surveys; ● There is low demand for the knowledge and understanding on inter-linkages between population dynamics and sustainable development among civil servants.
EQ4: To what extent has UNFPA policy advocacy and capacity building support helped to ensure that sexual and reproductive health (including Family Planning), and the associated concerns for the needs of young people, gender equality, and relevant population dynamics are appropriately integrated into national development instruments and sector policy frameworks in the programme country?
SRH Evaluation shows that many achievements resulted as of UNFPA support are integrated into national development instruments and SRH policy framework, including the following. ● Both CEMD and NMCR are currently functioning by using Kazakhstan’s own resources and allowed MoH to identify main causes of maternity deaths that have been addressed in MoH’s programs and plans57.
54 Key Informants interviews June 24-26 & July 1-4, 2019 55 Key Informants interviews July 24-26, 2019 56 UN Department of Economic and Social Affairs. World Population Ageing 2015: Highlights. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Highlights.pdf 43 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
● MICS supported by UNICEF and UNFPA is the main source of data for M&E indicators on SRH. It measures 8 reproductive health indicators including 3 MDG indicators (Adolescent birth rate, Contraceptive prevalence rate, Unmet need) and 5 Maternal and newborn health indicators including 2 MDG indicators (Antenatal care coverage, Skilled attendant at Delivery). The MICS questionnaire allows calculating other important indicators (e.g. proportion of demand for modern contraception satisfied, skilled attendant at delivery for the poorest quintile of the population). UNFPA also provided funds to conduct two national surveys on SRH among young people aged 15-19. Their results have been used in advocacy efforts to decrease age of consent to medical services including SRH services from 18 to 1658. ● In the 3rd CP, UNFPA supported a number of surveys on SRH among vulnerable populations, namely migrants, sex workers, persons living with HIV, and persons with different types of disabilities. Findings of the surveys were presented to decision-makers and to organizations that might make use of them. Two respondents59 mentioned that the findings helped them to raise attention to the sexual and reproductive health vulnerability of persons with disabilities and other key populations. Some respondents expressed a desire to repeat studies, because the results of the previously conducted studies are outdated and do not correctly reflect the current situation. ● The Concept of Family and Gender Policy in the Republic of Kazakhstan until 2030 was approved by President of Kazakhstan Nursultan Nazarbayev on December 6, 2016. According to the Concept, family is an important social institute, supporting of which creates a base for social policy. UNFPA backed the development of the Concept. First, the government intended to have the Concept of Family Policy (without Gender Policy). UNFPA and other UN agencies insisted the Concept should contain goals, principles, and tools on gender issues including gender equality. Second, the situational analysis of the Concept was based on data obtained with UNFPA support (MICS, youth survey etc.). ● The Government of Kazakhstan approved the Action Plan for the first stage (2017-2019) of implementation of the Concept of Family and Gender Policy60. The Action Plan contains 64 items allocated among 16 actors and specifies sources of funds. The Family Planning and Reproductive Health Chapter of the Action Plan includes 5 items, for implementation of which ministry of health, ministry of science and education, local administrations are responsible.
Adolescent and youth UNFPA policy and capacity building support helped to ensure that the other than SRH needs of young people start to be integrated into national development instruments and sector policy frameworks. Besides testing and implementation of valeology course, awareness of more than 50 representatives of decision and policy makers and representatives of media were raised about the high effectiveness of sexuality education in improving the students’ knowledge on SRH and safe sexual behavior and the importance of ensuring access of young people to quality SRH services and contraceptives through advocacy and communication events. In addition, UNFPA cooperated with a well- known singer, Kaliya who came out with a song “Kyz Tagdyry (Adolescent Girl’s Fate)” and assisted in shooting a video spot with global and national data related to young people’s reproductive health status.
UNFPA used the platform of an International Conference on Child Friendly Kazakhstan organized by the National Child Ombudsman and UNICEF61 to bring to policy and decision-makers' attention on what problems adolescents face and how often they are relate to their RH status and what adults should do to ensure the realization of their reproductive rights.
The 2014-2015 Youth Peer education analysis in Kazakhstan62 has driven recommendations for integrating international standards into peer-to-peer education, increasing funding for peer-to-peer education programmes. All the findings were communicated to EECARO and contributed to the Regional Analysis. Participation of young people, adolescents and members of Y-Peer network ensured voices of young people were included during formulation of development agenda. Under the leadership of UNFPA and UNV a Youth theme group was established and consists of 10 UN Agencies who joined its efforts in assisting UNCT in planning and implementing young people related projects. Advocacy efforts were made among ten government representatives to promote valeology course inclusion into school curricula. Majority of Y-peer activities in different regions were supported by UNFPA. In 2018 UNFPA supported involvement of Y-peer in Astana to various meetings with the Government and Parliament63 and ensure that the voices
57 Key Informants interviews July 24-28, 2019 58 Key Informants interviews June 24-25, 2019 & Annex 3: 24 59 Key Informants interviews June 24-26. 2019 60 План мероприятий по реализации Концепции по гендерной и семейной политике в Республике Казахстан до 2030 года (первый этап 2017 – 2019 годы). Accessed on August 12, 2019 https://www.enbek.gov.kz/sites/default/files/plan_mer_rus_0.doc 61 Key Informants interviews June 24, 2019 62 http://www.oecd.org/education/Education-Policy-Outlook-Country-Profile-Kazakhstan-2018.pdf 63 Key Informants interviews June 24-26 and July 4, 2019 44 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
of young people are heard.
At the same time, UNFPA faced the following challenges in its advocacy and capacity building activities64. ● The Ministry of Education did not recognize sexuality education as a priority; therefore it is very difficult to introduce sexuality education courses such as training on valeology, in existing educational program and to get an access to schools without legal permission of the respective authorities. But UNFPA made strategic efforts to include the valeology course into the curriculum of vocational schools. And now the Ministry of Education with UNFPA support initiated the piloting of sexuality education in several schools, starting with grade 965. ● The high Y-peer’s staff/volunteers turnover due to the age “grow out” is one of the challenges for the network as well as lack of the Y-peer resource centers throughout the country for meeting and training of Y-peer volunteers66.
Gender equality and women empowerment The following UNFPA policy and capacity building support helped to integrate gender equality issues into national development instruments and sector policy frameworks. First, The Concept of Family and Gender Policy till 2030 was developed, thoroughly discussed at different levels and approved by the Government’s Decree 384 of 6 December 2016. Second, models of multi-sectorial response to gender-based violence based on the Global Essential Services Package and Standard Operating Procedures for frontline services, such as health, psychosocial and police sectors. Third, promotion of maternal and reproductive health, gender equality, combating GBV and prevention of early/forced marriages through collaboration UNFPA with regional FBOs of Islam and Orthodox Christianity, government, and CSOs.
At the same time, UNFPA faced the following challenges67 in its advocacy and capacity building activities. ● Business is not interested and does not want to be involved in family and gender issues, especially in policy design frameworks. There is a lack of public discussions at various dialogue platforms, as well as knowledge of international and local best practices68. ● Despite an overall understanding of representatives of the Ministry of Health, Parliament members, the National Commission on Women Affairs, media representatives as well as local authorities on the need of sexuality education for adolescents and young people, it was necessary to put a lot of advocacy effort to encourage the Ministry of Education to introduce age-appropriate sexuality education into the national education curriculum69.
Population dynamics In the framework of the Country Program the UNFPA provides technical assistance to the government in using demographic data for planning, development and monitoring of policies and better understanding of causes behind demographic trends and consistent patterns in the country, in order to advocate and provide technical support to the government (attract best practices, international expertise) in the development of the conceptual demographic policy paper which would contain demographic analysis, population projection considering for linkage of population and development; in drafting national program documents considering for population as well. Document analysis and interviews with key informants70 proves that UNFPA advocacy efforts and support in building capacity of the Committee of Statistics of Kazakhstan and national and local governments contributed to development of a more functional integrated information system for the formulation, monitoring and evaluation of national and sectorial policies through series of activities.
UNFPA71: i) supports Kazakhstan in conducting and disseminating results of population surveys such as census, MICS that allowed collecting, analyzing, disaggregating data produced and utilized at national and sectorial levels in a timely manner; ii) provides capacity strengthening activities to key personnel of State Committee of Statistics and other public servants and parliamentarians, assistance to civil servants to participate in local and international training, conferences, study visits in various countries to learn new approaches for further application of integration methods and tools in population and demographic studies, and facilitate joint work of local specialists with international experts on study preparation, undertaking and data analysis and results dissemination; iii) assists in design and approval of new government policies concerning specific target / vulnerable groups based on results of in-depth, policy-oriented (demographic/population) studies; iv) improves national understanding of demographic and social development of the
64 Key Informants interviews June 24-26 & July 4, 2019 65 Key Informants interviews June 24-28, 2019 66 Key Informants interviews June 24-28 & July 4, 2019 67 Key Informants interviews June 24-28 & July 4, 2019 68 Key Informants interviews June 24-28 & July 4, 2019 69 Key Informants interviews June 24-26, 2019 70 Annex 3: 60 & Key Informants interviews June 24-26, 2019 71 ibid 45 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
country and factors behind such development; v) assists in identification and clarification of reasons behind demographic trends, including low birth rate, and in determination of the necessary support to families in having the wished number of children and strengthening inter-generation links, efficiently supporting quality of life of elderly people; supports identification of factors influencing demographic behavior of people, including migration. Moreover, UNFPA assists in analysis of functionality and development / update of information systems of data received from census, MICS, and other studies and provides international experience to show how the national system of regularly updated registries of various population groups enabling data disaggregation social groups, type of disability, gender, age and residence for monitoring of socio-economic status and planning efficient special-purpose social support.
UNFPA provides technical support to the country in creation of regularly updated population registries in order to use data in the development and implementation of targeted support policy and having record of population in the framework of future population and housing censuses in accordance with international census principles based on population registries. At the same time, UNFPA raise Government attention and improve understanding that only availability of important data and evidence-based approach can bring up issues that are either inconvenient to discuss (family planning, domestic violence, HIV/AIDs, etc.) or are not considered as important (issues connected to disable people, especially women, youth, etc.)72. All key informants73 stated that UNFPA contribution was especially important as it provides access to international experts and best practices. And one informant noticed: «There would have been nothing done in Kazakhstan without UNFPA support»74.
EFFICIENCY EQ5: To what extent has UNFPA made good use of its human, financial and technical resources, and has used an appropriate combination of tools and approaches to pursue the achievement of the Results defined in the UNFPA country programme?
Because Kazakhstan is an upper-middle-income country, a traditional development assistance model does not apply and traditional donors often cannot provide grants to Kazakhstan. The reality of this is that the UN and UNFPA in Kazakhstan is operating in a resource constraint environment where the Government of Kazakhstan remains the main donor, often requiring several layers and long complicated processes to obtain funding. Both UNFPA country programmes support implementation of state programmes of Kazakhstan75. The Government provides its commitments in accordance with the provisions of SBAA as of October 4, 1994. As a contribution to the programme the Government provides support to UNFPA on mobilization of additional resources from international donors with the purpose to adjust the CP funding. In addition, the Government tries to contribute both in-kind and in cash to ensure the successful Implementation of 3rd and 4th CPAPs. However, the current not favorable economic situation has led to many projects from UNFPA and other UN Agencies no longer being considered for funding76. Moreover, the culture of social involvement of the companies is not developed enough, so availability of funding from them is limited in this sense.
Overall, the activities implemented toward the achievement of outputs for all programme areas appeared to be reasonable for the amount of resources expended. Most respondents77 were unable to comment on the question of efficiency in details, but of those who did, most felt that UNFPA has been careful to manage its funds efficiently. The final amount from regular sources received for implementation of the 3rd CP constitute only 63,5% from expected regular resources and 77,5% from other resources. As for three years of implementation of the 4th CP, 57,7% from expected $2.65 millions of regular resources and 28,3% of $1.1 millions of other resources were received78.
SRH. Reduced financial resources were available for implementing the programs. The 3rd CP 2010-2015 (6-year) program planned to spend $7.7 million, including $4.2 million for Reproductive health and rights. In fact, $4.7 million were spent, including $2.9 million for Reproductive health and rights. For 4th country program, $3.75 million were planned (Reproductive health and rights - $2.05 million). Over three years (2016-2018), $2.065 million were spent, including $0.8 million for Reproductive health and rights. This indicates the annual Reproductive health and rights expenses in 2016-2018 have experienced nearly double reduction as compared to the annual amount spent in 2010-
72 Key Informants interviews June 24-28, 2019 73 ibid 74 Key informant interview, June 26, 2019 75 Annex 3: 64-65 76 Annex 3: 64-65 & Key Informants interviews June 24-28, 2019 77 Key Informants interviews June 24-28 & July 1-4, 2019 78 Annex 3: 59-60 46 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
2015. As a result, fewer funds were available for technical assistance including piloting interventions, conducting research for making evidence-based decisions, and hiring foreign and national consultants. It has led to a challenge to support trainings, especially in areas that are not considered as priority for the government like the implementation of the Minimal Initial Service Package. UNFPA has overcome the challenge by using a synergistic approach and increasing the government’s commitment. SRH issues are incorporated in all three-program components – SRH, youth and adolescents, P&D. The Youth Health Center located in Almaty is working closely with Y-peer and offers a venue for its work. The surveys (P&D component) have delivered data for situational analysis, needs assessments, and M&E in an SRH field. Additional resources from the government to scale up activities initially supported by UNFPA were allocated in two ways. First, the government spent money to continue and expand the models that were introduced by UNFPA. CEMD and NMCR models, trainings on effective perinatal care, sufficient standards and clinical protocols have been implemented nationwide by using resources from the state and local budgets. Because of the complexity of the budgeting practice, it is difficult to estimate a leveraging effect of the resources provided by UNFPA. The budgets of State Healthcare Development Programs, Salamatty Kazakhstan 2011-2015 and Densaulyk 2016-2019, are $2,818 mln and $5,394 mln respectively79. Significant amount of the budgets has been spent to strengthen capacity to reduce perinatal and maternal mortality. Second, the government co-financed three joint UN team - Kazakhstan regional programs: Raising Competitiveness of the Region through Innovative Approaches to Regional Planning and Social Services - using Semey as an example (2011 – 2015, total budget - $11,651,365; government of Kazakhstan - $9,816,365); Expanding the opportunities of the Mangystau region in achieving sustainable development and socio- economic modernization (2014 – 2016, total budget - $8,259,333; government of Kazakhstan - $6,769,833); Improving the welfare and quality of life in the Kyzylorda region through innovative approaches to delivering economic, social and environmental services to the local population, including those most vulnerable (2014 – 2016, total budget - $8,743,999; government of Kazakhstan - $6,452,999). UNFPA was a participating UN agency in all three programs and was focusing on achieving universal access to sexual and reproductive health (including family planning) through improved public demand for and provision of high quality education, information, communication, counseling and services to the population with special focus on women and young people. UNFPA has got an experience to perform activities with support from other donors. UNFPA conducted ‘Technical workshop on HIV and migration in Central Asia and Russian Federation’ held in Astana (now – Nur-Sultan) City on 19-20 February 2018. The Embassy of the Kingdom of the Netherlands in Kazakhstan provided financial support to this event.
Adolescent and youth. In the 4th country program allocation for adolescents and youth component constitute 22,77% from the whole budget and 99,19% were utilized in three years of the programme implementation. In 2014 total spending was $257,274, including by UNFPA $159,342 (62%), CSOs - $63,418 (25%), government - $34,514 (13%). In 2015 total spending was $269,825, including by UNFPA $81,507 (30%), civil society $172,271 (64%), government $16,047 (6%). In 2016 total spending was $120,324, including by UNFPA $35,100 (29%); civil society $85,223 (71%). In 2017 total spending was $108,442, including by UNFPA $43,752 (40%); civil society $64,690 (60%). And in 2018 total spending was $184,391, including by UNFPA $99,939 (54%), civil society $84,451 (46%).
Gender equality and women empowerment. Analysis of commitment and expenditures for 3rd and three years of 4th country programs show that the overall actual allocations of funding for the whole period for the Gender component of the 3rd CP constitutes 28,3% of total budget. In the 4th country program there are 12,03% allocated for gender equality component from the whole UNFPA budget and 93,68% were utilized in three years of the programme implementation. Further analysis of costs shows the following80. In 2014 total spending were $176,656, that includes costs: UNFPA - $140,687 (80%), and of CSOs - $35,969 (20%). In 2015 total spending was $233,261, including by UNFPA $149,489 (64%), CSOs $15,772 (7%), government $68,000 (29%). In 2016 total spending $72,693, including by UNFPA $40,581 (56%), civil society $32,112 (44%). In 2017 total spending $90,193, including by UNFPA $37,882 (42%), civil society $50,231 (56%), government $2,080 (2%). And in 2018 total spending was $80,910, including by UNFPA $53,210 (66%), civil society $27,701 (34%).
Population dynamics. The UNFPA Executive Board approved funding of the population and development for the 3rd CP in amount of $1.6 million within regular resources and $0.6 millions to be mobilized from other sources. Within the 4th country program funding for P&D direction were approved in total amount of $0.65 million, including regular resources in amount of $0.45 million and resources be mobilized from other sources – $0.2 million. Analysis of commitments and expenditures for 3rd and three years of 4th CP shows the following. UNFPA financial commitment constitute 28.7% and 17.33% out of overall programme budgets respectively. Real budget for 3rd CP for P&D was $1,360,888.44 (or 61.86%) out of $2,200,000 committed and utilization rate was 97,65%. The 3rd CP envisioned
79 KZT/USD exchange rates effective on dates when the programs were signed. 80 https://www.unfpa.org/data/transparency-portal/unfpa-kazakhstan 47 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
$600,000 (or 37.7%) to be mobilized for P&D activities. In total, for P&D activities $48,439.00 (or 8%) was mobilized. Mostly, needed other resources were provided by Government of Kazakhstan for project to increase competitiveness of eastern Kazakhstan, as well as from private sector, USAID and Soros/Friedrich Ebert Foundations. Real budget for three years of the 4th CP for P&D direction is $398,779.95 out of $650,000 committed for five years. Three year budget of 4th CP constitute 61.35% of financial commitments for the whole 4th CP for P&D direction. The 4th CP envisioned $200,000 to be mobilized from other resources and in three years only $42,536.19 (or 21.27%) was attracted. Those funds were mobilized from Government of Kazakhstan.
It is worth to note that UNFPA used from 20% to 60% of its financial resources to support the activities implemented by either its partners or together with partners, including civil society and the government81. There is an example when, in 2015, only 30% of the resources allocated to adolescents and youth was used by UNFPA, and the rest of funds were distributed among civil society organizations to implement various activities. Also, UNFPA has co-shared expenses to perform some activities, e.g. CEMD&CEPD trainings, with UN organizations (WHO, UNICEF) to ensure participation of well-recognized international professionals. Also, where it is possible, national consultants have leading roles. Moreover, it was noted82 UNFPA staff ability to coordinate the implementation of programs, professional skills and in-depth experience in a youth and gender areas resulted in clear formulation of tasks for training, research, etc., as well as to form recommendations for advocacy and dialogue with government partners. This indicates a good partnership strategy and the ability to implement programs effectively through long-term partnerships with multiple stakeholders, targeted technical training and strategic policy advocacy.
To achieve planned outcomes, UNFPA have made good use of its human and technical resources. Key informants 83 recognized professionalism, goal-oriented and very good attitude of the UNFPA staff in country as well as in the regional office. Evaluation team noticed pleasant and supportive atmosphere in the UNFPA offices in Almaty and Nur Sultan. The UN partners appreciate positive and result-oriented role of the Country manager and its leadership when replacing UN Country Resident. Also, it was noticed that the UNFPA approach to appreciate professional work of its personnel encourages former civil service servants to join CO team84 that definitely enriches UNFPA expertise and create important synergy needed for effective work and efficient use of limited resources. Many interviewees noted a good teamwork among UNFPA employees, namely: interchangeability, different program coordinators know and understand the directions of others, experience of working in state and international organizations and its utilization in daily work. The important role and effective use of national and international experts and consultants was also mentioned by key informants.
At the same time, need for more programme managers and a separate expert for monitoring and evaluation was mentioned by several key informant85. The biggest challenge experienced by the UNFPA country team86 was moving country office from Almaty to Nur Sultan as many people did not want to move and while agree to move the compensation had to be negotiated and approved. Office move from former capital of Kazakhstan to new one was complicated, but no pause in program implementation has been made. As of time of evaluation UNFPA both offices, country and regional, were functioning in full capacity and all operations go smoothly.
The efficiency of UNFPA CO activity was increased by the extensive use of the cooperation with volunteers in the 3rd CP specifically. Besides the national volunteers involved in their actions (especially through Y-peer network), cooperation was established also with UNV volunteers87. This approach allowed the country office to increase its capacity in terms of human resources, using also the opportunities provided by the UN system. Besides the financial side, the cooperation with UNV volunteers presents the advantage that they are generally accustomed to the UN procedures and working processes, therefore their involvement can considerably reduce the burden of regular staff.
In general, UNFPA country office managed to implement the planned activities and deliver the outputs as foreseen. Nevertheless, sometimes delays in delivering the contributions from the side of the government created delays in some of the planned activities. In some extreme cases88, as it was the late transfer of funds for the first year of Joint Semey project implementation, there was a need to postpone most the activities planned for 2011 within that framework. Additionally, national legislation related to procedures of using the public funds created problems for the
81 Key Informants interviews June 24-28, 2019 82 Key Informants interviews June 24-28, 2019 83 ibid 84 Key Informants interviews June 24-26, 2019 85 ibid 86 Key Informants interviews June 24-25, 2019 87 ibid 88 Key Informants interviews June 24, 2019 48 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
national partners in spending the UNFPA support on time, as it was the case of the printing of Kazakh version of the Multiple Indicator Cluster Survey’s final report in 2011.
As Kazakhstan is transitioning from being a recipient to being a donor of official development assistance, with a specific focus on neighboring countries, it might be reflected in decrease of funding of UNFPA activity in Kazakhstan. But it might create new opportunities for UNFPA at regional level where its expertise and support are in high demand89.
SUSTAINABILITY EQ6: To what extent has UNFPA been able to support its partners and the beneficiaries in developing capacities and establishing mechanisms to ensure ownership and the durability of effects?
SRH. 3rd and 4th CPs were developed in close consultation with key stakeholders including representatives from government agencies and NGOs. For instance, a working-level meeting was organized by UNFPA on 3-4 December 2015 in Ak-Bulak (Almaty oblast). UNFPA staff members, key stakeholders and partners discussed results of the 3rd CP and implementation of 4th CP. UNFPA has not been directly involved in provision of services. Almost all UNFPA initiatives have been planned and implemented in close collaboration with national partners. It means the national partners have been connecting to all stages of the UNFPA interventions and playing a leading role in their implementation. Exit strategies depend largely on type of partner – governmental or non-governmental. For governmental partners, the exit strategy has a form of a program transition or the change from one type of assistance program to another. For example, CEMD revealed two main causes of maternity deaths - obstetric hemorrhages and severe pre-eclampsia. After these two issues have been properly addressed by implementing response measures, nosocomial infections have become an important and urgent problem. Taking this into consideration, MoH with UNFPA support has started new pilot projects to improve the infection control in maternity hospitals. For non- governmental partners (NGOs), the exit strategy focuses on capacity building, i.e. creating a dialogue and educational platform for communication between authorities, professionals, and representatives of vulnerable populations. Kazakhstan Association for Sexual and Reproductive Health is a good example of such approach.
Adolescent and youth. Based on the analysis, it can be stated that UNFPA interventions aimed at ensuring sustainable results. However, results are mixed. Sustainability of the UNFPA results in area of sexuality education rests on factors outside of the UNFPA control. For example, integration of sexuality education of young people to existing school programmes and access to schools that can be provided only by the Ministry of education. As of time of evaluation, UNFPA is makes efforts to integrate valeology course into the curricula of vocational schools as sexuality education in secondary schools was not a first priority of the Ministry of education and there was a low understanding of the importance of such education by local education authorities. And now the Ministry of Education with UNFPA support initiated the piloting of sexuality education in several schools, starting with grade 9. UNFPA support to the Y-peer network and activities produced very good results through peer-to-peer learning. However, there are several challenges to Y-peer network sustainability. First, and most important is legalization and institutionalization of the network throughout the country. There is no national NGO that is registered and capable to function independently. Existing ‘spots’ of the Y-peer in regions faces high turnover of staff and volunteers, has high dependency from UNFPA support, lacks of meeting space for training and other activity, and lacks leadership with strong mobilization and initiative capacity. Interviewed Y-peer representatives90 were not been interested in institutionalizing the network through official registration in the country as NGO. Therefore, the Y-Peer in Kazakhstan cannot officially submit project proposals and seek support either from international organizations or national and local budgets. There are two challenges in registration of Y-peer91. The first one is a changed legislation. In mid of 2015 the Government of Kazakhstan introduced new requirements for NGOs registration with minimum years of working experience in the field and volunteer work is not considered as such working experience. The second one is lack of willingness and commitment of Y-Peer activists to start working as NGOs and making registration of NGO on their personal names.
Gender equality and women empowerment. Institutionalization of processes was one of the tools used by UNFPA during the CPs implementation92. This process contributes to the development of national ownership and therefore strengthens the sustainability of initiatives. For example, the intensive work on capacity building of the Committee on statistics on the SRH and family planning issues resulted in the incorporation of important indicators in the official data collecting system at national and sub-national level. The other important UNFPA approach to sustain its interventions
89 Annex 3: 64-65 & Key Informants interviews, June 24-25, 2019 90 Key Informants interviews, June 26 & July 4, 2019 91 ibid 92 Key Informants interviews, June 24-28 & July 1-4, 2019 49 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
is the involvement of NGOs in the UNFPA activities. National NGOs93 effectively channel the information and contribute to the advocacy efforts of UNFPA through working with the National Commission on Women affairs and Family-demographic policy. UNFPA efforts in building capacity of the healthcare institutions in providing high quality services are sustained by the national government’s commitment to ensure that all standards of healthcare are compliant with WHO protocols94. The sustainability of the UNFPA interventions was, in high respect, guaranteed by the Government’s active position and ensuring appropriate follow up and implementing mechanisms (i.e. on violence prevention in a series of statutory acts: the Law On preventing domestic violence, the Code on marriage and family, Strategy of gender equality in the Republic of Kazakhstan etc.). Besides the legislative and institutional developments, sustainability of the UNFPA activity in addressing SRH, Family Planning, Reproductive Rights, and Early Marriages and Gender Based Violence (GBV) issues rests on: promoting SOPs in daily practice of health, social and police work, and CPSS, as well as integration SOPs into educational curricula of the Academy of Internal Affairs; the involvement of the religious leaders and Faith-Based Organizations (FBOs) of Islam and Orthodox Christianity that resulted in a positive attitude of these communities towards the Agency activities and efforts in promoting sensitive issues in courses of religious institutions.
Population dynamics. During both country programmes implementation UNFPA builds and strengthens capacity of its partners to ensure that surveys and studies are conducted according the international standards and received data is reliable and can be used as evidence and base for future programming and government policies. Evaluation shows95 that results achieved by the CPs will be sustainable to a greater extent. This can be explained by the following factors. First, UNFPA surveys and studies are focused on particular issues, for instance, maternal health or disable people, and are aimed enriching data on certain issues and groups that state does not have but needs for the development of policy and programme documents. Second, UNFPA capacity building/strengthening activities for its partners, for example, the Committee of Statistics, are focused on sharing the best international practices, new approaches and methods, connecting them with various international experts and supporting their participation in the international events and helping them establish international contacts. The respondents96 appreciate the possibility provided by the UNFPA to access data generated by different international studies in which Kazakhstan does not take part. Moreover, introduction to new research areas encourages government of Kazakhstan get interested in new areas of studies as it happened with the Generation and Gender survey97. International experience is extremely important for researches to compare the Kazakh data/indicators with the data/indicators produced by other countries. Third, the UNFPA supports advocacy efforts aiming at development new programs and policy that are evidence-based and reflect needs of population of Kazakhstan98. Fourth, UNFPA provides support to not only studies and research but also makes sure that results of these studies are shared and disseminated to decision-makers in government and parliament of Kazakhstan99. This is very important as it helps promote the study itself as well as the idea that the informed decisions shall be made on the basis of impartial data and taking into consideration the opinions of people and certain target groups. This stand will facilitate proactive engagement of the general population in the 2020 national census and will improve people’s understanding of the importance of having data about the state of the society. Fifth, UNFPA approach to pilot programs/ educational courses first, measure their effectiveness, improve and only than disseminate to other regions and/or to all country. In this way the proposed programs/courses have more chances to be sustainable in longer term and is a very effective mechanism to ensure local ownership. In addition, cooperation and the indirect funding mechanism used by the UNFPA contributes to strengthening the capacity of it partners, who are mainly CSOs and researches.
At the same time, it should be mention about huge challenge100 facing by UNFPA in ensuring that its support within P&D will have lasting local ownership and the durability of effects. There are two factors influencing uncertainty in long-term sustainability. First, the absence of demographic education in the country that 'produces' cadres for the Committee of Statistics, state demography related institutions, professional community, CSOs. Second, high turnover of personnel in existing state agencies and institutions. There was an attempt to train 40 young professionals in Karl University in Check Republic. However, after their return from study neither of them stayed in state statistics and demography agencies. UNFPA country team clearly understands these challenges and made several steps. First, UNFPA involves older cadre of professionals that retired to study and research even the Fund understands that it is temporary measure. Second, UNFPA understands its limited ability to introduce academic education in universities, but national
93 Key Informants interviews, June 24-28, 2019 94 Annex 3: 66 95 Key Informants interviews, June 24-28 & July 1-4, 2019 96 ibid 97 ibid 98 ibid 99 ibid 100 ibid 50 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
programs and policies should be developed now. This is why UNFPA provides assistance to the Public Administration Academy to implement demographic education into skills development system of central and regional level civil servants to improve national capacity of those who make political and government decisions, assessment of demographic trends and linkages with sustainable development, reproductive health and reproductive rights, as well as strengthening gender equality, support to family and vulnerable population. The program supports improvement of body of knowledge on migration, data collection, capacity building and promotion of policy to support national efforts on efficient response to international and domestic migration, including ethnic and labor migration.
EQ7: To what extent have the partnerships established with ministries, agencies and other representatives of the partner government allowed the country office to make use of the comparative strengths of UNFPA, while, at the same time, safeguarding and promoting the national ownership of supported interventions, programmes and policies?
SRH. There are evidences101 that UNFPA focuses on development and institutionalization of policies, strategies and laws in partnership with national stakeholders. In past three years, three comprehensive documents with regulatory policies were approved by the government, namely: Kazakhstan Family Planning National Framework Program for 2017-2021; Operational action plan to reduce maternal mortality in the Republic of Kazakhstan; and Concept of Family and Gender Policy in Kazakhstan until 2030. The new Сode On the Health of the People and the Healthcare System is being drafted in Kazakhstan. MoH based on UNFPA advice promotes decreasing the age of voluntary agreement for healthcare services without parental consent from the age of 18 to 16 years of old. The question was discussed during public hearings and provoked a stormy reaction, especially for abortion102. Some opponents wrongly considered that this initiative promotes abortions among girls under 18 years. To ensure sustainability of implementation of new strategies, standards and protocols, UNFPA have trained decision-makers and professionals to apply new knowledge in practice. The total number of professionals (obstetric-gynecologists, neonatologists, midwives, nurses, primary health care providers, national and regional health authorities, coordinators, experts etc.) trained in 2016-2018 is 864.
UNFPA established partnership with public authorities in the field of adolescents and youth at national level with the Ministry of Education and Science, Ministry of Labor and Social Protection. At local level such collaboration was founded between UNFPA and local akimats, departments of education, management of colleges and schools. Those partnerships allowed using the UNFPA comparative strengths, namely: evidence-based approach to programmes development through research and surveys, capacity building development of civil servants and government officials, development and integration of new educational courses, etc. UNFPA brings new contemporary concepts to Kazakhstan that meet the needs of target groups. For example, the introduction and update of the valeology course with an additional content on reproductive health and equality of men and women was appreciated, as “unfortunately, even parents do not always know how to discuss sexual and reproductive health issues with own children. Therefore, it is always important to communicate this knowledge to teenagers’ parents, too. What UNFPA is doing is a very important thing.103” The other themes that emerged from interviews with respondents’ include UNFPA Kazakhstan expertise in facilitating policy dialogue with government at all levels; Agency’ strong advocacy role, especially in sensitive areas as “being a traditional society, increasing access to sexual reproductive health is still a challenge in rural areas in Kazakhstan. UNFPA is a prominent actor, not just with funds, but also with training and research”104.
UNFPA actively advocates for a peer-to-peer approach in ten youth training centers (Y-peer centers) that already operate in Kazakhstan. UNFPA promote creation of the national Y-peer network as a reliable partner of the Government that can provide youth and adolescent at the local level with information and education on leadership, healthy lifestyle and safe behavior, reproductive health protection by using a peer-to-peer methodology. The summer leadership school is a good practice supported by UNFPA.
UNFPA established effective partnership with public authorities in the field of gender equity at national and regional levels including the National Commission on Women Affairs and Family-Demographic Policy under the President of Kazakhstan, Ministry of health, akimats and local branches of the National Commissions. Those partnerships are built in the UNFPA comparative strength as well. UNFPA promotes national ownership through various interventions, programmes and policy design. UNFPA cooperate with the National Commission on Women Affairs and Family-
101 Annex 3: 60 & Key Informants interviews, June 24-28 & July 1-4, 2019 102 «Легализация абортов до 18 лет: плюсы и угрозы». https://zonakz.net/2018/12/06/legalizaciya-abortov-do-18-let-plyusy-i-ugrozy/ accessed August 8, 2019 103 Key Informants interviews, June 27, 2019 104 Key Informants interviews, June 28, 2019 51 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Demographic Policy under the President of Kazakhstan105 since 2007 and provided technical assistance: i) to increase capacity of policy makers and CSOs in protection of the interests of vulnerable groups; ii) to use evidence-based data for the development of policies on improvement of access of vulnerable groups, especially women, migrants, adolescent and youth, elderly people and persons with disabilities; iii) to the Government in planning, implementing and monitoring of family planning and reproductive health services; iv) to mainstream gender equality, eradication of gender-based violence and practices that cause harm to girls’ welfare such as early and forced marriage, escalation of measures of interdepartmental response to GBV by the public health, social support and public justice sectors of Kazakhstan; and v) to the Government in achieving the Millennium and the Sustainable Development Goals;
UNFPA actively supports UN Women work with the Ministry of National Economy and the National Commission on Women Affairs and Family-Demographic Policy to incorporate special gender needs of women into national development programs and intergovernmental processes of Kazakhstan106. Most of this work is intended to provide assistance to Kazakhstan in developing and implementing national targets of the gender-related Sustainable Development Goals (SDGs), especially SDG 5 ‘Achieve gender equality and empower all women and girls’. In 2017, implementation of joint project Support to Nationalization of Gender-Linked Sustainable Development Goals in Central Asian Countries supported by the Ministry of Foreign Affairs and UN Women was launched. It started with identification of priority national indicators and targets to monitor SDG implementation. Follow up work was focused on collecting national indicators to monitor implementation progress in the global 2030 Agenda for Sustainable Development and defining national 2030 Agenda priorities relevant to strategic national and local development priorities.107
UNFPA established productive relationships with key government partners working in P&D sphere including State Committee on Statistics; National commission on women, family and demographic policy; Public administration academy under President of Kazakhstan, etc108. Partnership with members of Parliament takes place in the framework of the Asian Forum of Parliamentarians on Population and Development that focuses on law making related to fulfillment of obligations in the field of reproductive health, gender equality and population and development arising from international conventions, ICPD Program for Action, SDG and other documents.
UNFPA managed to establish good cooperation with its governmental partners using its access to international experience and experts. It strives to have a constructive dialogue with its partners around their needs and interests. The UNFPA does not tell its partners what they have to do. With the help of the dialogue UNFPA helps them understand their needs and “inform” the Agency about their interests and intentions109. The Fund provides support to its partners and makes sure that they achieve the results by exercising the complex approach that will eventually guarantee the sustainable results. Everyone110 likes this approach because it makes the partners the owners of their results and failures, makes them responsible for what they do and what they achieve. MICS is a very good sample of how UNFPA managed to transfer full responsibility for this research to the Committee of Statistics. In addition, national ownership is ensured by government funding of the selected UNFPA programs that make Kazakhstan be very thorough while considering what Fund activity to support111. Several government respondents112 do understand that sustainability and ownership of results achieved with UNFPA support depends mostly on them as well as on state support of the P&D activity.
At the same time, some key respondents113 noticed factors influencing government ownership at national and regional levels. First, absence of state policy in demography, low understanding of demographic tendencies (especially about aging) and high dependency of government (executive branch) on parliamentarians' interests (politics). Second, the representatives of the public institutions, especially at regional level, do not know how to ‘read’ and interpret survey/study/research that limits their ability to apply received evidences in government programs and policies. Third, UNFPA has limited opportunity to influence government policies as, on one hand, the Fund depends on government funding, and, on the other hand, not always have direct access to key decision-makers and/or is member of working groups where decisions are discussed and approved as well as and control over use of survey/study data and results.
105 Key Informants interviews, June 24-28 & July 1-4, 2019 106 ibid 107 http://eca.unwomen.org/ru/where-we-are/kazakhstan/sustainable-development-agenda 108 Key Informants interviews, June 24-28, 2019 109 Key Informants interviews, June 24-26, 2019 110 Key Informants interviews, June 24-28 & July 1-4, 2019 111 Key Informants interviews, June 24-26, 2019 112 ibid 113 Key Informants interviews, June 24-28, 2019 52 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
The respondents114 noted that it would be good to increase the number of studies and statistical data and to have a tighter control over the quality of received data, especially at the regional level, in order to strengthen the results sustainability.
EQ8: To what extent have some of the results of pilot projects being used to scale up interventions and/or bring relevant evidence to policy-makers to adopt such approaches?
From the beginning, three pilot projects in SRH area - CEMD, Infection Control and Youth Health Centre – were created as models for further scale-up. CEMD, a well-recognized initiative supported by UNFPA, is now working in almost all regions of Kazakhstan. Republican Centre for Healthcare Development plays a leading role and has got some funds to hire national experts, produces and disseminates annual reports with CEMD findings. A pilot project for improving infection control in maternity hospitals is being realized in Zhambyl region. Lessons learnt from this project have been already used nationwide as series of recommendations in the Operational action plan to reduce maternal mortality in the Republic of Kazakhstan. Youth Health Centre established this year in Almaty City is the third pilot project in SRH. After piloting, the model will be expanded to all regions of Kazakhstan and will contain not only operating procedures, but also financing mechanisms.
The following pilot projects were implemented within adolescents and youth component: ● Pilot 1: Successful experience in piloting sexuality education in Eastern Kazakhstan was presented to government during several national and regional advocacy events that now being implemented in other regions. ● Pilot 2: Implementation of pilot valeology courses resulted in recommendation of their integration in school/college curricula throughout the country. ● Pilot 3: Development Y-PEER network resulted in established of local offices in 10 oblasts. As of challenges discussed above ownership and sustainability of the networks is in doubt.
The following pilot projects were implemented within gender equality area: ● Pilot 1: Results of piloting of introduction of MSR to GBV were reflected in the Concept of Family and Gender Policy up to 2030, National Programme Kazakhstan without Violence in the Family and respective National Road Map. UNFPA assisted the General Prosecutor Office (GPO), sectoral ministries, and the local government to adapt and pilot the SOPs and the Essential Service Package of MSR to GBV to the Kazakh context and train CPSS staff in 15 regions to assist GBV victims as well as integrating the SOPs into teaching programme. ● Pilot 2: Piloting results of the educational courses addressing SRH, Family Planning, Reproductive Rights, and Early Marriages and Gender Based Violence (GBV) issues into educational curricula of the religious institutions.
There are several pilot projects and/or project started with UNFPA support within P&D which results were scale up or being implemented by local state institutions and CSOs. • Pilot 1. In 2015 the first national survey on domestic violence that was mentioned above. • Pilot 2. The first wave of the national Generations and Gender survey (GGS) was conducted in Kazakhstan during the period of 16 April - 31 July of 2018. Data was collected by the Committee on Statistics using NIDI technologies, software and tablets, and processed by the NIDI data base specialists. NIDI provided the GGS database to the Committee on Statistics after its finalization in January 2019. In total 14500 respondents were covered by the GGS first wave. UNFPA provided technical support to the Committee on Statistics on the preparation for the GGS, namely: i) international consultant assisted in sampling; ii) training of 32 specialists from regional statistical departments of the Committee on Statistics from 16 regions and 8 core staff members as resource specialists on applying NIDI technologies in GGS data collection process; iii) monitoring of GGS field works in Almaty city and rural households in Taldykorgan region; iv) GGS data analysis - development of analytical report on GGS first wave. Data received from the GGS will be used for development of state program on domestic violence prevention115.
UNFPA support to Kazakhstan was important not only in introducing new areas of surveys/studies such as domestic violence or reproductive health of disable people but also update specialists of the Committee of Statistics on new approaches and methodologies in already ongoing studies, such as census (GIS technology to be used in 2020) and
114 Key Informants interviews, June 24-28, 2019 115 Annex 3: 60 & Key Informants interviews, June 24-26, 2019 53 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
MICS (delegating more responsibility to the Committee on Statistics of Kazakhstan and supporting them in field works on data gathering)116.
In conclusion, it should be mentioned some additional approaches through which UNFPA tries to ensure sustainability. First, throughout thorough planning process based on ‘what changes we want to see and what contribution should be made to achieve those results”117. Second, institutionalization of processes that contribute to the development of national ownership and therefore strengthens the sustainability of initiatives is one of the tools used by UNFPA during the CP implementation. For example, the intensive work on capacity building of the Committee of Statistics on the SRH and family planning elements resulted in the incorporation of important indicators in the official data collecting system at national and sub-national level. Third, an important element of sustainability is the involvement of civil society organizations118 in the UNFPA activities and development of their capacity to plan strategically and implement efficiently activities related to priority program directions. Well-established and respectful CSOs may inform population more effectively and contribute to the advocacy efforts of UNFPA with higher efficiency. At the same time there are some other challenges mentioned by respondents119 for sustainability within P&D areas mentioned by key informants that should be considered in addition to mentioned above, including: lack of local experts on demography; there is no standards and/or certification for demographist that can be developed and regulated by a professional organization (such organization might have exist if there is replenishment with new cadre from demographic/statistics departments); there are no open survey data for secondary use, except MICS; and there are lack of express studies and follow-up monitoring of studies. In conclusion, during evaluation many respondents stated that UNFPA is good at implementing pilot initiatives but sometimes it is hard to understand which UN agency an initiative is originated from, in particular on youth problems (UNFPA or UNICEF), or gender (UNFPA or UN Women)120.
EQ9: To what extent has the UNFPA country office contributed to the functioning and consolidation of UNCT coordination mechanisms?
UN agencies’ work and programmes at the country level is guided by the United Nations Development Assistance Framework (UNDAF). UNDAF is a strategic programme document that describes the collective response of the UN system to national development priorities. It is based on five inter-related programming principles: human rights based approach; gender equality; environmental sustainability; results based management and capacity development. In Kazakhstan UNDAF for 2010-2015 was successfully completed. A review of the United Nations Development Assistance Framework 2010-2015121 identifies a variety of strengths, as well as continuing challenges. It has demonstrated a high level of partnership and the possibility of further initiatives to assist Kazakhstan in its development. Significant achievements have been noted across all three current priority areas (Improved Economic and Social Welfare, Environmental Sustainability, and Effective Governance). Key challenges in implementing the 2010-2015 UNDAF relate mainly to monitoring and evaluation: the Results Matrix has been perceived as a ‘one-off’ product necessary for programme planning and reporting, rather than as an essential day-to-day element of programme management. In addition, roles and responsibilities for UNDAF results monitoring and reporting have failed to be clearly identified, so have not become fully operational.
The new Partnership Framework for Development (PFD), Kazakhstan, 2016-2020 was signed in July 2015 by the Deputy Minister of Foreign Affairs and the UN Resident Coordinator. The document is also co-signed by representatives of 21 UN entities.122 The PFD is the result of a consultative process with the Government and other partners. It analyzes how the United Nations system can continue to most effectively coordinate its activities in response to national priorities,
116 Key Informants interviews, June 24-26, 2019 117 Key informant interview, June 25, 2019 118 Key Informants interviews, June 24-28, 2019 119 Key Informants interviews, June 24-26, 2019 120 Key Informants interviews, June 24-28, 2019 121 Final evaluation of the RFD Kazakhstan 2016-2020, Marina Gurbo, 2019 122United Nations Country Team in Kazakhstan consists of the following organizations, programmes and representative offices that are either based or represented in Astana (country offices) and Almaty (sub regional offices): the International Labour Organization (ILO); the Office of the High Commissioner for Human Rights (UNOHCHR); the United Nations Entity for Gender Equality and the Empowerment of Women (UN Women); the Joint United Nations Programme on HIV/AIDS (UNAIDS); the United Nations Development Programme (UNDP);the United Nations Department of Public Information (DPI); the United Nations Department of Safety and Security (UNDSS); the United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP); the United Nations Educational, Scientific and Cultural Organization (UNESCO); the United Nations Population Fund (UNFPA); the United Nations High Commissioner for Refugees (UNHCR); the United Nations Children’s Fund (UNICEF); the United Nations Office for Disaster Risk Reduction (UNISDR) ; the United Nations Office on Drugs and Crime (UNODC); the United Nations Regional Centre for Preventive Diplomacy for Central Asia (UNRCCA); the United Nations Volunteers (UNV); and the World Health Organization (WHO). The International Organization for Migration (IOM) and the World Bank are invited members of the Country Team 54 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
while serving as an easily accessible overview of United Nations goals and activities in Kazakhstan. The PFD emphasizes the unique relationships Government and the UNCT due Kazakhstan’s emergence as a new kind of partner, donor and regional power. The UNCT has been redefining its role in Kazakhstan in light of the ambitious vision of the “Kazakhstan - 2050” strategy, while remaining a valued, rights-based and trusted partner of the Government, able to mobilize a broad and complementary range of expertise and knowledge. At the same time, the United Nations in Kazakhstan have been operating in a resource constraint environment where the Government of Kazakhstan remains the main donor. Being a middle-income country, Kazakhstan has to rely on own resources and use other kinds of development financing and partnerships to support its sustainable development. As the mid-term review (MTR) pointed out, there is recognition in the UNCT to diversify its resource mobilization and partnership base efforts by engaging more with a private sector, IFIs and various development funds.
The UN-Kazakhstan Partnership Framework for 2016-2020123 defines three key thematic areas for UN support and cooperation with Kazakhstan, namely: i) Reduced Disparities and Improved Human Development; ii) Strengthened and Innovative Public Institutions; and iii) Enhanced International and Regional Co-operation. The priorities laid down in the UN Partnership Framework fully reflect the UNFPA’s activities in three areas outlined in the 4th National Programme of the UNFPA designed for 2016-2020, in particular: population, reproductive health and gender equality. UNFPA contribution to UN-Kazakhstan partnership area outcomes presented in Table 18.
Table 18. UNFPA roles and indicative resources by 2016-2020 PFD Results RFD Pillars/Outcomes UNFPA role/ Indicative Resources (USD) Pillar 1: Reduced Disparities and Improved Human Development Outcome 1.1: Improved equitable Policy advice and advocacy, as well as technical assistance (if and when needed), on access to integrated quality social strengthening reproductive health and family planning services to ensure more services (health, education, social equitable access and further improve the quality of services. Special emphasis will be protection, legal et al.) for the placed on comprehensive sexuality and reproductive health education, information and population, including for socially service provision for adolescents and young people, especially those living in rural and vulnerable and disadvantaged remote areas. Support with specialized surveys and other data collection efforts, to individuals and groups further strengthen the evidence base for informed policy development. $3,050,000 Pillar 2: Strengthened and Innovative Public Institutions Outcome 2.1: Rights holders benefit Provision of policy advice and advocacy, as well as support for the Government in using from improved policymaking and demographic data for planning and policy development, including through the implementation through enhanced establishment of a national system of population registers and better understanding of participation at sub- national and the causes of the latest national population trends and patterns. national levels $350,000 Outcome 2.2: Judicial and legal Provide expertise on data collection and analysis, relating to national domestic violence systems and public institutions are surveys and a multi-sectoral response to gender-based violence. fair, accountable and accessible to all $200,000 Pillar 3: Enhanced International and Regional Co-operation Outcome 3.1: The Government, Support the Government in addressing CEDAW Concluding Observations and Universal together with partners, promotes Periodic Review recommendations within its mandate/agreed division of labour within Sustainable Development Goals (SDGs) the UN System. in the region, and leads in promoting $150,000 and implementing United Nations principles, standards and Conventions
The UNFPA role in the UN-Kazakhstan Partnership Framework took into account the organization’s comparative advantages such as mandate and mission, experience and established contacts in Kazakhstan, availability of technical resources and recognized expertise as well as political neutrality and integration to the UN country system. The Partnership Framework reflected the UNFPA positioning in areas, such as – SRH, maternal health, family planning and prevention of HIV and other STIs as well as UNFPA contribution to (a) implementing effective perinatal technologies; (b) improving maternal mortality monitoring; (c) advocating for ensuring access to family planning services and commodities; (d) expanding the Y-peer network for youth; (e) advocating for comprehensive sexuality education; (f) providing evidence of vulnerable and key populations’ access to maternal and reproductive health; (g) engaging faith- based organizations in advocacy for maternal and reproductive health and in preventing gender- based violence; and (h) building the capacity of policymakers to address population and development issues. Besides several lessons from the third UNFPA programme cycle were considered as well. Among them: (a) strengthen national ownership and accountability for results; (b) explore strategies for diversifying the sources for programme funding; (c) improve
123 Annex 3: 25 55 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
programme monitoring and evaluation; (d) ensure universal access to quality sexual and reproductive health services and information; (e) ensure comprehensive sexuality education; (f) strengthen partnerships with civil society and religious organizations; (g) increase national capacity on population and development for the formulation of human rights-based policies, with a special focus on vulnerable populations. At time when the UN-Kazakhstan Partnership Framework was designed and approved it reflected the interests, priorities and mandate of the UNFPA in Kazakhstan to a great extent.
One of the key aims of the 2016-2020 PFD is to implement new approaches to coordination mechanisms, improving joint programming, monitoring and evaluation and reporting among UN agencies. Key elements of the PFD management include the establishment of the working and thematic groups. UNFPA representatives take part, directly or indirectly, in all of them (Table 19)124.
Table 19. The UNFPA participation in UNCT working groups, June 2019 Groups Participants UNFPA role The Steering Committee UNCT representatives and high-level Government entities Provides needed input through UN Resident Coordinator and UNCT representatives Results Implementation and Robust and inclusive participation of UN agencies built upon Inter- Contribution to Annual Management Group Agency Programme Working Group Work Plan Thematic Sub-groups by six PFD outcomes: Outcome 1.1 IOM, UNAIDS, UNESCO, UNFPA, UNHCR, UNICEF, UNODC, UN Described in Table 15 Women, WHO Outcome 1.2 ILO, IOM, UNCTAD, UNDP, UNECE, UNEP, UNESCO, UNHCR, n/a UNIDO, UN Women, WHO Outcome 1.3 IOM, UNDP, UNDPI, UNECE, UNEP, UNESCO, UNICEF, UNIDO, n/a UNISDR, UNOPS, WHO Outcome 2.1 IOM, OHCHR, UNDPI, UNESCO, UNFPA, UNHCR, UNICEF, UNISDR, Described in Table 15 UNODC, UNV, WHO Outcome 2.2 IOM, OHCHR, UNDP, UNFPA, UNHCR, UNICEF, UNODC, UN Described in Table 15 Women Outcome 3.1 IOM, UNDP, UNDPI, UNECE, UNEP, UNESCAP, UNESCO, UNFPA, Described in Table 15 UNHCR, UNICEF, UNISDR, UNOCHA, UNODC, UNOPS, UNRCCA, UN Women, WHO SDGs data monitoring group UN agencies Head of the group Gender Theme Group Selected UN agencies Member Joint United Nations TG on Selected UN agencies Member HIV/AIDS (JUNTA) UN Joint Communications UN agencies Member Group Operations Management UN agencies Member Team
The evaluation has shown that the UNFPA partners think highly of the UNFPA’s initiatives, willingness of leadership to jointly address pressing issues and/or raise issues that the Kazakh government might find uneasy. The respondents commented on the important role the Fund plays in groups on gender, SDGs and HIV/AIDS. The evaluation has demonstrated that the respondents appreciated the work of the UNFPA in the groups in particular, since the UNFPA made it possible for all stakeholders interested in addressing certain issues to take part in their work. In addition to the UN agencies, the new participants include representatives of CSOs, government and public institutions, international donors, Embassies and others.
There are several good examples of the collaboration125 among UN Agencies, Government of Kazakhstan, civil society. They include: Violence against Women project supported by GOK and led by UN Women with important contribution of UNFPA, UNICEF and UNDP; Father’s and Youth Days prepared and implemented by UNCT with participation of related UN agencies including UNFPA; MICS supported by UNICEF and UNFPA; National Survey on Prevalence of Violence against Women, implemented by UNFPA, UN Women and WHO; Three 2016-2017 joint programmes were implemented in East Kazakhstan, Mangystau, and Kyzylorda regions, involving seven UN agencies; Reproductive Health
124 Annex 3: 25 & Key Informants interviews, June 24-25, 2019 125 Annex 3: 9, 60 & Key Informants interviews, June 24-28 & July 1-4, 2019 56 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
Situation Analysis, a Market Segmentation Analysis, and a Budget Impact Analysis of introduction of free-of-charge oral contraceptives was implemented by UNFPA with support of the MOH; A joint Gender Equality and Women Empowerment advocacy campaign and other actions have been carried by UN Women, UNFPA, UNICEF and UNDP focusing on youth engagement in ending violence against women and girls; consolidated efforts of several UN agencies to increase capacity of national stakeholders in implementation of Ending violence against women commitments under nationalized SDGs and CEDAW; and National Generations and Gender Survey supported by UNFPA and the Netherlands Interdisciplinary Demographic Institute (NIDI).
The joint programmes enhanced cooperation between the UN agencies and were able to deliver higher level results. However, despite successful cooperation, joint programming and coherent work among the UN Agencies still remain a challenge in Kazakhstan. There are several factors influencing progressive implementation of the Delivering as One Standard Operating Procedures126. First, missions and size of the UN Agencies are different, and when bigger agencies cooperate more easily the smaller institutions have lesser motivation and opportunities to collaborate. Second, in some instances unhealthy competition between the UN Agencies for resources, visibility and leadership in certain programme areas may further compromise/undermine the UN ability to deliver as one. Third, when the UNCT supports country commitment to achieving the SDGs, better alignment of PFD outcomes with specific SDGs targets and mandates and comparative advantages of several UN agencies holds a potential to strengthen more coordination and complementarity between the UN agencies’ interventions. Moreover, the joint planning and harmonization of some common services under the Business Operation Strategy (BOS) reduced duplication of UN institution activities, but joint resource mobilization remains a challenge. As the Operation Management Team (OMT) continues its operation through procurement of common services to support short-term needs of individual agencies rather than PFD in general and in the absence of the UNCT M&E and lack of performance indicators, the capacity of OMT to monitor efficiency and effectiveness of resources allocation for the PDF results remains limited.
However, it should be mentioned that all interviewed respondents127 think that cooperation and coordination among the UN organizations in Kazakhstan is good. The evaluation has demonstrated that the UN agencies have better cooperation at the program and issue-specific level rather than on general one. Human factor also plays an important role in that sense. Nearly all respondents commented on the current country manager of the UNFPA, who is very energetic, easygoing and simply terrific. She is genuinely concerned about the Fund’s work in Kazakhstan and she wants it to be as effective and instrumental as possible. In addition, in absence of UN Residence Coordinator, UNFPA Country manager undertakes its role. Her effective and professional leadership was mentioned by all respondents interviewed.
EQ10: What is the main UNFPA added value in the country context as perceived by UNCT and national stakeholders?
Major UNFPA comparative advantages include its mandate, namely population and development challenges. The respondents128 noted that the UNFPA is the only international organization in Kazakhstan, which is consistently addressing the issues of population and demographic, ageing and youth policy, practical issues in the area of gender and gender-based violence, family planning, and reproductive and maternal health. UNCT recognized that the specific objectives and expertize makes UNFPA unique in providing policy advice and advocacy, as well as technical assistance, strengthening reproductive health and family planning services to ensure more equitable access and further improvement the quality of services. UNFPA special expertise lays on comprehensive sexuality and reproductive health education, information and service provision for adolescents and young people, especially those living in rural and remote areas. PFD noticed UNFPA central role in supporting the Government in using demographic data for planning and policy development, including through the establishment of a national system of population registers and better understanding of the causes of the latest national population trends and patterns. Also, the Fund brings expertise on data collection and analysis, relating to national domestic violence surveys and a multi-sectoral response to gender- based violence and supports specialized surveys and other data collection efforts, to further strengthen the evidence base for informed policy development.
Many respondents129 noted that UNFPA brings new contemporary concepts to the country needed for addressing interests and challenges facing by various target groups. For example, the introduction and update of the valeology
126 Annex 3: 6 & Key Informants interviews, June 24-28, 2019 127 Key Informants interviews, June 24-28 & July 1-4, 2019 128 ibid 129 ibid 57 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
course with an additional content on reproductive health and equality of men and women: “Unfortunately, even parents do not always know how to discuss sexual and reproductive health issues with own children. Therefore, it is always important to communicate this knowledge to teenagers’ parents, too. What UNFPA is doing is a very important thing130.” Some common themes that emerged from respondents’ feedback on an added value include UNFPA Kazakhstan facilitation of policy dialogue, a strong advocacy role especially in sensitive areas: “Being a traditional society, increasing access to sexual reproductive health is still a challenge in rural areas in Kazakhstan. UNFPA is a prominent actor, not just with funds, but also with training and research” 131, as well as UNFPA strong partnership with the government and state institutions.
The UNFPA’s activities are not limited to one type of activities. The Fund uses a complex approach in addressing pressing issues when compared to other UN agencies that have clear-cut types of support. The support rendered by the UNFPA to thematic studies helps the Fund and its partners to define areas for “emerging sensitive priorities (like HIV, consent for sex, abortion, etc.) that UNFPA records and addresses in its work”132. It was echoed by the other respondent who noticed, “UNFPA is not afraid to remind that social issues go along with economy and the Fund is the only agency raising such issues”133. The international experts’ support helps the Fund’s partners gain new knowledge and skills, apply new approaches in addressing pressing issues. The distinctive feature of the UNFPA is its approaches for working with the partners134. The UNFPA does not impose its vision on the partners. It rather motivates them to present own initiatives. Taking into consideration the small amount of finance the organization has at its disposal when compared to other UN agencies, the UNFPA manages to identify the most pressing issues that require solution and can produce effective results and then implements pilot projects around these issues. But some of these pilot projects can turn into full-fledged national programmes as it was the case with the initiative to engage youth in ending violence against women and girls through partnership with religious leaders on development of an educational course for theological colleges of Islam and Orthodox communities.
Cooperation with Islamic and Orthodox Christian religious leaders (discussed above) deserves special attention and brings value of UNFPA programme, as it is unique for any UN institution, especially in Muslim countries like Kazakhstan.
The peculiar feature of the UNFPA is its ambition to operate in line with the UN principle Delivering as One135 via coordination, linking and involving different actors in activities. The Fund is a big promoter and supporter of cross- sectoral cooperation. The UNFPA is well aware of the strengths and weaknesses of the public authorities and it addresses the most pressing issues when interacting with the public authorities and other partners. The Fund monitors the performance of its partners very thoroughly and in its turn the Fund also reports to partners and expert groups every year and provides consultations on future cooperation. This also constitutes the distinctive feature of UNFPA when comparing it to other UN agencies136. Due to limited finance the Fund has only some activities at the national level137.
Much strengths identified above are the result of the UNFPA corporate features. But respondents138 identified certain features, which are specific only to the country office. Among them is the UNFPA Kazakhstan staff, who is very attentive to the needs of their partners; ‘they can listen to them and hear what they say’139. As one of the respondents put it: “The Fund plans its activities taking into consideration our needs and proposals. UNFPA did not tell us what to do”140. The Fund keeps track of activities of other donors to avoid overlapping in their work. It coordinates its activities by organizing and conducting joint events. The Fund adds activities to its mandate, which are relevant to Kazakhstan. The important thing is that UNFPA works on small but system changes that eventually result in sustainable initiatives achieved as of capacity building efforts.
The respondents appreciate the work of the Fund in Kazakhstan because the UNFPA is open to work with CSOs, it can clearly divide the responsibilities between the partners and itself, implements the projects together with partners,
130 Key Informants interviews, June 28, 2019 131 Interviews 132 Key informant interview, June 25, 2019 133 ibid 134 Key Informants interviews, June 28 & July 1-4, 2019 135 Annex 3: 25, 47 136 Key Informants interviews, June 24-28 & July 1-4, 2019 137 Key Informants interviews, June 24-25, 2019 138 Key Informants interviews, June 24-28 & July 1-4, 2019 139 Key Informants interviews, July 1, 2019 140 Key Informants interviews, July 2, 2019 58 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
provides immediate response to emerging issues and makes decisions, which are informed and carefully weighted, and defines activities that would be realistic in terms of their implementation. As one of the respondents put it: “With little funds the UNFPA has very focused priorities and many success stories”141.
The visibility and level of attribution of certain results of the UNFPA work by population in Kazakhstan is still very low142. Despite the number of interventions and the produced many tangible results, the UNFPA partners and target population groups do not necessary attribute the interventions to the UNFPA and/or know about them. It should be noted that the general public knows more about UNICEF, UNDP and WHO and not the UNFPA. Therefore the Fund has to strengthen its capacity to communicate results of its work and to define clearly attributable "signature" products in order to raise the UNFPA visibility, particularly among potential donors, private sector and groups of supporters.
The main UNFPA added value in Kazakhstan’s context as perceived by the stakeholders143 includes the following. In the field of reproductive health and rights the UNFPA Kazakhstan is the only organization focusing on SRH issues for general public and for vulnerable populations, specifically persons with disabilities. Even though engaging adolescents and youth has long been a part of UNICEF's mandate, reproductive health needs of adolescents and youth are mostly addressed by UNFPA. The Fund is not afraid to deal with sensitive SRH issues even with organizations which are considered as conservative and very traditional (e.g. faith-based organizations) and makes them allies to ensure reproductive health and rights. UNFPA promotes data-driven decision-making and evidence based practice in SRH area. It works based on findings of surveys and results of pilot projects. The Fund understands country’s priority issues, e.g. decreasing maternity mortality, and uses the comprehensive approach which includes ensuring access to SRH services for all, the ‘beyond the number’ tool, preventing unwanted pregnancies, especially among adolescents, peer- to-peer learning etc. to address the problem. The UNFPA activities in the area adolescents and youth are often referred to as value added areas. Compared to other UN agencies, UNFPA is often referred to as an organized, flexible, and less bureaucratic UN Agency. Stakeholders noted that in addition to its work with government, UNFPA stands out as one of the only organizations working with youth to prevent sexual transmission of HIV through sexual and reproductive health programs, including vulnerable groups such as people with disabilities. According to the respondents144, the UNFPA Kazakhstan value added in the area of gender includes highlighting the area of GBV itself since the issue of domestic violence only was in the spotlight in the past. UNFPA support the Government in addressing CEDAW Concluding Observations and Universal Periodic Review recommendations is within its mandate/agreed within the UN System. In the area of P&D the value added of the UNFPA Kazakhstan145 is the international expertise and support in conducting census and various surveys according to international standards, capacity building in certain areas and experience exchange throughout the country, joint programs with government institutions and increased government understanding in demographic tendencies and importance of data, increased quality of surveys conducted by the State Committee of Statistics as well as knowledge of certain research like Generation and Gender, policy and advocacy work with government, engagement to SDGs nationalization. Also, respondents146 noticed UNFPA role in reminding other donors about social issues to be addressed along with economy; not being afraid to bring up sensitive priorities raised from survey to address them including HIV/AIDs, consent from 16 year old; in promoting and consolidating government and donors to work on SDGs; and working jointly with government on increasing its better understanding of demography and its importance.
141 Interview, July 2016 142 Key Informants interviews, June 24-28 & July 1-4, 2019 143 ibid 144 ibid 145 ibid 146 ibid 59 EVALUATION REPORT: The 3rd and 4th UNFPA Country Programmes for Kazakhstan (2010-2018)
CHAPTER 5: CONCLUSIONS
5.1. Strategic level
Conclusion 1. UNFPA Kazakhstan approach in 3rd and 4th CPs to use evidence based data Origin: EQ1, 2, 3, 10 on emerging population issues as well as UNFPA position to raise social issues that often Evaluation criteria: are disturbing and inconvenient contributed to relevance of the national policy designed Relevance and promoted by UNFPA along with other UN Agencies. UNFPA strategy of programme Associated interventions is responsive to global challenges and national interests and needs. recommendation: 1 However, M&E of UNFPA is still remains a challenge as such responsibility assign to Assistant representative and programme areas’ managers and there is no solely dedicated person to perform this function within the CO team.
Conclusion 2. UNFPA Kazakhstan Country Programme documents lack clearly defined Origin: EQs 2-3, 5 output/outcome indicators and their sources. Annual report format does not reflect Evaluation criteria: output/outcome indicators presented in the CPs that make difficult to monitor Effectiveness achievement of indicators by country programme as well as annually. As results, the Associated output and outcome indicators were not usable to reflect the achievements of UNFPA. recommendation: 1 First, as it was mentioned, most of them are not always correctly reflecting advocacy goals. Second, the indicators don’t have clear operational definitions to measure and interpret them. Third, it is difficult to monitor progress towards the planned outcomes during the programmes, because the output indicators are measured and reported only at baseline and at the end of the programs, but not annually or bi-annually.
Conclusion 3. The 3rd UNFPA Country Programme contributed to several achievements Origin: EQs 2-3, 7 made by Kazakhstan, including a significant reduction in maternal and infant mortality, Evaluation criteria: ratification of the Convention on the Rights of Persons with Disabilities, changes in the Effectiveness state health-care programme to ensure better access to health services and Associated commodities, such as the inclusion of antiretroviral drugs in the basic benefit package for recommendation: 2 HIV positive persons. Over the past three years of the 4th CP UNFPA contributed to the development of three strategic documents approved by the government: the Concept of Family and Gender Policy in Kazakhstan until 2030, the Kazakhstan Family Planning National Framework Program 2017-2021, the Operational action plan to reduce maternal mortality in the Republic of Kazakhstan. However, the output indicators have not been able to correctly reflect the contribution of UNFPA to these achievements.
Conclusion 4. During implementation of the 3rd and 4th CPs UNFPA Kazakhstan made Origin: EQ 5, 8, 9 smooth transition from concentrating on capacity building of its partners to policy and Evaluation criteria: advocacy and made important shift in attracting more national government and other Efficiency development partners resources. As Kazakhstan is an upper-middle-income country Associated where a traditional development assistance model does not apply and traditional donors recommendation: 2 often cannot support the country, UNFPA operates in a resource constrained environment, further aggravated by decreases in the amount of core resources provided from the corporate level, worsening economic situation and undeveloped corporate social responsibilities of the companies. Given this situation UNCT collaboration and UNFPA partnership with civil society organizations, government and other development partners increased efficient use of limited financial, human and expert resources, including joint efforts in nation-wide and/or pilot initiatives. At the same time, UNFPA has not yet used its leadership position to extend its activity and attract resources from donors like EU, USAID for regional programmes.
Conclusion 5. The UNFPA has demonstrated added value in its programmatic areas and Origin: EQ 10 the Agency partners recognize it. The value added of the UNFPA country programmes Evaluation criteria: includes both corporate UNFPA comparative advantages, which are part of its mandate Added value and mission as well as features specific only to the country office. Among them new Associated knowledge and skills received by partners, modern approaches to problem solving, recommendation: 3 attention and support received in all UNFPA programmes’ areas, CO attitude. However, UNFPA visibility and recognition, even by its partners, remains an issue.
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Conclusion 6. UNFPA ensured sustainability of achieved results by provision of evidence- Origin: EQs 6-8 based support to advocacy and policy work, strengthening capacity through introducing Evaluation criteria: its partners to the best international practices, supporting partners participation in Sustainability training and conferences, advocating positive results of pilot projects at national level Associated and engaging key ministries in implementation of new concepts. UNFPA plans recommendation: 3 sustainable results of its interventions at CP design stage with careful revision of achieved results considering challenges in environment and best local and international practices. However, achieved results in some areas (e.g. adolescent & youth – Y-peer) are mixed in term of sustainability.
Conclusions 7. The UNFPA activities clearly contributed to better coordination of the UN Origin: EQ 9 agencies in Kazakhstan. There are several UN institutions the UNFPA cooperates closely Evaluation criteria: with (UNICEF, UN Women, WHO, UNAIDS) and their joint activities are complementary, Coordination create synergies and reflect the interests, priorities and mandate of the UNFPA in Associated Kazakhstan (as it states in the UN-Kazakhstan Partnership Framework). However, despite recommendation: 4 successes, in general, joint programming and coherent work among the UN Agencies remain a challenge in Kazakhstan as of competition for resources, recognition and visibility. At the same time, all respondents recognized positive and effective leadership of the UNFPA Country Manager.
5.2 Programmatic level
SRH Conclusion 8: UNFPA has made significant achievements to ensure sexual and Origin: EQs 2-4 reproductive health and rights. UNFPA has been supporting the successful government Evaluation criteria: efforts to reduce maternal deaths by improving and expanding CEMD, improving Effectiveness infection control at healthcare facilities, addressing other issues of sexual and Associated reproductive health. Moreover, Ministry of Health developed Road Map on recommendation: 5 implementation of mentioned in Conclusion 2 the Kazakhstan Family Planning National Framework Program 2017-2021. However, there are still unmet need of population to access family planning / SRH services, including contraceptives.
SRH Conclusion 9. UNFPA funding for the implementation of the SRH component has Origin: EQ 5 been decreasing, fewer funds were available for technical assistance including piloting Evaluation criteria: interventions and conducting research for making evidence-based decisions, especially Efficiency to ensure access to SRH services for vulnerable populations and the commitment of the Associated government became very important. The government provided funds and resources to recommendation: 2 continue and expand the models that were introduced by UNFPA. CEMD and NMCR models, trainings on effective perinatal care, sufficient standards and clinical protocols have been implemented nationwide by using resources from the state and local budgets. Moreover, government of Kazakhstan is favorite supporting UNFPA in areas where it has more interests, like maternity and infant mortality when other areas like access to contraceptives, state supports ‘on words’ and has to be still ‘convince’ by UNFPA. This is why UNFPA analysis of economic contribution of certain programs / activities was important to prove their efficiency and was necessary in convincing government to release more funding and should be employed for as a part of advocacy strategy for attraction of the government and development actors resources.
Adolescent and youth Conclusion 10. In program 3 and especially 4, UNFPA Origin: EQs 2-4 implemented the pilot projects on sexual education of youth and adolescence in some Evaluation criteria: regions. As a result, UNFPA started with revision of the valeology course, development of Effectiveness the Methodological Guidelines for Teachers, training teachers, and trained teachers Associated taught their students. Studies with control and experimental groups provided evidences recommendation: 6 on the effectiveness of the course on raising awareness of young people on reproductive health issues, which UNFPA used to convince the Ministry of Education. Strategic approach used by UNFPA in promoting of the valeology course attracted attention of the government and now the Ministry of Education tasked the National Academy of Education and Nazarbayev Intellectual School to work on piloting of integration of
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sexuality education into school curriculum starting from grade 9. It was only a first important step of introduction of a Comprehensive Sexuality Education into the school curriculum that should be advocate further.
Adolescent and youth Conclusion 11: Over the years of the implementation of the 3rd Origin: EQs 6-8 and especially the 4th country programs (where work with young people is singled out as Evaluation criteria: a separate component), UNFPA provided various types of support to the Y-PEER Sustainability network. However, there is no long-term strategy and comprehensive approach for Associated working with Y-PEER network and with adolescents and youth in general. The Y-PEER recommendation: 6 network has a good capacity and desire to share the knowledge and continue developing the Y-PEER network because a peer-to-peer technology works best of all. However, network experiences high turnover of staff and volunteers, lacks strong leadership and there is no long-term strategy and comprehensive approach on how Y-PEER centers can operate without local administration support and develop a sense of ownership among target groups as a place that youth will be interested to attend and share the information received with peers. While the 4th country program is still developing, there is no very clear vision of institutionalization of Y-PEER network.
Adolescent and youth Conclusion 12. The UNFPA comprehensive approach for Origin: EQs 6-8 improving adolescent- and youth-friendly reproductive health services, which focuses on Evaluation criteria: not only programmatic activities of Youth Health Centres but also on measures to make Sustainability them sustainable, should be considered as best practice of advocacy efforts. Associated recommendation: 6 Gender Conclusion 13. The Concept on Family and Gender Policy till 2030 was approved Origin: EQs 2-4 by the Government. However, its implementation in the part related to sexual education Evaluation criteria: and universal access to quality family planning services and counseling for vulnerable Effectiveness groups of population and close monitoring is not sufficient. It is equally important to Associated have a common understanding of all stakeholders of the UNFPA programs, not only at recommendation: 7 the national level (e.g. The National Commission on Women affairs and Family- Demographic Policy in Kazakhstan), but also in the regions, about the purpose of the Concept of Family and Gender Policy, because models of gender relations have a significant impact on the level of functional stability of the family, especially when Kazakhstan is moving towards preservation of traditional family values.
Gender Conclusion 14. In September 2015, Kazakhstan joined the UN Sustainable Origin: EQ 9 Development Goals, in which 5 of the 17 goals are gender-sensitive. These goals require Evaluation criteria: national adaptation, localization and accounting within the framework of all strategic Coordination directions and tasks of the state that UNFPA in partnership with other UN institutions, Associated such as UN Women, can facilitate and support during implementation and monitoring of recommendation: 7 the achievement of the SDGs.
Gender Conclusion 15. UNFPA, together with the UN Women and its other partners from Origin: EQs 2-3 government, civil society and religious communities has a comprehensive approach to Evaluation criteria: addressing gender-based violence. First, UNFPA supports studies that show the extent of Effectiveness the problem and assist in identification of risk factors. Secondly, UNFPA participated in Associated the development of standards (for the police, medical organizations, crisis centers, etc.) recommendation: 2, 8 for assisting victims of GBV and piloting these standards in the South Kazakhstan region. Thirdly, the problem of violence against women, in particular its prevention, is included in the training module on SRH for college students. However, despite achieved results, there are lack of institutionalization of the standard operational procedures, specifically, in the health sector; use of SOPs are not introduced into the functional responsibilities of staff; CSPS staff lack capacity and competencies to promptly and properly react to the needs of GBV survivors as well as to share already gained experience in working with GBV issues.
Gender Conclusion 16. UNFPA Kazakhstan positive experience in working with religious Origin: EQs 2-4, 6, 8 Islam and Christian Orthodox leaders of on sexual and reproductive health, gender and Evaluation criteria: gender-based violence and youth will become increasingly important. However, when Sustainability
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UNFPA achieved better support and results with Muslim community more effort in Associated promoting stated above issues are needed in working with Orthodox community (based recommendation: 2, 8 on EQs 2-4, 6, 8).
Gender Conclusion 17: The UNFPA collaborates closely with key youth and women Origin: EQ 9 advocate with the national policy frameworks and UN Partnership Framework including Evaluation criteria: UN Women, UNICEF, UNDP, etc. UNFPA is recognized leader in implementing pilot Coordination initiatives but sometimes it is difficult to understand which UN agency an initiative is Associated originated from, in particular on youth problems (UNFPA or UNICEF), or gender (UNFPA recommendation: 4 or UN Women).
P&D Conclusion 18. The UNFPA is the only programme in Kazakhstan that works with Origin: EQs 1-3, 6-7 population data, dynamics and projections issues. The necessity to have updated data, Evaluation criteria: including disaggregated and sectoral data, to monitor population dynamics and the SDGs Effectiveness indicators urged the UNFPA Kazakhstan to stress the importance of P&D among its Associated partners, including government and state institutions of Kazakhstan. However, recommendation: 9 Kazakhstan does not have comprehensive population policy that is increasingly important considering changes in population dynamics and population aging. In addition, survey and study reports prepared by and/or with UNFPA support should openly accessible, better publicized and data open to researchers.
P&D Conclusion 19. Huge challenge to sustainability and long-term effects of the UNFPA Origin: EQs 6-8 work on improvement of demographic statistical data and achievement in Kazakhstan Evaluation criteria: include absence of formal demographic education in the universities along with high Sustainability turnover of personnel in statistics-related state agencies. Introduction of the Associated demographic-related courses for civil servants in the Public administration Academy recommendation: 3, 9 under President of Kazakhstan can satisfy high-level demand of such specialists only to certain extent.
P&D Conclusion 20: The UNFPA activities were effective since they combined the Origin: EQs 2-4 development of the national policy and programme documents through involvement of Evaluation criteria: different stakeholders, studies important for the informed decision making, capacity Effectiveness building of its partners and their support and proactive engagement in the international Associated processes with practical activities at the national and regional levels. The UNFPA recommendation: 3, 9 achieved all planned outputs of the 3rd CP and in progress to delivery expected outputs of the 4th country programme. Unfortunately, evaluation cannot say to what extent outcome indicators of the 3rd programme were achieved, as needed data was not found. The evaluation has demonstrated that there is limited access to reports and/or to their reference on conducted by UNFPA or with its support surveys and studies and produced data that is very important for advocacy and policy work.
P&D Conclusion 21: UNFPA improves national understanding of demographic and social Origin: EQs 6-7, 10 development of the country and factors behind such development; assists in Evaluation criteria: identification and clarification of reasons behind demographic trends; supports Sustainability identification of factors influencing demographic behavior of people, including migration. Associated UNFPA was successful in raising and improving Government attention and understanding recommendation: 3, 9 of importance to social issues along with economic based on evidence-based approach that can bring up issues that are either inconvenient to discuss (family planning, domestic violence, HIV/AIDs, etc.) or are not considered as important (issues connected to disable people, especially women, youth, etc.). The UNFPA contribution was especially important as it provides access to international experts and best practices. However, as of limited knowledge of foreign languages of civil servants, the Russian-speaking countries were selected for study visits that limits public authorities exposure to new trends, methodologies and techniques existed at international level.
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CHAPTER 6: RECOMMENDATIONS
6.1 Strategic Recommendations
Strategic Recommendation 1. Improve M&E planning and reporting to better recognize and Priority: High promote achieved results. To: Country/Regional Offices Operational implication Based on UNFPA should review CP output and outcome indicators and their targets and sources to conclusions: 1, 2, 20 correctly reflect advocacy goals, namely: policy development, placement on the policy agenda, policy adoption, policy implementation, policy M&E, policy maintenance. Furthermore, UNFPA should report progress in achievement of outcome indicators in its annual reports. Also, report format of indicators in annual reports should be aligned with their format and targets described in the UNFPA country programme documents. In addition, UNFPA CO might benefit from having one person responsible for M&E function rather splitting such role among several members of team. If considered later, it will require additional CO position. Such steps will ensure better relevance and effectiveness at planning stage as well as help measuring expected results rather than just any results achieved.
Strategic Recommendation 2. Explore resource mobilization strategy outside of Kazakhstan, Priority: High precisely at regional level. To: Regional/Country Offices Operational implication Based on UNFPA Kazakhstan is recognized leader within Central Asia countries with its achievement in conclusions: 3, 4, 9, decreasing maternity mortality, combating GBV, cooperating with government on socially 15, 16 important issues. As traditional development assistance model does not apply and traditional donors often cannot support the UNFPA CO activity, it is important in consultation with Agency partners to develop resource mobilization strategy that envision development agencies like EU and/or USAID approach of funding UNFPA regional rather than individual country (especially middle-income) activity and projects. Such resource mobilization strategy can envision UNFPA collaboration and partnership with regional-level civil society organizations, governments within regions and other development partners working or interested in working at regional level. Moreover, it creates conditions for sustainability of results achieved in Kazakhstan throughout the region. UNFPA can employ international experts to provide technical assistance in consultation with CO managers.
Recommendation 3. To increase its advocacy and policy work effectiveness based on evidence Priority: High UNFPA should provide access to secondary data collected during its survey and studies and To: Country Office better promote and publicize reports of surveys/studies/research conducted by CO to all Based on stakeholders, including Government and Parliament of Kazakhstan. conclusions: 5, 6, 19, 20, 21 Operational implication UNFPA should develop online source where secondary data and reports (or their references) on surveys/studies/researches conducted/supported by the Agency are collected and presented (by programme areas, year of implementation). Access to secondary data assists to academician, statisticians, young researches to conduct various analysis avoiding high cost research stage of collecting data through survey and studies and boost interest to population research. Availability of UNFPA conducted/ supported reports on surveys/studies/researches in one place assists various stakeholders in using them in their work, including positive and evidence-based approach in raising the Government of Kazakhstan and Parliament attention and improving their understanding of social issues and advocating their inclusion into national agenda as important component of the Kazakhstan development. Short-term technical assistance of IT specialist will be needed as well as time of CO programme managers to collect and organize respective secondary data sets and reports on surveys/studies/researches conducted/supported by UNFPA.
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Strategic Recommendation 4. UNFPA has to raise its visibility, particularly among potential Priority: High donors, private sector and groups of supporters. To: Country/ Regional Offices Operational implication Based on UNFPA should strengthen its capacity to communicate results of its work and to define clearly conclusions: 7, 17 attributable "signature" UNFPA products as, despite the number of interventions and the produced many tangible results, the visibility and level of attribution of certain results of the UNFPA work in Kazakhstan is still very low. To achieve it UNFPA can focus on digitalization of monitoring of health services as from 2020 all medical histories will be digitalized. Also, UNFPA can benefit from digitalization of advocacy and policy approach. Therefore specific indicators should be developed and regularly measured on UNFPA visibility level in consultation with key stakeholders. UNFPA should involve international and/or local IT and monitoring expert support and technical assistance to define its “signature” products, marketing/communication approach and tangible results.
6.2. Programmic Recommendations
SRH Recommendation 5. UNFPA should assist MOH in implementation of its Road Map for the Priority: Medium Kazakhstan Family Planning National Framework Program 2017-2021 in order to support To: Country Office government of Kazakhstan in satisfying unmet needs in assess to family planning services and Based on conclusion: contraceptives. Moreover, UNFPA can assist government in addressing evolving needs in this 8 area while designing new Health Development programme for 2020-2023.
Operational implication Approach to improvement of access to family planning services can be borrowed from the UNFPA comprehensive approach to advocate for Youth Health Centers. For this UNFPA together with other development actors and UN agencies can create (if needed), manage and maintain coalitions of relevant governmental and civil society organizations. Moreover, UNFPA should employ various advocacy approaches, including new ones arisen from the digitalization, which are appropriate for advocacy goals, unmet needs and circumstances with focus on vulnerable populations. It will require UNFPA support to advocacy activities of its partners such as technical assistance and provision of local and/or international expert assistance that will contribute to obtain long-lasting effects.
Adolescent and Youth Recommendation 6. UNFPA should continue support of Adolescent & Priority: Medium Youth component focusing on: i) continuing advocacy on the integration of sexuality course into To: Country/ the school curricula throughout the country; and 2) developing strategy of institutionalization of Regional Offices the Y-peer network. Based on conclusions: 10, 11, Operational implication 12 UNFPA continuing support to A&Y component will ensure sustainability and ownership of Agency activities. Based on government recognition and support to the piloting of integration of sexuality education into school curriculum starting from grade 9 UNFPA should continue advocating for integrating of a Comprehensive Sexuality Education including valeology course into the school curricula throughout the country either as separate course or part of disciplines such as Self-Knowledge, Physical Culture, Biology etc., (since a load more than 36-hour might be difficult for perception by school students). To achieve it UNFPA would need technical support by involving local and international experts to implement such education and/or monitor results of sexuality course implementation for further improvement. In order to sustain UNFPA achievements of working with Y-peer network, strategy of institutionalization of the network and its registration as civil society organization should be developed. International and/or local expert should be employed for this activity.
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Gender Recommendation 7. UNFPA should support a proper and adequate understanding and Priority: Medium implementation of the new Concept on Family and Gender Policy till 2030 at national and To: Country/ regional levels in the part related to gender equality issues through a prism of family values and Regional Offices institutionalization of SDGs. Based on conclusions: 13, 14 Operational implication In order to reach long-lasting results of ensuring of proper interpretation and implementation of gender issues in national documents at all levels UNFPA in consultation with its government and civil society partners should provide technical assistance (workshops, training, dialogue platforms) and invite international and/or local expert support.
Gender Recommendation 8. UNFPA should continue its support to combating GBV. Priority: Medium To: Country Office Operational implication Based on UNFPA should: i) advocate the Government of Kazakhstan on institutionalization of developed conclusions: 15, 16 SOPs for GBV victims by key Ministries in daily work of their staff and further their inclusion into curricula of education institutions; ii) assist institutionalization use of the standard operational procedures, specifically, in the health sector into the functional responsibilities of staff; iii) strengthen CSPS staff capacity and competencies to promptly and properly react to the needs of GBV survivors. In order to achieve long-lasting results UNFPA should initiate establishment of multi-sectoral coalition of national partners (government, civil society, religious communities, business) and UN agencies and other development actors present in Kazakhstan and provide access to already gained experience in working with GBV issues through meeting, dialogue, study visits and strengthen national and local government and CSPS staff capacity through workshops and on-site training, technical assistance and expert support.
P&D Recommendation 9. Develop the Government of Kazakhstan comprehensive population Priority: Medium strategy/policy that considers population dynamics, including aging issues. To: Country/ Regional Offices Operational implication Based on This strategy is needed to ensure that UNFPA support will sustain and government policy is conclusions: 18, 19, evidence-based. Moreover, the strategy should advocate for formal education in demography 20, 21 and continue education of civil servants on population issues through, for example, the Public Administration Academy. At the same time, demography- and population development courses can be introduced at college/school level. In consultation with its national partners and experts UNFPA should assist government with international expertise to develop strategy and short term courses for civil servants and students as well as explore civil servants, CSOs experts to other than Russian-speaking countries experience, new methodologies and techniques of collecting evidence-based data needed for advocacy and policy work.
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ANNEXES
Annex 1. Terms of Reference
Annex 2. List of persons/institutions met
Annex 3. List of documents consulted
Annex 4. The evaluation matrix
Annex 5. Abstract of the evaluation report
Annex 6. Stakeholders’ mapping
Annex 7. UNFPA Intervention logic for 3rg and 4th CPs by programme components
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Annex 1. Terms of Reference for the Evaluation
Terms of reference for the evaluation of The Kazakhstan UNFPA Country Programme
A. INTRODUCTION
The United Nations Population Fund (UNFPA) is the lead United Nations sexual and reproductive health agency for ensuring rights and choices for all. The strategic goal of UNFPA globally is to achieve three transformative results by 2030: ending unmet need for family planning, ending preventable maternal deaths, and ending gender-based violence and harmful practices. In pursuing its goal, UNFPA has been guided by the International Conference on Population and Development (ICPD) Programme of Action (1994), the Millennium Development Goals (2000) and the 2030 Agenda for Sustainable Development (2015).
UNFPA began its work in Kazakhstan in 1992 focusing mainly on strengthening maternal health through supply of medical equipment, contraceptives and provision of basic training for service providers. The following two country programmes (2000-2004 and 2005-2009) made a gradual shift from a supply-oriented to a technical assistance programme focused on reproductive health and rights, health, population, gender and sustainable development linkages for evidence-based policy formulation.
UNFPA Kazakhstan effectively collaborates with the Government, line ministries (Ministries of Foreign Affairs, Healthcare and Social Development, Education and Science, Internal Affairs, Committee on Statistics under the Ministry of National Economy), civil society, development partners (UN sister agencies), and academic institutions (Academy of Public Administration under the President of Kazakhstan and the State University for Up-Grading Education of Health personnel). Through all the country programme cycles the Government of Kazakhstan has been a principal strategic partner of UNFPA.
As the current programme cycle is approaching completion, the UNFPA Country Office in Kazakhstan, in collaboration with the UNFPA Regional Office for Eastern Europe and Central Asia and UNFPA Evaluation Office, is planning to conduct an independent evaluation of the third and fourth UNFPA Country Programme for Kazahkstan (2010-2018) as part of the Country Office evaluation plan and in accordance with the UNFPA evaluation policy (DP/FPA/2013/5). The UNFPA country programme evaluation (CPE) will provide an independent assessment of relevance, performance and sustainability of UNFPA support provided to Kazakshstan during 2010-2018, as well as analysis of various facilitating and constraining factors influencing programme delivery. The overall objective of the evaluation is to assess the extent to which the country programmes achieved intended results and use the findings for the purposes of further programme design and interventions. The primary users of this evaluation are the decision-makers within the UNFPA country offices and organization as a whole, government counterparts in the country, the UNFPA Executive Board, and other development partners. The UNFPA Regional Office for Eastern Europe and Central Asia and UNFPA Headquarters divisions, branches and offices will also use the evaluation as an objective basis for programme performance review and decision-making.
The evaluation will be managed by the evaluation manager of the country office evaluation manager with guidance and support from the UNFPA Regional Advisor on Monitoring and Evaluation, and in consultations with the Evaluation Reference Group. A team of competitively selected independent evaluators will conduct the evaluation and prepare the evaluation report.
B. CONTEXT
B1. Country Profile Kazakhstan was an aid recipient country in the early 1990s and transitioned from a lower-middle income to an upper- middle income country status in 2006, or less than two decades (World Bank in Kazakhstan Country Snapshot , October 2018 http://pubdocs.worldbank.org/en/530541539098312156/Kazakhstan-Snapshot-Oct2018.pdf). Kazakhstan ranks 56th in the Human Development Index with positive prospects (Human Development Report, 2015). In 2017 the total population of the Republic of Kazakhstan amounted to approximately 18 million with a very low density. Kazakhstan is characterized by large distances and uneven distribution of population across the country; the southern regions being thickly populated while the Western and Northern-Eastern regions – least-populated. The population of the country is quite young; the median age is 29 years. The proportion of young people aged 14-28 of the total population is 25%.
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The Government recognizes that such a high proportion of youths lays a background for economic development and it undertakes certain measures at the national level to improve capacities of youths.
Maternal, infant mortality and life expectancy have significantly improved. The infant and maternal mortality has dropped 4.5 times from 1990. The progress achieved in Maternal mortality reduction in the last 5 years are in large part due to the implementation of efficient perinatal technologies recommended by WHO. A UNFPA survey on adolescents and their sexual behavior carried out in 2018 generated important findings whereby almost one third of the respondents (out of 4,360 adolescents from all over the country which is statistically representative) reported having been or being sexually active. A considerable part of adolescents was not concerned about promiscuous sexual relations with a higher risk; the use of contraception among adolescents and youths was not common. In addition, only a very small proportion (about 9%) could answer correctly to all the questions related to STI and HIV knowledge. Comprehensive sexuality education is not part of the school curriculum. The existing national legislation does not allow adolescents younger than 18 to access health information and services without parental consent.
In Kazakhstan, HIV infections are at a concentrated stage. HIV prevalence among group of population aged 15-49 years in 2015-2016 was 0.2% Sexual intercourse as the route of HIV transmission accounted for 5% in 2001 and grew to 62% in 2017. In the last decade Kazakhstan has continued to see an increase in new HIV infections. Stigma and discrimination vis-à-vis people living with HIV remains very high, with over 70% of people interviewed (UNAIDS study) stating that they would not buy vegetables from a HIV-positive seller.
In Kazakhstan, there is no policy addressing delivery of family planning services to vulnerable population with special needs (people with disabilities, adolescents, migrants) and population with high HIV-infection risks (injecting drug users, sex workers) and people living with HIV. In the last 7 years, Kazakhstan has achieved some progress in human rights protection and promotion of gender equality. Key legislative documents were adopted to address prevention of domestic violence and counteraction to human trafficking, pension coverage, as well as gender equality strategy.
B2. UNFPA Country Programme The 3rd UNFPA Country Programme Document for Kazakhstan (DP/FPA/CPD/KAZ/3) has been approved by the UNDP/UNFPA/UNOPS Executive Board on the 9th July, 2009. The UNFPA financial commitment over 5 years towards the programme was approved at $ 5.9 million from regular resources ($ 3.2 million for reproductive health and rights component, $ 1.6 million for population and development component, $ 0.4 for gender equality component and $ 0.7 for programme coordination and assistance). UNFPA also committed to mobilize $1.8 million from other resources to co-fund the programme.
The country programme (2010-2015) is aimed at ensuring high-quality maternal health services, universal access to SRH services and information, prevention and response to gender-based violence, and provision of evidence-based data on emerging population issues. UNFPA keeps a policy dialogue supporting ICPD agenda with the Parliament, the National Commission on Women Affairs and Family-Demographic Policy under the President of Kazakhstan and the Ministry of Foreign Affairs, on performance of Kazakhstan’s international commitments in line with the ICPD PA and other international treaties, strengthening national policies to promote the gender equality, prevent gender based violence and harmful practices, and ensure reproductive rights of population of Kazakhstan and universal access to SRH services and information, with special focus to vulnerable population groups.
In line with UNFPA’s business model for upper middle income countries, the country programme hasl shifted to advocacy and upstream policy support. The emphasis is on institutionalization and sustainability of capacities, including development, implementation and accountability mechanisms for evidence-based programming and policy making in the areas of population dynamics, health, gender, data systems and youth. The programme supports the government in: (a) ensuring the realization of reproductive rights and supporting universal access to sexual and reproductive health services, including family planning; (b) empowering young people and ensuring access to comprehensive sexuality education; (c) providing effective multi-sectoral response to gender based violence; (d) improvement of population databases for formulation of rights-based informed policies. The linkages of the country programme results to the UNFPA Strategic Plan 2014-2017 theory of change (annex 5)
C. OBJECTIVES AND SCOPE OF THE EVALUATION
The overall objectives of evaluation: (i) an enhanced accountability of UNFPA and its country office for the relevance and performance of its country programme and (ii) a broadened evidence-base for the design of the next programming cycle.
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The specific objectives: ● To provide an independent assessment of the progress of the country programme towards the expected outputs and outcomes set forth in the results framework of the country programme; ● To provide an assessment of country office (CO) positioning within the developing community and national partners, in view of its ability to respond to national priority needs while adding value to the country development results. ● To draw key lessons from the past and current cooperation and provide a set of clear, specific and action- oriented forward-looking strategic recommendations in light of agenda 2030 for the next programming cycle.
The evaluation is expected to be completed by September 2019 and carried out in accordance with the Evaluation Implementation Plan (ref: Annex 6).
Scope of evaluation: The evaluation will cover Kazakhstan and the following four programmatic areas: reproductive health, adolescents and youth, gender and population and development.
The evaluation (including country studies) will cover all activities planned and/or implemented during the period 2010- 2018. Since Kazakhstan did only carry out a ‘light evaluation’ in the previous cycle, the period covered will include the previous country cycle, i.e. 2010-2015. Cross-cutting areas will include: partnership, resource mobilization and communication.
The evaluation should analyze the achievements of UNFPA against expected results at the output and outcome levels, its compliance with the UNFPA Strategic Plans for 2014-2017 and 2018--2021, the UN partnership Framework, and national development priorities and needs.
D. EVALUATION CRITERIA AND EVALUATION QUESTIONS
The following evaluation questions addressing the evaluation criteria: relevance, effectiveness, efficiency, and sustainability as well as coordination with the UNCT, and added value will be used for the evaluation.
Relevance: EQ1.To what extent is the UNFPA support (i) adapted to the needs of the population with emphasis on the most vulnerable population (ii) and in line with the priorities set by international and national policy frameworks (iii) aligned with the UN Partnership Framework (iv planned interventions adequately reflect the goals stated in the UNFPA Strategic Plan?
Effectiveness: ● EQ 2To what extent have the intended programme outputs been achieved? ● EQ 3.To what extent did the outputs contribute to the achievement of the planned outcomes (i. increased utilization of integrated SRH Services by those furthest behind, ii. increased the access of young people to quality SRH services and sexuality education, iii. mainstreaming of provisions to advance gender equality, and iv. developing of evidence-based national population policies) and what was the degree of achievement of the outcomes? ● EQ4.To what extent has UNFPA policy advocacy and capacity building support helped to ensure that sexual and reproductive health (including Family Planning), and the associated concerns for the needs of young people, gender equality, and relevant population dynamics are appropriately integrated into national development instruments and sector policy frameworks in the programme country?
Efficiency: ● EQ5To what extent has UNFPA made good use of its human, financial and technical resources, and has used an appropriate combination of tools and approaches to pursue the achievement of the Results defined in the UNFPA country programme?
Sustainability: ● EQ6.To what extent has UNFPA been able to support its partners and the beneficiaries in developing capacities and establishing mechanisms to ensure ownership and the durability of effects? ● EQ7To what extent have the partnerships established with ministries, agencies and other representatives of the partner government allowed the country office to make use of the comparative strengths of UNFPA, while, at the
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same time, safeguarding and promoting the national ownership of supported interventions, programmes and policies? ● EQ8To what extent have some of the results of pilot projects being used to scale up interventions and/or bring relevant evidence to policy-makers to adopt such approaches?
UNFPA Country programme coordination with UNCT: ● EQ 9To what extent has the UNFPA country office contributed to the functioning and consolidation of UNCT coordination mechanisms?
UNFPA Country programme added value: ● EQ10.What is the main UNFPA added value in the country context as perceived by UNCT and national stakeholders?
E. METHODOLOGY AND APPROACH
The evaluation will be based on a participatory design that is expected to include quantitative and qualitative data collection methods.
The proposed methodology by the evaluation team will elaborate in detail on the relevant data sources, sampling size and techniques, data collection instruments and procedures, ethical considerations, as well as the strategies necessary for mitigating the major limitations of the proposed design, if any.
Data Collection The evaluation will use a multiple-method approach to data collection, including documentary review, group and individual interviews, focus groups and field visits to programme sites as appropriate. The data will be carried out through a variety of techniques ranging from direct observation to informal and semi-structured interviews and focus/reference groups discussions.
The evaluators will be required to take into account ethical considerations when collecting information.
Data validation The Evaluation Team will use a variety of methods to ensure the validity of the data collected. Besides a systematic triangulation of data sources and data collection methods and tools, the validation of data will be sought through regular exchanges with the CO programme managers and the Evaluation Reference Group.
Data Analysis The evaluation team will ensure the following in analyzing data, formulating finding and reaching to conclusions. i. Are the findings substantiated by evidence? ii. Is the basis for interpretations carefully described? iii. Is the analysis presented against the evaluation questions? iv. Is the analysis transparent about the sources and quality of data? v. Are cause and effect links between an intervention and its end results explained and any unintended outcomes highlighted? vi. Does the analysis show different outcomes for different target groups, as relevant? vii. Is the analysis presented against contextual factors? viii. Does the analysis elaborate on cross-cutting issues such as equity and vulnerability, gender equality and human rights?
Stakeholders participation The evaluation will adopt an inclusive approach, involving a broad range of partners and stakeholders. The evaluation manager will perform a stakeholders mapping for each country in order to identify both UNFPA direct and indirect partners (i.e., partners who do not work directly with UNFPA and yet play a key role in a relevant outcome or thematic area in the national context). These stakeholders may include representatives from the government, civil-society organizations, the private-sector, UN organizations, other multilateral organizations, bilateral donors, and most importantly, the beneficiaries of the programme. The stakeholder mapping must be concluded before the design phase.
An Evaluation Reference Group (ERG) will be established by the UNFPA Country Office country comprising key programme stakeholders (national governmental and non-governmental counterparts, Evaluation Manager from the
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UNFPA Country Office). The ERG will review and provide inputs to the country case study, provide feedback to the evaluation design report, facilitate access of evaluators to information sources, and provide comments on the main deliverables of the evaluation, in particular the country case studies at the draft stage.
F. EVALUATION PROCESS
The evaluation will unfold in four phases, each of them including several steps. a. Preparation phase (December 2018-Feb. 2019): This phase, managed by the UNFPA Offices, will include: ● Drafting of programme evaluation (CPE) terms of reference (ToR); ● Establishing an Evaluation Reference Group (ERG); ● Receiving approval of the CPE ToR from the UNFPA Regional Office; ● Selecting potential evaluators from three companies already vetted (LTAs); ● Recruiting evaluators and establishing an Evaluation Team chaired by the Evaluation Team Leader; ● Preparing the initial set of documentation for the evaluation, including the list of projects and stakeholder map.
The preparation phase may include a short scoping mission to the UNFPA Country Office in Kazakshtan located in Astana by the Evaluation Team Leader to gain better understanding of the development context, UNFPA programme and partners, refine the evaluation scope, identify potential sites for field visits etc. b. Evaluation design phase This phase will include: ● a documentary review of all relevant documents available at UNFPA HQ and CO levels regarding the country programmes for the period being examined; ● a stakeholder mapping – The evaluation managers will prepare a mapping of stakeholders relevant to the evaluation. The mapping exercise will include state and civil-society stakeholders and will indicate the relationships between different sets of stakeholders; ● an analysis of the intervention logic of the programme, - i.e., the theory of change meant to lead from planned activities to the intended results of the programme; ● the finalization of the list of evaluation questions; ● the development of a data collection and analysis strategy as well as a concrete work plan for the field phase.
At the end of the design phase, the evaluation team leader will produce a design report, that will outline the detailed evaluation methodology, criteria, timeframes and the structure of the final report.
The design report must include the evaluation matrix, stakeholders map, final evaluation questions and indicators, evaluation methods to be used, information sources, approach to and tools for data collection and analysis, calendar work plan, including selection of field sites to be visited – prepared in accordance with the UNFPA Handbook “How to Design and Conduct a Country Programme Evaluation”. The design report should also present the reconstructed programme intervention cause-and-effect logic linking actual needs, inputs, activities, outputs and outcomes of the programme. The design report needs to be reviewed, validated and approved by the UNFPA Evaluation Manager before the evaluation field phase commences. c. Field phase After the design phase, the evaluation team will undertake a three-week in-country collection and analysis of the data required in order to answer the evaluation questions final list consolidated at the design phase. At the end of the field phase, the country evaluation team will provide the COs with a debriefing presentation on the preliminary results of the evaluation, with a view to validating preliminary findings and testing tentative conclusions and/or recommendations. d. Synthesis and dissemination phase During this phase, the Country Evaluation Team will continue the analytical work initiated during the field phase and prepare country case studies, taking into account comments made by the UNFPA Country Office and Evaluation Reference Group at the debriefing meeting and the Evaluation Team Leader.
This first draft country report will be submitted to the Evaluation Reference Group for comments (in writing). Comments from the Country Evaluation Reference Group and evaluation managers will be consolidated. The draft
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country report will form the basis for a dissemination seminar/s, which will be attended by the CO as well as all the key programme stakeholders in the Evaluation Reference Group (including key national counterparts). The final report will be drafted by the Team Leader based on the comments received. This first draft evaluation report will be shared with the Evaluation Steering Committee for the feedback and comments. The final Evaluation report will be shared with stakeholders in the country, in a format to be agreed upon.
G. Expected outputs/ deliverables The evaluation team will produce the following deliverables: ● evaluation design report including (as a minimum): a) a stakeholder map; b) the evaluation matrix (including the final list of evaluation questions and indicators); c) the overall evaluation design and methodology, with a detailed description of the data collection plan for the field phase. The design report should have a maximum of 70 pages; ● a first draft evaluation report and first draft country study accompanied by a debriefing PowerPoint presentation synthesizing the main preliminary findings, conclusions and recommendations of the evaluation, to be presented and discussed with the Evaluation Steering Committee during the (online or in person) debriefing meeting foreseen at the end of the field phase; ● a second draft evaluation report and country case study (followed by a second draft, taking into account potential comments from the Evaluation Steering Committee) and Evaluation Reference Group. The evaluation report should have a maximum of 50 pages (plus up to 70 pages for each Case Study, and plus annexes); a PowerPoint presentation of the results of the evaluation for the dissemination seminar to be held in each office and led by the national evaluators; ● a final evaluation report including country case study, based on comments expressed during the dissemination seminars. ● An evaluation brief (maximum 4 pages) summarizing the evaluation report.
All deliverables will be written in English and Russian. The PowerPoint presentation for the dissemination seminars and the final evaluation report might need to be translated in Kazakh if requested by national counterparts.
Work plan/ Indicative timeframe
Phases/deliverables Dates
Preparation phase December 2018 -February - Drafting and approval of the ToR 2019 - Recruitment of experts (TL, RA, National Experts) Evaluation design phase: March/April 2019 - Submission of the design report Training phase: May - Training on evaluation design Field phase: June/July - Data Collection - Debriefing CO Synthesis and dissemination phase: July/September 2019 - Development of Country Case Studies - Dissemination - Finalization of the Country Case Studies - 1st draft Evaluation Report - 2nd final draft Evaluation Report - Final Evaluation Report - Evaluation brief
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H. COMPOSITION OF THE EVALUATION TEAM
An Evaluation Team Leader and two Evaluators who are external to UNFPA will carry out the evaluation. There should be at-least one member in the evaluation team should be female. The evaluation team members will combine knowledge and experience in evaluation with technical knowledge and expertise in areas related to the UNFPA development and humanitarian programme
The evaluation team will consist of: A Team Leader with overall responsibility for the design and implementation of the CPE. S/he is responsible for the production and timely submission of all expected deliverables of the CPE including design report, draft and final evaluation reports. She/he will lead and coordinate the work of the Evaluation Team and ensure quality of the evaluation products. The Evaluation Team Leader will be responsible for covering at least one programmatic area of the CPE. The Evaluation Team Leader should have the following qualifications:
The Evaluation Team Leader should have the following qualifications: ● Advanced degree in social sciences, political sciences, economics or related fields; ● Minimum 7 years of experience of complex evaluations in the field of development aid for UN agencies and/or other international organizations in the position of lead evaluator, ● Specialization in one of the programmatic areas covered by the evaluation (reproductive health and rights, gender equality, population and development, adolescent and youth policies) ● Demonstrated ability and knowledge to collect and analyze qualitative and quantitative data (a training on data analysis using software e.g. SPSS would be preferable); ● Good knowledge and experience of programme evaluation in the humanitarian settings will be strong assets; ● Familiarity with UNFPA or UN programming; ● Excellent writing and communication skills; ● Excellent command of both spoken and written English is required. Good knowledge of Russian would be an asset.
Two evaluators (team member), who will each provide expertise in one programmatic area of the evaluation The evaluators will take part in the data collection and analysis work, and will provide substantive inputs into the evaluation processes through participation at methodology development, meetings, interviews, analysis of documents, briefs, comments, as advised and led by the Evaluation Team Leader. The modality and participation of evaluators in the CPE process, including participation in interviews/meetings, provision of technical inputs and reviews of the design report, drafting parts of the evaluation reports, will be agreed by the Evaluation Team Leader and done under her/his supervision and guidance. The necessary qualifications of the evaluators will include: a) ▪ Advanced degree in social sciences, public health, women's studies, gender equality, population studies, demography, statistics or related fields; ▪ At least 5 years of experience in conducting evaluations as a member of evaluation team or individual evaluator for UN agencies and/or other international organizations; ▪ Demonstrated ability and knowledge to collect qualitative and quantitative data; ▪ Knowledge of demographic, political, social and economic conditions in the area in which the evaluation will be conducted; ▪ Good knowledge of the national development context and be fluent in Russian and English (good knowledge of Kazakh would be desirable) ▪ Familiarity with UNFPA or UN programming; ▪ Excellent writing and communication skills; ▪ Knowledge of Kazakh would be desirable. b) A research assistant will collect, compile and analyze available data in the format requested by the team leader as per the evaluation handbook, and be supported and supervised by evaluation manager; assess availability of data and existing gaps by using the following questions: ● What studies exist ● What data are available that is linked to the country programme and country situation (SIS – output results, country office annual reports; GPS – financial data; major surveys – conducted under the CP; financial resources; etc.) ● Providing input for the synthesis phase
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Qualification of research assistant ● Bachelor’s degree in statistics, social sciences, population studies, economics or related fields; ● Minimum 2 years of experience in data collection and analysis (with the use of the relevant statistical software packages); ● Knowledge of qualitative/quantitative research methods; ● Familiarity with UNFPA or UN operations; ● Fluency in written and spoken English and Russian. Knowledge of Kazakh an asset.
I. Remuneration and duration of contract
The exact number of workdays and workload distribution will be proposed by the Evaluation Team in the evaluation design report, subject to approval by UNFPA.
Payment of the evaluation consultancy fees will be made in three tranches against the following milestones: ● 20% Upon approval of the evaluation design report by UNFPA ● 40% Upon acceptance of the first draft final evaluation report by UNFPA ● 40% Upon acceptance of the final evaluation report by UNFPA
Daily Subsistence Allowance (DSA) will be paid per nights spent at the place of the mission following UNFPA DSA standard rates. Travel costs will be settled separately from the consultant fees.
J. Management and conduct of the evaluation
The evaluation will be guided by these terms of reference approved by the UNFPA Regional Office on behalf of UNFPA Evaluation Office, and the UNFPA Handbook “How to Design and Conduct a Country Programme Evaluation”. The evaluation and country case studies will be conducted by an independent Evaluation Team whose members are pre- qualified by the UNFPA Regional Office, but will be managed by the UNFPA Country Office.
The Evaluation Steering Group: Evaluation Steering Committee (ESC) will have overall responsibility for management and coordination of all components of the evaluation including evaluation design, implementation and dissemination of the evaluation results. The Evaluation Steering Committee will have overall supervision on the Evaluation Team (including International Team Leader and National Team) and evaluation processes. ESC will be comprised of the UNFPA Representative, Assistant Representative, M&E Focal Point, Programme Associate and RO M&E Advisor.
The role of the ESC will include the following tasks, but not limited to: ● Develop and agree ToR for the evaluation along with ToR for Reference Group(s) and ToRs for all Evaluation Team members (International Team Leader, National Evaluators, National Experts and National Research Assistants); ● Act as first point of contact to the Evaluation Team; ● Develop initial list of stakeholders for interviews and propose documentation for review; ● Review and approve draft design report; ● Review and approve draft evaluation report (including preliminary findings, conclusions and recommendations) and Case Studies; ● Liaise with the Evaluation Reference Groups for any issues related to the evaluation; ● Provide management response to the final evaluation report; ● Review and approve the final evaluation report and Case Studies; ● Disseminate the final evaluation report to relevant stakeholders.
The Evaluation Manager will:
● Provide support to the whole evaluation exercise, provide feedback for quality assurance during the preparation of the design report, field work, case studies, dissemination seminar, and the final report; ● Conduct stakeholders mapping with support of the research assistant; ● Provide research assistant with available internal and external data relevant to the country ● Provide national experts with the relevant data ● Facilitate the establishment of the Reference Group at country level ● Be supported by the RO M&E adviser
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The reference group composed of representatives from the UNFPA country office, the national counterpart, the UNFPA regional office as well as from UNFPA relevant services in headquarters.
The main functions of the Reference Group will be: ● to discuss the terms of reference drawn up by the evaluation manager; ● to provide the evaluation team with relevant information and documentation on the programme; ● to facilitate the access of the evaluation team to key informants during the field phase; ● to discuss the reports produced by the evaluation team; ● to advise on the quality of the work done by the evaluation team; ● to assist in feedback of the findings, conclusions and recommendations from the evaluation into future programme design and implementation.
BIBLIOGRAPHY AND RESOURCES
1. UNFPA Kazakhstan website www.kazakhstan.unfpa.org 2. UNFPA Country Programme Document for Kazakhstan for 2010-2015 3. UNFPA Country Programme Document for Kazakhstan for 2015-2020 4. United Nations – Kazakhstan Partnership Framework 5. UNFPA Strategic Plan (2008-2013) and its Mid-Term Review 6. UNFPA Strategic Plan (2014-2017) 7. UNFPA Strategic Plan 2018-2021 8. Handbook “How to Design and Conduct a Country Programme Evaluation at UNFPA” (http://www.unfpa.org/admin-resource/how-design-and-conduct-country-programme-evaluation-unfpa) 9. UNFPA Evaluation Webpage (http://www.unfpa.org/evaluation) 10. National MDG Final Report 11. UNDP Human Development Reports for Kazakhstan 12. National RH programme for 2017-2021 13. National ICPD@15 report
Annexes: Annex 1: Ethical Code of Conduct for UNEG/UNFPA Evaluations Annex 2: Evaluation Quality Assurance and Assessment: Tools and Guidance (https://www.unfpa.org/admin- resource/evaluation-quality-assurance-and-assessment-tools-and-guidance) Annex 3: How to Design and Conduct a Country Programme Evaluation at UNFPA (https://www.unfpa.org/admin- resource/how-design-and-conduct-country-programme-evaluation-unfpa) Annex 4: Equity-focused and gender-responsive lens evaluation (https://www.evalpartners.org/evalgender/no-one- left-behind#guidance)
Annex 5: Country Programme Theory of Change
Annex 6: Evaluation Implementation Plan
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Annex 1: Ethical Code of Conduct for UNEG/UNFPA Evaluations
Evaluations of UNFPA-supported activities need to be independent, impartial and rigorous. Each evaluation should clearly contribute to learning and accountability. Hence evaluators must have personal and professional integrity and be guided by propriety in the conduct of their business. In particular:
1. To avoid conflict of interest and undue pressure, evaluators need to be independent, implying that members of an evaluation team must not have been directly responsible for the policy- setting/programming, design, or overall management of the subject of evaluation, nor expect to be in the near future. Evaluators must have no vested interests and have the full freedom to conduct impartially their evaluative work, without potential negative effects on their career development. They must be able to express their opinion in a free manner.
2. Evaluators should protect the anonymity and confidentiality of individual informants. They should provide maximum notice, minimize demands on time, and respect people’s right not to engage. Evaluators must respect people’s right to provide information in confidence, and must ensure that sensitive information cannot be traced to its source. Evaluators are not expected to evaluate individuals, and must balance an evaluation of management functions with this general principle.
3. Evaluations sometimes uncover suspicion of wrongdoing. Such cases must be reported discreetly to the appropriate investigative body.
4. Evaluators should be sensitive to beliefs, manners and customs and act with integrity and honesty in their relations with all stakeholders. In line with the UN Universal Declaration of Human Rights, evaluators must be sensitive to and address issues of discrimination and gender equality. They should avoid offending the dignity and self-respect of those persons with whom they come in contact in the course of the evaluation. Knowing that evaluation might negatively affect the interests of some stakeholders, evaluators should conduct the evaluation and communicate its purpose and results in a way that clearly respects the stakeholders’ dignity and self-worth.
5. Evaluators are responsible for the clear, accurate and fair written and/or oral presentation of study limitations, evidence based findings, conclusions and recommendations.
For details on the ethics and independence in evaluation, please see UNEG Ethical Guidelines and Norms for Evaluation in the UN System http://www.unevaluation.org/search/index.jsp?q=UNEG+Ethical+Guidelines http://www.unevaluation.org/papersandpubs/documentdetail.jsp?doc_id=21
[Please date, sign and write “Read and approved”]
Annex 5: Country Programme 2015-2020 Theory of change.
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THEORY OF CHANGE. Kazakhstan Country Programme 2016-2020
SP Outcome 1: Increased availability SP Outcome 2: Increased priority on SP Outcome 3: Advanced SP Outcome 4: Strengthened national and use of integrated sexual and adolescents, especially on very young gender equality, women’s and policies and international development reproductive health services (including adolescent girls, in national development girls’ empowerment, and agendas through integration of evidence- family planning, maternal health and policies and programmes, particularly reproductive rights, including based analysis on population dynamics and HIV) that are gender-responsive and increased availability of comprehensive for the most vulnerable and their links to sustainable development, meet human rights standards for quality sexuality education and sexual and marginalized women, sexual and reproductive health and
CP Output 1.1: Strengthened policy CP Output 2.1: Young people have CP Output 3.1: Strengthened CP Output 4.1: Strengthened national framework and institutional guaranteed access to quality sexual national policies and data systems and increased availability mechanisms to deliver integrated and reproductive health services, institutional mechanisms to and accessibility of evidence-based maternal, sexual and reproductive information and education. promote gender equality, to analysis on population dynamics and their health services, with particular focus on prevent gender based violence links to sustainable development for the most vulnerable and key formulation rights-based policies. Risks: The current financial and economic crisis might force the Government to cut on public expenditures that will have a negative impact on quality social services, especially for the most vulnerable and disadvantaged. Public services have limited capacities in ensuring equitable access and focuses on general population but not on vulnerable and disadvantaged. Although, Kazakhstan has adopted/ratified a number of international conventions, their full implementation is still lacking. Strategic Interventions: Advocacy and Policy Dialogue/Advice; Strengthening of institutional capacities to ensure sustainability
Output 1.1 Indicators: Output 2.1 Indicators: Output 3.1 Indicators: Output 2.1 Indicators:
Clnical protocols and State standards of New long-term national policy 2016 multiple indicator standards adopted for national curriculum include document on gender equality cluster survey (MICS) and PHC and hospital levels on elements of comprehensive that integrates UPR 2020 Population and SRH, including FP and HIV sexuality education in recommendations and housing census completed services that meet human accordance to UNESCO obligations related to sexual and and data available and rights standards, including standards reproductive rights, prevention accessible freedom from Y-Peer national network is of GBV and early marriages National integrated system discrimination, coercion institutionalized and acts as Mechanism of health system of population registers is in and violence. implementing partner of response to gender-based place which provides inter- Percentage of health UNFPA and Government violence is in place alia information on providers at primary health institutions in providing Number of civil society and vulnerable population care and hospital levels information to adolescents faith based organizations that groups. practicing the newly and youths on SRH, gender, have supported the National family and adopted clinical protocols leadership and institutionalization of demographic policy and standards communication skills. programmes to engage men document that integrates Number of key facilities of Legal provisions are in and boys on gender equality population projections, 78
Annex 2. List of persons/institutions met
# Institutions Persons
1. Center for the Study of Public Opinion (CIOM) Gulzhan Alimbekova 2. Center for analytical research and forecasting of the Institute of Economic Batzhan Akmoldina (skype) Research 3. Congress of neonatologists and gynecologists Bekturgan Karin 4. Department of organizational work and regional development of the Gulmira Zharilkasimova apparatus of the akim of the Turkestan region; Commission for women affairs and family-demographic policy under the akim of the Turkestan region 5. Department of education under akimat of Turkestan Region and National Akmaral Asilbekova Commission on women affairs and family-demographic policy in Turkestan region 6. Department of education under akimat of Turkestan Region and National Zhanna Commission on women affairs and family-demographic policy in Turkestan region 7. Departments of preparation and implementation of National Censuses Nurlan Kozhakov 8. East Kazakhstan Health Department (former) and Center of family health Saule Mukusheva (now) 9. Expert of UNFPA Alexandr Kosukhin 10. Expert of the Committee of Statistics Yerbolat Mussabek 11. Expert of the Committee of Statistics Gulnar Kukenova 12. Hazrat Sultan Mosque Ruslan Sultanov 13. Hazrat Sultan Mosque Aisha (Tatiana Sitchenko) 14. Kazakhstan Association on Sexual and Reproductive Health (KMPA) Galina Grebennikova 15. Ministry of Foreign Affairs Olzhas Toguzbayev 16. Ministry of Foreign Affairs Assel Erdenova 17. Ministry of Health (former) and akimat of Nur-Sultan city Akmaral Baurzhanova 18. National Center for healthy lifestyle development Sholpan Karzhaubayeva 19. National Commission on women affairs and family-demographic policy Erlan Raiganiyev (former) and Мinistry of Labor and Social Protection (now) 20. Office of Statistics for Sustainable Development Goals Ainur Dossanova 21. Regional Perinatal Center #1 of Turkestan Oblast Rahima Nalibaeva 22. Regional Perinatal Center #1 of Turkestan Oblast Zhanna Idyrova 23. Service of social and psychological support for domestic violence victims Marat Tarakhtyev under the akimat of Saryagash district of Turkestan oblast 24. Service of social and psychological support for domestic violence victims Marat Mamyrtaiyevich under the akimat of Saryagash district of Turkestan oblast Tarakhtiyev 25. Parliament of the Republic of Kazakhstan Irina Unzhakova 26. Public Association of Women with Disabilities "Shyrak" and Deputy of Lyazzat Kaltayeva Almaty Maslikhat (local Parliament) 27. Public Fund "Aman-saulyk" Bakhyt Tumenova 28. UN Resident Coordinator Dina Khassenova 29. UNFPA Giulia Valiese 30. UNFPA Raimbek Sissemaliyev 31. UNFPA Serik Tanirbergenov 32. UNFPA Gaukhar Abuova 33. UNFPA Gaziza Moldakulova 34. UNICEF Kanat Sukhamberdiev 35. UNAIDS Aliya Bokazhanova 36. UN Department of Global Communication Vlastimil Samek 37. UN Women Elaine Conkievich 38. Y-peer network Kamilla Tuyakbaeyva- 39. Y-peer network Oxana Yanchenuk
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Annex 3. Documents consulted
English 1. Asian Development Bank (2018). Kazakhstan Country Gender Assessment. 2. Boniș, S. (2015). Evaluative evidence using light methodology of UNFPA Kazakhstan Country Programme 2010- 2015 3. Buzdugan, T. (2009). Evaluation of the Reproductive Health Component of the Kazakhstan UNFPA Country Programme for 2005-2009 4. Contribution to Kazakhstan’s Roadmap to Attain the SDGs (2017): a mission report of Mainstreaming Acceleration and Policy Support (MAPS); 5. Convention on the Elimination of All Forms of Discrimination against Women (2018). Fifth periodic report submitted by Kazakhstan under article 18 of the Convention, due in 2018 6. Committee on Statistics of the Ministry of National Economy of the Republic of Kazakhstan, http://stat.gov.kz/ 7. Development Strategy of Kazakhstan 2030, downloaded from https://www.zakon.kz/60241-strategija- kazakhstan-2030-i-ee.html 8. Evaluation Handbook: How to Design and Conduct a Country Programme Evaluation at UNFPA, UNFPA Independent Evaluation Office, February 2019. Downloaded from www.unfpa.org/evaluation 9. Gurbo, M. (2019). Final evaluation of the PFD Kazakhstan, 2016-2020 10. ICPD. Action program after 2014. Global obligations. 11. Index Mundi, 2015, downloaded from https://www.indexmundi.com/kazakhstan/ 12. International Covenant on Civil and Political Rights (2016). Concluding observations on the second periodic report of Kazakhstan 13. IOM. Mapping on irregular migration for Central Asia (2014) 14. IOM. Migrant Vulnerabilities and Integration needs in Central Asia (2017) 15. IOM. Risk analysis on return migration and challenges in Central Asia (2017) 16. Joint Programme Document for UNDP/UNICEF/UNFPA/UNV “Raising Competitiveness of the Region through Innovative Approaches to Regional Planning and Social Services (using Semey as an Example) 17. Kazakhstan Family Planning National Framework Program, 2017-2021 18. Ministry of Health of the Republic of Kazakhstan (2018), http://dsm.gov.kz/en 19. National MDG Final Report, downloaded from https://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf 20. National RH programme for 2017-2021, downloaded from https://kazakhstan.unfpa.org/sites/default/files/pub-pdf/ 21. National Voluntary Report on SDG implementation in Kazakhstan, downloaded from downloaded from https://sustainabledevelopment.un.org/vnrs/ 22. Kazakhstan 2050 Strategy, downloaded from http://www.mfa.kz/ru/sydney/content-view/kazakstan-2050- strategiasy-2 23. Mensah, S.A. Gender Sensitive Data Gathering Methods. Gratis Foundation. http://www.un.org/esa/sustdev/csd/csd15/lc/gender_method.pdf 24. Multiple Indicator Cluster Survey (MICS) in the Republic of Kazakhstan 2015. Monitoring the situation of children and women. Directed by N.S. Aidapkelov, Astana 2016, 396 p 25. Partnership Framework for Development, Kazakhstan, 2016-2020 (2015) 26. Poalelungi, O. (2009). Evaluation of Population and Development Component of the Kazakhstan UNFPA Country Programme for 2005-2009 27. OECD (2018). Kazakhstan’s Official Development Assistance (ODA), downloaded from http://www. oecd.org/dac/dac-global-relations/kazakhstan-official-development-assistance.htm 28. OECD (2018). Reforming Kazakhstan: Progress, Challenges and Opportunities, https://www.oecd.org/eurasia/countries/OECD-Eurasia-Reforming-Kazakhstan-EN.pdf 29. Report of the Secretary-General on repositioning the United Nations development system to deliver on the 2030 Agenda: our promise for dignity, prosperity and peace on a healthy planet (A/72/684– E/2018/7) 21 December 2017 30. Results and resources framework for Kazakhstan. CPD Kazakhstan [2016-2020] (DP/FPA/CPD/KAZ/4), https://www.unfpa.org/cpd-kazakhstan-2016-2020-dpfpacpdkaz4 31. Results and resources framework for Kazakhstan. DP/FPA/CPD/KAZ/3 32. Ruzvidzo, T. May 2007. Measuring Gender Equality: Taking Stock – Looking Forward. OECD Development Centre. https://www.oecd.org/dev/38640915.pdf. 33. Sample survey on violence against women in Kazakhstan, the Statistical Committee of the Ministry of National Economy of the Republic of Kazakhstan, 2017
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34. Strategic Plan for Development of the Republic of Kazakhstan 2010, https://planipolis.iiep.unesco.org/sites/planipolis/files/ressources/kazakhstan-dev-report-2001.pdf 35. Strategic Plan for Development of the Republic of Kazakhstan 2020, http://www.akorda.kz/en/official_documents/strategies_and_programs 36. State Programme for Development of Healthcare in the Republic of Kazakhstan 2011-2015, www.akorda.kz 37. Тhree-year strategies of Ministry of Healthcare and Agency for Statistics for 2009-2011 issued in 2008, and bills on Equal Rights and Equal Opportunities of Women and Men. 38. Trading Economics, downloaded from https://tradingeconomics.com/kazakhstan/indicators 39. UN Country Situation Analysis Kazakhstan (2014), https://www.academia.edu/9832715/UN_Kazakhstan_Country_Situation_Analysis_2014_DRAFT_ 40. UNCT Follow-up Action to the PFD Mid-term Review Recommendations, 10 August 2018 41. UNDAF for the Republic of Kazakhstan, 2010-2015, https://www.unfpa.org/sites/default/files/portal- document/Kazakhstan-UNDAF%202010-2015.pdf 42. UN Department of Economic and Social Affairs. World Population Ageing 2015: Highlights. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Highlights.pdf 43. UNDP. Kazakhstan Country Programme Outcome Evaluation 2016-2018: Diversification of the economy provides decent work opportunities for the underemployed, youth, and socially vulnerable women and men; 44. UNDP. Kazakhstan Country Programme Outcome 1.3. Evaluation: Ecosystems and natural resources are protected and sustainably used, and human settlements are resilient to natural and human-induced disasters and climate change; 45. UNDP. Kazakhstan Country Programme: Regional Cooperation Outcomes Evaluation 46. UNDP Human Development Reports for Kazakhstan, downloaded from http://hdr.undp.org/sites/all/themes/hdr_theme/country-notes/KAZ.pdf 47. United Nations in Kazakhstan. Business Operations Strategy 2018-2020 48. UNECE Regional Conference on ICPD+25, 1 - 2 October 2018: Mr. Olzhas Toguzbayev, Deputy Director of the Department on Multilateral Cooperation, Ministry of Foreign Affairs 49. UNICEF. Technical assistance to the Government of the Republic of Kazakhstan, local governments of East Kazakhstan, Kyzylorda and Mangistau Regions in developing quality, sustainable and outcome-based services for adolescents and youth and promoting youth centred policies at local and national level: Outcome & Impact Report 50. UNICEF (2018). Promoting Adolescent Mental Health and Prevention of Suicide in Kyzylorda Oblast, Kazakhstan: Summary Report of the Key Findings and Lessons Learned from the Evaluation of the Programme 51. UNICEF (2018). Assessment and Documentation of Good Practices on Disaster Risk Reduction for Children’s Resilience in Kazakhstan, a final report 52. UNEG Code of Conduct for Evaluations - http://www.unevaluation.org/document/detail/100; 53. UNEG Ethical Guidelines - http://www.unevaluation.org/document/detail/102; 54. UNEG Norms for Evaluation in the UN System - http://www.uneval.org/document/detail/21; 55. UNEG Standards for Evaluation in the UN System - http://www.uneval.org/document/detail/22; 56. UNEG Guidance Integrating Human Rights and Gender in the UN System - http://www.uneval.org/document/detail/1616; 57. UNESCO Institute for Statistics, downloaded from http://uis.unesco.org/ 58. UNESCO (2019). Lifelong Learning for All in Central Asia by 2030: Evidence, Policy Options. and Capacity to Build a Life Learning System 59. UNFPA CP Annual Workplan, 2010 – 2018 60. UNFPA Country Office Annual Report, 2010 – 2018 61. UNFPA Strategic Plan, 2008-2013 and its Mid-Term Review 62. UNFPA Strategic Plan, 2014-2017 63. UNFPA Strategic Plan, 2018-2021 64. UNFPA Country Programme Document for Kazakhstan for 2010-2015 65. UNFPA Country Programme Document for Kazakhstan for 2015-2020 66. Viberga, I. (2011). Impovement of family planning in Kazakhstan through application of UNFPA/WHO approaches 67. Women's Empowerment Principles, downloaded from https://www.unglobalcompact.org/take- action/action/womens-principles 68. World Bank data, downloaded from https://data.worldbank.org/country/kazakhstan?view=chart 69. World Population Review (2018), downloaded from http://worldpopulationreview.com/countries/kazakhstan-population/ 70. World Bank (2018). Kazakhstan Sustainable Development Goals: first monitoring report
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Russian 71. Жусупов Б. (2012). Состояние репродуктивного здоровья инвалидов по зрению, слуху и движению в Восточно-Казахстанской области Казахстана (анализ индикаторов) 72. Жусупов Б. (2013). Состояние репродуктивного здоровья людей, живущих с ВИЧ-инфекцией (анализ индикаторов) 73. Жусупов Б. (2013). Состояние репродуктивного здоровья женщин, оказывающих услуги коммерческого секса (анализ индикаторов) 74. Комиссия по правам человека при президенте Республики Казахстан. Специальный доклад: о ситуации с правами мигрантов в Республике Казахстан (2013) 75. Легализация абортов до 18 лет: плюсы и угрозы, downloaded from https://zonakz.net/2018/12/06/legalizaciya-abortov-do-18-let-plyusy-i-ugrozy/ on August 8, 2019 76. Международной конференции по народо- населению и развитию (МКНР). (2014). Программа действий Международной конференции по народонаселению и развитию на период после 2014 года Глобальные обязательства высокого уровня 77. План мероприятий по реализации Концепции по гендерной и семейной политике в Республике Казахстан до 2030 года (первый этап 2017 – 2019 годы). Accessed on August 12, 2019 78. Повестка дня в области устойчивого развития, downloaded from http://eca.unwomen.org/ru/where-we- are/kazakhstan/sustainable-development-agenda 79. Y-PEER People: 15 лет в Казахстане 80. Социологическое исследование по изучению состояния репродуктивного здоровья подростков и молодых людей 15-19 лет, их сексуального поведения и доступа к услугам и информации в области охраны репродуктивного здоровья, 2018 81. Стратегия гендерного равенства в Республике Казахстан на 2006 – 2016 годы, утверждена Указом Президента Республики Казахстан от 29 ноября 2005 года № 1677
Websites 82. http://ru.soros.kz/press_center/press_releases/child_marriage 83. https://www.enbek.gov.kz/sites/default/files/plan_mer_rus_0.doc 84. https://www.unfpa.org/data/transparency-portal/unfpa-kazakhstan 85. UNFPA Kazakhstan website - www.kazakhstan.unfpa.org
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Annex 4. Evaluation matrix
EQ 1 (Relevance): To what extent is the UNFPA support (i) adapted to the needs of the population with emphasis on the most vulnerable population (ii) and in line with the priorities set by international and national policy frameworks (iii) aligned with the UN Partnership Framework (iv planned interventions adequately reflect the goals stated in the UNFPA Strategic Plan? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed The needs of the ● Evidence for a needs assessment, ● CPD ● Document analysis population, in identifying the varied needs of diverse stakeholder ● CPAPs ● Interviews with UNFPA country office staff particular those of groups ● National ● Interviews with implementing partners vulnerable groups, ● The selection of target groups for UNFPA-policy/strategy documents ● Interviews/focus groups with final beneficiaries were taken into supported interventions in the first three ● Needs ● Interviews with NGOs, including local organizations, working in the same mandate area account during the components of the programme is consistent with assessments as UNFPA but not partners of UNFPA programming identified needs (as detailed in the common ● Surveys (including process country analysis) MICS) and census data ● Extent to which the interventions ● Other relevant planned within the CPAPs were targeted at the studies used to understand most vulnerable population groups in a prioritized the HR and GE context, manner including those produced by the government, academia, the United Nations, reports produced ● by international human rights organizations, and reports produced by community-based/ local organizations General. CPAP for Kazakhstan is based on the Program Document for Kazakhstan DP/FPA/KAZ/4 approved by the Executive Board of UNFPA and UNDP on 30 June 2015. CPAP is developed in accordance with the Partnership Framework for Development (PFD) for the Republic of Kazakhstan, 2016-2020, in the course of consultations with the government organizations, non-government sector, UN agencies and donor organizations. The CPAP is fully aligned with the UNFPA Strategic Plan, 2014–2017. The CPAP is focused on the assistance to the country in achieving Sustainable Development Goals (SDG). It will support implementation of the national priorities, including long-term Strategy Kazakhstan-2050, Economic Policy Nurly Zhol, National Program of Healthcare Development Densaulyk 2016-2020 with a focus on universal access to sexual and reproductive health care services.
The first UNFPA CP in Kazakhstan in 2000-2004 strengthened national capacity in policy design on safe motherhood and reproductive health and improved access to appropriate information and services in pilot regions. The pilot regions included South Kazakhstan, East Kazakhstan, mainly Semipalatinsk region, Karaganda, Akmola (now Astana) and Almaty. The support was provided on the national level to data collection, processing and analysis and recommendations were prepared on data use in social development planning.
The second UNFPA CP (2005-2009) addressed linkages between population, sustainable development and poverty in order to raise efficiency of government policy on improving welfare of residents of the country; dissemination of pilot safe motherhood program, creation of critical mass of healthcare professionals trained on efficient perinatal technologies and family planning. A special focus was turned to control over spread of HIV-infection and violence against women. In the framework of the second CP technical assistance was provided to preparation and delivery of census of 2009; obtainment of information and preparation of analytical reports on vital population issues, including crude mortality, family status, ageing and migration; it helped to develop a youth movement to deliver peer-to-peer training on SRH, prevention of unwanted pregnancy, STI transmission, including HIV; training of healthcare personnel and improvement of quality of reproductive health services to youths. The impact of the program was largely determined by successful pilot project in South-Kazakhstan Oblast as a model replicated in the former Semipalatinsk nuclear test site.
The third UNFPA CP (2010-2015) addressed quality of mother care services, improved access to services and information on sexual and reproductive health care, prevention of gender-based violence, and provision of evidence on vital population issues, promotion of needs of vulnerable population in the regional and national development programs.
The fourth UNFPA CP (2016 – 2020) aims to: improve equal access to comprehensive high-quality social services (health, education, social security, rights, etc.) for people of Kazakhstan, including socially vulnerable and disadvantaged persons and groups; foster human rights by involving holders of rights are into decision-making; support fair, responsible, accountable and available to all judicial and legal systems and government institutes; and contribute to the achievement of SDGs in the region jointly with the Government and partners.
SHR. Situational analyses were performed for the third and fourth CP. The third CP situational analysis highlighted a number of problems in SRH area, including high maternal mortality, unmet need for modern contraception, and high prevalent risky sexual behavior, which led to high syphilis and abortion rates. Most young people aged 15-24 didn’t have HIV comprehensive correct knowledge. The country program would help to solve these problems.
The fourth CP situation analysis showed many positive changes, in particular a significant reduction in maternal mortality. However, confidential enquiries revealed that only 16% of maternal deaths were unavoidable. In addition, despite the decline in abortion rate, it remained high, especially among vulnerable groups. Modern contraceptive method utilization was not changed, mainly due to their high prices. Sex workers, young migrants, as well as rural youth were identified as vulnerable groups. In spite of the existence of youth-friendly centers, their number was limited and availability of reproductive health services for youths, especially in rural area, remained low. In addition, there was no specific policy on the provision of SRH services for vulnerable groups, in particular persons with disabilities, adolescents and migrants. In Kazakhstan, before treating a patient under the age of 18, consent must be obtained from the patient’s parent or legal guardian. Legally requiring parental consent for prevention and treatment services of adolescents would likely decrease utilization these services overall, leading to significant negative health outcomes. Decreasing the age of voluntary agreement for healthcare services without parental consent from the age of 18 to 16 years of old is needed, especially for SRH services. Kazakhstan’s economy has suffered from global oil prices fallen sharply since mid-2014. Therefore, it was important to support the government to retain positive trends in SRH, particularly in maternal mortality reduction and fill the gap identified in the 4th CP situational analysis.
Adolescent & Youth. Before developing areas of activity, research/study is conducting and the needs for a specific target group identified, and on their basis goals, activity and indicators formulated. The UNFPA team is actively involved, together with researchers, in agreeing upon research issues and discussing findings. Support was provided in identifying, evaluating and analyzing the pressing issues of vulnerable groups – adolescent and youth, elderly people and persons with disabilities (sight and hearing impaired persons, persons with musculo-skeletal and mental disorders), migrants, and people living with HIV – to reflect results of the analysis in the national development programs. The Nazarbayev Intellectual Schools (NIS) and National Academy of Education developed and tested a training course for college students aimed at delivering correctly information about sexual and reproductive health and reproductive rights. More than 300 college teachers were trained to teach students in reproductive health protection. They trained more than 30,000 teenagers and young people in how to preserve reproductive health, prevent unwanted pregnancies, abortions and sexually transmitted infections
Gender. The UNFPA Kazakhstan supported programs are relevant due to the fact that they are based on in-depth analysis of data and active consultations with youth, women and the most vulnerable group. There are a few reasons that prove relevance of the program implementations, namely: (a) approaches based on research/study; (b) step by step approach to the Government program on family and gender from the National plan to Strategy and Concept; (c) focus on a family-demographic approach; (d) target assistance: people with disabilities; religious; vulnerable groups; (e) Piloting: Course for the school developed and teaching in NIS (they try to promote it to all schools) and the National Academy of Education that tests textbooks; (f) GBV: advocacy and technical support. The UNFPA collaborates closely with key youth and women advocate with the national policy frameworks and UN Partnership Framework including UNWomen, UNICEF, UNDP etc. Kazakhstan has its own way in promotion of gender issues. Currently, it has reached such a level that a focus is put on preservation of family values. An evidence-based approach to the status of vulnerable groups, where collection and analysis of evidence-based data was supported by UNFPA, provided the basis for developed conceptual documents of the country.
P&D. UNFPA jointly with the UN Statistics Division assisted Kazakhstan in the first census of the independent Kazakhstan in 1999 by providing necessary technical and advisory support to preparation and delivery of the census, training of personnel and data processing. The first UNFPA CP in Kazakhstan in 2000-2004 strengthened national capacity in access to appropriate information and services in pilot regions. The pilot regions included South Kazakhstan, East Kazakhstan, mainly Semipalatinsk region, Karaganda, Akmola (now Astana) and Almaty. The support was provided on the national level to data collection, processing and analysis and recommendations were prepared on data use in social development planning. The second UNFPA CP (2005-2009) addressed linkages between population, sustainable development and poverty in order to raise efficiency of government policy on improving welfare of residents of the country. In the framework of the second CP technical assistance was provided to preparation and delivery of census of 2009; obtainment of information and preparation of analytical reports on vital population issues. The third UNFPA CP (2010-2015) 84
addressed improved access to services and information on sexual and reproductive health care, prevention of gender-based violence, and provision of evidence on vital population issues, promotion of needs of vulnerable population in the regional and national development programs. The UNFPA CP supported progress in strengthened capacity of government and policy decision-makers to understand demographic trends and linkages of population and development. Implementation of the 4th UNFPA country program aims to support data collection, access and analysis to inform policy- making in the field of population flow and its linkage with reproductive and sexual health and reproductive rights. The objectives and ● The objectives and strategies of the CPD ● CPD ● Document analysis strategies of the and the CPAPs in the components of the ● UNDAF ● Interviews with UNFPA country office staff UNFPA support are programme are in line with the goals and priorities ● CPAPs ● Interviews with other United Nations agencies consistent with the set out in the UNDAF ● National policies ● Interview with government officials priorities in relevant ● CPD goals are reflected in the P&D and strategies ● Interviews with implementing partners national strategies component of the programme ● UNFPA strategic ● Interviews with other development actors (i.e., NGOs/groups working in the areas in and policies, in the ● The CPD (across all components) aims at plan which UNFPA strategic the development of national capacity ● Country office ● UNFPA works, but that do not partner with UNFPA) plan, aligned with ● Extent to which a human rights-based staff the QCPR and the approach (with the integration of gender equality) ● UNCT UN Partnership has been used to develop the country programme, ● Implementing Framework including a specific focus on the needs of partners vulnerable populations ● Other actors ● Extent to which specific attention has advancing SRHR/working on been paid to adolescents and youth, UNFPA mandate areas (not heterogeneously understood, in the four formally partnering with components of the programme UNFPA) ● Extent to which objectives and strategies of each component of the programme are consistent with relevant national and sectorial policies ● Extent to which the objectives and strategies of the CPD have been discussed and agreed upon with the national partners ● Evidence that the strategic plans of funds and programmes are consistent with and guided by QCPR General. The fourth country programme (2016-2020) is aligned with national development priorities, including the Kazakhstan 2050 strategy, the new economic policy (Nurly Zhol), and the state health programme for 2016-2020. Guided by a rights-based approach and results-based management principles, the programme is also aligned with the post-2015 development agenda, the UNFPA strategic plan, 2014-2017, and the UNFPA business model. The programme will contribute to four out of six outcomes of the United Nations Partnership Framework for Development, 2016-2020. UNFPA will mainstream humanitarian response and preparedness throughout the programme, and the key beneficiaries of the programme will be women and young people, particularly those most in need.
SHR. The Partnership Framework for Development (PFD), Kazakhstan, 2016-2020 has three Strategic Pillars and Six Outcomes as well as five inter-sectoral links or principles including: (1) a human rights-based approach, particularly for vulnerable groups; (2) specific capacity development for monitoring and evaluation; (3) improving the overall evidence base; (4) youth involvement; and (5) gender equality. 3rd and 4th CPs have clearly contented these principles. The first and main Strategic Pillar ‘Reduced disparities and improved human development’ includes an Outcome ‘Improved equitable access to integrated quality social services (health, education, social protection, legal et al.) for the population, including for socially vulnerable and disadvantaged individuals and groups’. SRH services are an important part of efficient, integrated, people-centred health services that are advised to create under the PFD.
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Adolescent & Youth. In the 4th Country programme the UNFPA activities in the field of Adolescent and Youth are focused on engagement in evidence-based policy dialogue, advocacy and knowledge transfer to (a) incorporate the rights of young people in national laws and policies; (b) introduce comprehensive sexuality education in national education curricula; (c) better institutionalize Y-peer as a partner and expand its community-based information and education services on leadership, sexual and reproductive health, HIV and gender; and (d) ensure better data on young people.
Gender. UNFPA assisted the National Commission on Women Affairs and Family Demographic Polciy in the development of conceptual documents on a family-demographic policy in line with the commitments assumed by the country at the International Conference on Population and Development (ICPD); on improvement of the status of disabled persons for subsequent ratification by Kazakhstan of the Convention on the Rights of Persons with Disabilities; National Action Plan on improvement of the status of elderly people in Kazakhstan in accordance with the principles of Madrid International Plan of Action on Ageing and in the development of the Concept of Family and Gender Policy in the Republic of Kazakhstan until 2030. In the 4th Country programme UNFPA activities in the field of gender equality and women’s empowerment employed evidence-based policy dialogue, advocacy and knowledge transfer to (a) develop a new long-term national policy document on gender equality that integrates Universal Periodic Review recommendations and obligations related to sexual and reproductive rights, prevention of gender-based violence and early marriages; (b) strengthen coordinated institutional mechanisms for providing a multisectoral response to gender-based violence; (c) strengthen the partnerships between government, civil society and faith-based organizations to promote gender equality, and prevent gender-based violence and early marriages; and (d) promote gender transformative approaches and engagement of men and boys in addressing gender inequality and gender-based violence.
P&D. The 4th CP focuses on strengthening national policies and international development agendas through integration of evidence-based analysis on population dynamics and their links to sustainable development, sexual and reproductive health and reproductive rights, HIV and gender equality. It is aligned with National development priority, namely: address demographic imbalances; and PFD outcome: right-holders benefit from improved government policymaking and implementation through enhanced participation at subnational and national levels. The planned ● Evidence that interventions in CPAPs ● CPD ● Document analysis interventions adequately reflect the goals stated in the UNFPA ● CPAPs ● Interviews with UNFPA country office staff adequately reflect Strategic Plan ● UNFPA strategic ● Interviews with implementing partners the goals stated in ● Extent to which the reallocation of funds plan ● Interviews/focus group discussions with final beneficiaries the UNFPA Strategic towards new activities is justified ● Country office Plan staff ● Implementing partners ● Final beneficiaries General. The 4th CP is concentrated on (a) supporting advocacy and policy dialogue to ensure the realization of reproductive rights and universal access to integrated maternal, sexual and reproductive health services, with a focus on the most vulnerable; (b)empowering young people and ensuring their access to comprehensive sexuality education; (c) strengthening national policies and institutional mechanisms to promote gender equality and prevent gender-based violence and harmful practices; (d) supporting data collection, access and analysis to inform policies in the area of population dynamics and their links with sexual and reproductive health and reproductive rights.
SHR. The SRH outcomes of the plans and country programs are following:
UNFPA 2014–2017 Strategic Plans Goal: The achievement of universal access to sexual and reproductive health, the realization of reproductive rights, and the reduction in maternal mortality. The work of the organization is centred on attaining this goal, particularly through an enhanced focus on family planning, maternal health, and HIV/AIDS Outcome 1: Increased availability and use of integrated sexual and reproductive health services (including family planning, maternal health and HIV) that are gender-responsive and meet human rights standards for quality of care and equity in access Outcome 2: Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education and sexual and reproductive health services
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UNFPA 2018-2021 Strategic Plans Goal: Achieved universal access to sexual and reproductive health, realized reproductive rights, and reduced maternal mortality to accelerate progress on the International Conference on Population and Development agenda, to improve the lives of adolescents, youth and women, enabled by population dynamics, human rights, and gender equality Outcome 1. Every woman, adolescent and youth everywhere, especially those furthest behind, has utilized integrated sexual and reproductive health services and exercised reproductive rights, free of coercion, discrimination and violence Outcome 2: Every adolescent and youth, in particular adolescent girls, is empowered to have access to sexual and reproductive health and reproductive rights, in all contexts
3rd UNFPA Country Program 2010-2015 Outcome 1 Women and young people, especially those in rural areas and from high-risk groups, have improved access to [reproductive and sexual] health-care services. Outcome 2. Universal access to high-quality sexual and reproductive health services and services to prevent HIV and sexually transmitted infections is ensured for everyone in need, with a focus on vulnerable population groups.
4th UNFPA Country Program 2016-2020 Outcome 1. Increased availability and use of integrated sexual and reproductive health services (including family planning, maternal health and HIV) that are gender-responsive and meet human rights standards for quality of care and equity in access Outcome 2. Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education and sexual and reproductive health
So, the 3rd and 4th Country Programs are completely aligned with the goals of UNFPA 2014–2017 and 2018-2021 Strategic Plans. The 4th CP has more focused on achieving its outcomes through advocacy and policy dialogue. The 4th CP was developed and approved before UNFPA 2018-2021 Strategic Plan. The country office verified that the current 4th CP is inline with the new UNFPA Strategic Plan. Because Kazakhstan is classified by UNFPA as a country with the lowest need and highest ability to finance its own programmatic interventions, UNFPA funds are allowed to be allocated mostly for advocacy, policy dialogue and advice. As a result, some population groups including migrants, disabled persons, and refugees that were defined in the 3rd CP as vulnerable and key populations are not mentioned in the 4th CP.
All SRH planned interventions adequately reflect the goals stated in the UNFPA Strategic Plans with adjustment to the needs of the country. The interventions have aimed to reduce maternal mortality and achieve universal access to sexual and reproductive health (including family planning services), particularly among vulnerable populations (adolescents and youth, women in rural area, persons with disabilities, people living with HIV, sex workers).
Adolescents & Youth. Interventions on adolescents and youth issues reflected the goals stated in the UNFPA Strategic Plans: In 2014-2017 Strategic Plan - women, adolescents and youth are the key beneficiaries of UNFPA work. Goal - the achievement of universal access to sexual and reproductive health, the realization of reproductive rights, and the reduction in maternal mortality. The work of the organization is centred on attaining this goal, particularly through an enhanced focus on family planning, maternal health, and HIV/AIDS. Outcome 1: Increased availability and use of integrated sexual and reproductive health services (including family planning, maternal health and HIV) that are gender-responsive and meet human rights standards for quality of care and equity in access At the country level, UNFPA addresses these challenges primarily through advocacy, policy dialogue/advice, and capacity development, such as by supporting national governments to develop guidelines, protocols, standards, and quality of care mechanisms. All of this work is in the broader context of strengthening national health systems with a view to achieving universal health coverage, and is undertaken jointly with a range of national and international partners. Outcome 2: Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education and sexual and reproductive health services. The second output focuses on comprehensive sexuality education. UNFPA works on ensuring that curricula meet international standards and on training educators who deliver comprehensive sexuality education that promotes respect for gender equality and the rights of adolescents and youth to have control over and decide freely and responsibly on matters related to their sexuality. UNFPA collaborates closely with partners such as UNESCO and UNICEF on these areas. The organization prioritized the most vulnerable and marginalized, particularly adolescent girls and also indigenous people, ethnic minorities, migrants, sex workers, persons living with HIV, and persons with disabilities. UNFPA focused its work to improve their health and their ability to participate in the decision-making process on the issues that affect their lives, whether those decisions are made at the individual, familial, community, or national levels. 87
In Strategic Plan 2018-2121 there are two outcomes aiming at women, adolescent and youth, namely: Outcome 1. Every woman, adolescent and youth everywhere, especially those furthest behind, has utilized integrated sexual and reproductive health services and exercised reproductive rights, free of coercion, discrimination and violence. Outcome 2: Every adolescent and youth, in particular adolescent girls, is empowered to have access to sexual and reproductive health and reproductive rights, in all contexts. Both outcomes are familiar with all interventions under the 4th country program.
So, Adolescents and youth component was not separated in the 3rd Country Program. The 4th Country Program of Adolescent and youth components are completely aligned with the goals of UNFPA 2014–2017 and 2018-2021 Strategic Plans.
Gender. Interventions on gender issues reflected the goals stated in the UNFPA Strategic Plans: UNFPA Strategic Plan for 2008-2011 specified gender-related issues in its goal, namely, Goal 3 stated - Gender equality advanced and women and adolescent girls empowered to exercise their human rights, particularly their reproductive rights, and live free of discrimination and violence. UNFPA has been a constant advocate for gender equality along with other United Nations agencies. Given the centrality of gender to all development policy, UNFPA always a strong advocated and supported for ongoing efforts to ensure system-wide and agency-specific gender-based action consistent with their mandates. Equally, while being a strong voice for gender concerns, UNFPA support gender-based programmes that are consistent with its strategic plan.
In Strategic Plan 2014-2017, Outcome 3: Advanced gender equality, women’s and girls’ empowerment, and reproductive rights, including for the most vulnerable and marginalized women, adolescents and youth. As reflected in the outputs, UNFPA focuses on three elements. The first output pertains to the systems that monitor compliance with human rights obligations and recommendations. The work in this area is primarily advocacy and policy dialogue/advice and capacity development to both promote the establishment and use of these systems, and to assist national authorities to monitor violations of reproductive rights. The second major area of emphasis is gender-based violence and harmful practices such as female genital mutilation/cutting (FGM/C). A particular focus to the integration of gender-based violence (GBV) programming into broader SRH services, including in the context of humanitarian programming. The third output stems from the central role that civil society and faith-based organizations play in promoting reproductive rights and gender equality. UNFPA support civil society and it promoted accountability on these issues, and also ensure that men and boys are engaged for the promotion of gender equality and to address their unique SRH needs
In Strategic Plan 2018-2021, there are two outcomes aiming at women, adolescent and youth, namely: Outcome 1: Every woman, adolescent and youth everywhere, especially those furthest behind, has utilized integrated sexual and reproductive health services and exercised reproductive rights, free of coercion, discrimination and violence. Outcome 2: Every adolescent and youth, in particular adolescent girls, is empowered to have access to sexual and reproductive health and reproductive rights, in all contexts. Therefore, both outcomes are familiar with all interventions under the 4th country program in gender component.
So, the 3rd and 4th Country Programs on gender component is completely aligned with the goals of UNFPA 2008-2011, 2014–2017 and 2018-2021 Strategic Plans.
P&D. Interventions aimed at achieving output 4: Strengthened national data systems and increased availability and accessibility of evidence-based analysis on population dynamics and their links to sustainable development for the formulation of rights-based policies. To achieve it UNFPA uses evidence-based policy dialogue, advocacy and knowledge transfer to (a) strengthen the institutional capacities for demographic analysis and projections as a basis for informed policy formulation and monitoring in the areas of sexual and reproductive health, gender equality and gender-based violence, and population and development inter-linkages, and with regard to the specific needs of vulnerable and key populations; (b) assist in the development of a comprehensive population policy; (c) ensure that the 2020 census is well organized and data are available and accessible; and (d) ensure the development of an integrated system of population registers.
Key informant contributions: ● Yes, as there is lack of state data; ● Interventions were based on needs assessments, studies, discussions with stakeholders and potential beneficiaries, UNFPA CP strategy ● 3 pilots, including but not limited to: ⮚ Educational course of children (EK); ⮚ Gender-based violence study � used as baseline for SDG and government policy;
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⮚ Generation and gender survey.
EQ 2 (Effectiveness): To what extent have the intended programme outputs been achieved? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed Policy and ● Extent to which investments into ● National budget ● Interviews with Ministry of Health other relevant government ministries and institutional reproductive health care and family planning information organizations mechanisms for the services have been increased ● National ● Interviews with WHO and other relevant United Nations agencies improved access of ● Extent to which favorable conditions for disaggregated statistics ● Document review people to integrated the access to reproductive health care and family related to reproductive ● Interviews with (local/national) societies for obstetrics and gynecology high-quality planning services, especially to vulnerable and health ● Interviews with health professionals reproductive and target population have been created ● Reproductive and ● Interviews and focus groups, discussions with service users (and those in the sexual health care ● Evidence that additional national clinical sexual health care strategy community who do not use the services) services with a focus guidelines and standards on sexual and ● Reproductive on more vulnerable reproductive health have been developed and normative tools, guidelines, and target groups implemented strategies have been ● Extent in which developing capacity and ● Training modules strengthened empowering midwives and nurses of obstetrical ● Monitoring reports facilities supports the development of active ● Field visits position of their professional associations ● Final ● Extent in which the national system of beneficiaries/members of confidential enquiries into maternal and perinatal the community (including mortality and morbidity has been strengthened those who use the services ● Evidence that data on the status of and those who do not) reproductive health, needs and services is collected ● Relevant reports ● Extent in which preparedness of the (on SRHR) produced by country to render adequate services to ensure national/international reproductive and sexual health services in women’s rights groups and emergencies has been improved human rights ● Evidence that mechanisms of public- bodies/organizations private partnership in the field of sexual and reproductive health care have been developed SHR. 3rd UNFPA Country Program 2010-2015 Output 1: Maternal health strategies are approved and action plans are developed and implemented Output indicator: ● Percentage of health-care institutions implementing effective perinatal technologies. Target: In line with the long-term programme of health-care development in Kazakhstan up to 2020
Output 2: Health-care providers have the capacity to expand the delivery of high-quality family planning and reproductive health services, with a focus on vulnerable groups, including rural populations and the poor Output indicators: ● Number of trained health-care providers. Target: at least three persons in each health-care institution 89
● Training programme is incorporated into the curricula of all tertiary and secondary medical schools. Target: programme incorporated
Output 3: Women and young people have improved access to high-quality sexual and reproductive health and services to prevent HIV and AIDS Output indicator: ● Percentage of services certified as youth-friendly. Baseline: 0; Target 75
Output 4: Women and young people are equipped with high-quality information to prevent and reduce the risk of unwanted pregnancies and HIV transmission Output indicators: ● Percentage of young people aged 15-24 who are aware of sexual and reproductive health and HIV prevention issues. Baseline: 19 per cent; Target: 50 per cent ● Percentage of regions of the country involved in youth peer network. Baseline: 12, Target: 75
4th UNFPA Country Program 2016-2020 Output 1: Strengthened policy framework and institutional mechanisms to deliver integrated sexual and reproductive health services, with particular focus on the most vulnerable and key populations Output indicators: ● Percentage of health service providers at primary health care and hospital levels practicing the newly adopted clinical protocols and standards Baseline: 0; Target: 60% ● Contraceptives included in the list of basic benefit package for vulnerable and key populations Baseline: No; Target: Yes ● Number of key facilities in all 16 regions of Kazakhstan that use in their routine work the ‘near -miss cases’ review approach of confidential audit ‘beyond the numbers’ Baseline: 11; Target: 32 Output 2. Strengthened national laws, policies and programmes that include adolescent and youth and their human rights and needs. Output indicators: ● United Nations Educational, Scientific and Cultural Organization standards on comprehensive sexuality education are integrated into national standard curricula Baseline: No; Target: Yes ● Percentage of regions of Kazakhstan with Y peer presence Baseline: 25%; Target: 60% ● Existing legislation is revised to decrease age from 18 years to 16 years in receiving sexual and reproductive health services without parental consent Baseline: No; Target: Yes
Achievement of the 3rd CP output indicators was analysed by an external consultant and presented in the ‘Evaluative evidence report’.
Percentage of health-care institutions implementing effective perinatal technologies. Target: In line with the long-term programme of health-care development in Kazakhstan up to 2020. It’s stated that the indicator and its target are not specific enough to be measured and make conclusions.
Number of trained health-care providers. Target: at least three persons in each health-care institution It was difficult to measure due to the uncertain base: in order to determine if the indicator is achieved, there is a need to determine what healthcare institutions have to be considered.
Training programme is incorporated into the curricula of all tertiary and secondary medical schools. Target: programme incorporated There is no evidence that training programme has been incorporated into the curricula of ALL tertiary and secondary medical schools, especially because of autonomy given to educational institutions.
Percentage of services certified as youth-friendly. Baseline: 0; Target 75 Limited information is available regarding the certification process (definition of the "services", definition of ‘youth-friendly’, certification body etc.)
Percentage of young people aged 15-24 who are aware of sexual and reproductive health and HIV prevention issues. Baseline: 19 per cent; Target: 50 per cent We can only guess what definition and source of data should be used to measure the indicator. In addition, the target is very ambitiousюs, because it supposes a dramatic improvement of the knowledge.
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Percentage of regions of the country involved in youth peer network. Baseline: 12, Target: 75. It’s difficult to measure because Y-peer doesn’t have any formal registration in any region of Kazakhstan.
Progress in achievement of the 4th CP output indicators. Percentage of health service providers at primary health care and hospital levels practicing the newly adopted clinical protocols and standards Baseline: 0; Target: 60% Contraceptives included in the list of basic benefit package for vulnerable and key populations Baseline: No; Target: Yes Number of key facilities in all 16 regions of Kazakhstan that use in their routine work the ‘near -miss cases’ review approach of confidential audit ‘beyond the numbers’ Baseline: 11; Target: 32 United Nations Educational, Scientific and Cultural Organization standards on comprehensive sexuality education are integrated into national standard curricula Baseline: No; Target: Yes Percentage of regions of Kazakhstan with Y peer presence Baseline: 25%; Target: 60% Existing legislation is revised to decrease age from 18 years to 16 years in receiving sexual and reproductive health services without parental consent Baseline: No; Target: Yes
Except the last indicator, all indicators don’t have clear definitions allowing to measure outcomes: Percentage of health service providers at primary health care and hospital levels practicing the newly adopted clinical protocols and standards Baseline: 0; Target: 60% It’s unclear which health organizations should be considered as health service providers and what are considered as newly adopted clinical protocols and standards.
Contraceptives included in the list of basic benefit package for vulnerable and key populations Baseline: No; Target: Yes Next year Obligatory Social Medical Insurance will be fully implanted in Kazakhstan. The basic benefit package will only include emergency and treatment of urgent conditions. Contraceptive expenses will be able to be compensated only by Obligatory Social Medical Insurance. Further, vulnerable and key populations are not defined.
Number of key facilities in all 16 regions of Kazakhstan that use in their routine work the ‘near -miss cases’ review approach of confidential audit ‘beyond the numbers’ Baseline: 11; Target: 32 Definition of key facilities is not provided.
United Nations Educational, Scientific and Cultural Organization standards on comprehensive sexuality education are integrated into national standard curricula Baseline: No; Target: Yes National standard curricula are common programmes of study in schools, vocational schools, colleges, and universities. The indicator doesn’t inform which level of education is considered.
Percentage of regions of Kazakhstan with Y peer presence Baseline: 25%; Target: 60% It’s difficult to measure because Y-peer doesn’t have any formal registration.
The main problem with output indicators they is they don’t meet SMART criteria that are originally proposed to set goals and objectives but now are well accepted in M&E147: Specific; Measurable; Achievable and Attributable; Relevant and Realistic; Time-bound, Timely, Trackable, and Targeted.
Document analysis and key informant interviews shows the following achievements:
3rd UNFPA Country Program 2010-2015 Training tools on effective perinatal technologies were developed and was incorporated into curricula of Medical University and Medical College of Semei. Republican Centre for Obstetrics, Gynecology and Perinatology was identified as an organization that took accountability for implementation of effective perinatal and antenatal technologies in the country. The assessment of the progress in evidence-based perinatal technologies implementation was performed and disseminated. Effective perinatal technologies were implemented in five regions of the country through replication of effective pilot experience earlier received in Southern Kazakhstan Oblast. Reports on government’s response to the population needs in family planning and access of law enforcement officers to reproductive health were developed, discussed, and passed to the
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government National Healthcare Development Program 2011-2015 «SALAMATTY KAZAKHSTAN» was issued. One of its goals was maternity mortality reduction (by 2013 to 28,1, by 2015 – to 24,5 per 100,000 live births). This goal was planned to be achieved by implementation and expansion safe motherhood, making pregnancy safer, effective perinatal technologies. These technologies were jointly introduced and supported by UNFPA, UNICEF and WHO. In 2013, national surveys of sex workers and people living with HIV supported by UNFPA was conducted to measure access to SRH and family planning services in these population groups. Baseline assessment of effective perinatal technologies implementation was conducted and disseminated. Postpartum/post abortion clinical protocols and National Guideline on Family Planning were developed. A model of perinatal care quality management at the facility levels was piloted in Mother and Child Centre of Ust-Kamenogorsk and Perinatal Centre of Semey City. Austrian certifying body confirmed ISO 9001 certification of these centres. After quality assessment, the hospital-based near-miss case review (NMCR) developed by WHO and supported by UNFPA was recommended to scale-up to all regional perinatal centres. An Action Plan on introduction of Minimum initial service package for sexual and reproductive health in disasters (MISP) into the National Emergency Preparedness Plan was developed and agreed with respective stakeholders. Good results of Confidential Enquiry into Maternal Deaths (CEMD) were recognized by the Ministry of Health as an effective and useful tool for improvement of quality of care that lead to a decision in initiation of perinatal deaths auditing (Confidential Enquiry into Perinatal Deaths – CEPD) in 2016. A Contraceptive market segmentation analysis was conducted and its results were submitted to the Ministry of Health. Training package materials for Family Planning services at the primary health care levels were developed and piloted. The training package utilized the advanced teaching technology for effective adults learning and contained the latest WHO recommendations on Family Planning. Partnership between UNFPA and leading faith-based organizations (Sunni Islam and Orthodox Christianity) on issues of reproductive health and family planning was established. FBOs’ representatives were educated on human rights, maternal and reproductive health, prevention of GBV and harmful practices. They recognized importance of these issues for their parishioners and wished to introduce a special teaching course into the educational curricula in madrassas and seminaries.
4th UNFPA Country Program 2016-2020 Based on CEMD experience and lessons learnt, Confidential Enquiry into Perinatal Deaths (CEPD) methodology, tools, and instructions were developed with UNFPA technical support. CEPD regulations were endorsed by the Ministry of Health. To ensure the sustainability and to increase the efficiency of CEMD and NMCR, Ministry of Health issued an Order (Prikaz) appointing Republican Centre for Healthcare System Development (RCHD) as a new coordination body and introduced two supporting mechanisms, namely 1) financial stimulation of national experts who conduct reviews and 2) implementations of CEMD and NMCR as facility accreditation requirements. National working group developed Kazakhstan Family Planning National Framework Program for 2017-2021 with UNFPA technical support. Respective Action Plan was integrated into the Road Map of the State Healthcare Development Programme. National standards for maternal and neonatal care in health facilities starting from the first level of care (PHC and first-level hospitals) were developed based on European standards for maternity care recommended by UNFPA. The Standards cover the spectrum: from pre-pregnancy services to postnatal services including care of newborns. National experts assisted by UNFPA conducted perinatal care assessments in three regions of Kazakhstan. The results leaded to adjustment of the effective perinatal care training course. Economic Analyses for Governmental Investment in Oral Contraceptives (OC) in Kazakhstan were conducted in 2016 and 2017. The latter analysis was focused on youth aged 15-19. It was demonstrated that an intervention to increase uptake of oral contraceptives among girls aged 15-19 by providing oral contraception free of charge could generate direct benefits for the state budget by decreasing expenses associated with abortions and unintended pregnancies. Virtual Contraceptive Consultation (VIC), a distance learning platform on Family Planning, was translated into Kazakh. VIC is intended for family planning providers (primary health care physicians, obstetricians and gynecologists) who manage family planning clients and work in the EECA region. VIC courses were integrated into curricula of post-graduate training at the Kazakh Medical Post- Graduate University.
National Guideline on Quality Assurance (QA) and Monitoring and Evaluation (M&E) tools for Youth Friendly Services (YFS) was developed, piloted and revised. A youth-friendly health centre opened in Almaty. The centre, supported by the Ministry of Healthcare, the Almaty city administration and the United Nations Population Fund (UNFPA), offers the services of gynecologist, anthologist, psychologist, social worker and other experts. It is positioned as a centre of excellence on adolescent and youth health. CEMD revealed that the proportion of maternity deaths due to the two main causes, obstetric hemorrhages and severe pre-eclampsia, significantly declined because of improved perinatal care. 92
Under these circumstances, sepsis caused by hospital-acquired infections (HAI) became an urgent issue. UNFPA was requested by MoH to address HAI at perinatal care facilities. UNFPA (a) mobilized international expertise, (b) conducted infection control assessment, (c) conducted training for multidisciplinary teams (clinicians, epidemiologists, microbiologists) to respond to identified gaps, (d) supported the development of Action Plan. This methodological approach demonstrated high effectiveness and is planned to be expanded by MoH on the national level.
At the same time the following challenges were identified: Reduced financial resources were available for implementing the programs. The 3rd CP 2010-2015 (6-year) program planned to spend 7.7 million US dollars, including 4.2 million for Reproductive health and rights. In fact, 4.7 million USD were spent, including 2.9 million for Reproductive health and rights. For 4th 2016-2020 (5-year) program, 3.75 million USD were planned (Reproductive health and rights - 2.05 million USD). Over three years (2016-2018), 2.065 million USD were spent, including 0.8 million USD for Reproductive health and rights (note: Coordination and assistance is considered in the 4th CP as a separate budget category, its expenses for 2016-2018 were 0.17 million USD). This indicates the annual Reproductive health and rights expenses in 2016-2018 have been reduced to two-thirds of their annual amount spent in 2010-2015. As a result, less funds were available for technical assistance including piloting interventions, conducting research for making evidence-based decisions, and hiring foreign and national consultants.
3rd and 4th CPs don’t have clear and feasible monitoring and evaluation plans. The 3rd UNFPA CP has element of an M&E plan - outcome and output indicators. However, reaching the specific values of targets depended not only on UNFPA, but on other stakeholders, especially the government, i.e. the indicators were not enough specific to show the UNFPA performance. In addition, there aren’t precise definitions of the indicators, how and when they should be measured, who collect data, and what resources needed for M&E activities. The 4th UNFPA CP contains output indicators that aim to measure the UNFPA performance rather than partners’ achievements. Yet these indicators still have similar limitations: unclear or imprecise definitions, unknown source of data, big number of qualitative (yes/no) indicators. For example, a value of the output indicator ‘Percentage of health service providers at primary health care and hospital levels practicing the newly adopted clinical protocols and standards’ depends on how numerator and denominator are defined, especially what we consider under 'the newly adopted clinical protocols and standards ’.
Effectiveness of advocacy, policy dialogue and advice largely depends on willingness and readiness of the government to make changes in specific areas. The government is keen to reduce maternal mortality. Therefore, UNFPA suggestions and initiatives are met very positive and supporting feedback from the government. On other hand, UNFPA initiatives in family planning, e.g. providing free modern contraceptives for vulnerable populations or decreasing the age since which adolescents can get SRH services without parental consent, are not so attractive for the government why they require much more time to overcome resistance.
Cooperation between UN organizations has became enormously important when greater support is provided in policy and advocacy rather than in service delivery, what is relevant for Kazakhstan. UNFPA and UNICEF have supported effective youth-friendly services with focus on SRH and suicide prevention, respectively. Two models of service delivery have been piloted in different facilities –at youth-friendly health centre and at one of PHC centres (polyclinics). Because both models have the same target group – adolescents and youth, it would be reasonable to explore possibility to create and test one comprehensive model of youth-friendly services.
Effective advocacy should consist of complex solutions based on comprehensive analyses that take into account not only professional aspects, but economy, public relations etc. It is a common practice in Kazakhstani where all innovations requiring additional investments should be justified by economical analysis and approved by the ministry of national economic in addition to a profile ministry. Absence of economic considerations that should ideally include cost-benefit or cost-effectiveness analysis delays government’s decisions to embody innovations.
National legislation, ● Evidence that reproductive rights of ● Strategy and ● Document review policy and programs adolescents and young people, in particular, access protocols ● Interviews with MOPH and other relevant government ministries allowing for the of adolescents and young people to sexual and ● Monitoring reports ● Interviews with UNICEF and WHO and other relevant United Nations agencies rights and needs of reproductive health care services and relevant ● Developed ● Health professional interview young people and information /education are in place curriculum ● FGD with diverse groups of young people youths have been ● Extent in which comprehensive SRH ● Field visits ● Interviews with peer educators strengthened education has been incorporated in the national ● Consultation ● Teachers interview formal education system; meeting minutes ● Meeting with implementing partners ● Extent in which the national Y-Peer ● Operational study ● Meeting with school health educators
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network has been expanded to make it a reliable by universities partner of the government in providing ● Policy briefs adolescents and young people on the local level with information and education on leadership, sexual and reproductive health and gender equality ● Evidence on the needs of adolescents and young people is available Adolescents, youth: 4th UNFPA Country Program 2016-2020 Output 2. Strengthened national laws, policies and programmes that include adolescent and youth and their human rights and needs
Indicator 1: United Nations Educational, Scientific and Cultural Organization standards on comprehensive sexuality education are integrated into national standard curricula ● Existing “Valeology” course for students of the colleges, modified by national consultants and strengthened with SRH component, successfully piloted in 2015 in selected colleges of Eastern Kazakhstan. Colleges’ teachers in the region were trained through ToT trainings. Therefore, the Valeology Course is integrated into the curricula of colleges in Eastern Kazakhstan region and being taught in all colleges of the region. In 2016, 35 000 students received education on SRH protection. ● Successful experience on piloting of sexuality education in Eastern Kazakhstan was presented to government during several national and regional advocacy events, including conferences, round tables with policy and decision makers (members of Parliament, specialists of ministries and academia experts), and workshops for secondary schools’ directors and parents' associations, training for journalists and lectures for colleges’ students. ● More than 30 policy and decision makers (MPs, Ministry of Health and Social Development, Ministry of Education and Science, Heads of 14 vocational regional education units, the National Academy of education) were sensitized through advocacy workshop on successful experience on piloting of sexuality education in Eastern Kazakhstan and agreed on the necessity of introduction of sexuality education into the vocational education system. This was conducted under the leadership of the National Commission for Women Affairs and Family and Demographic Policy under the President of the Republic of Kazakhstan. ● To verify the effectiveness of the training courses sociological researches were conducted in 3 regions - including pre and post-test assessment of students' knowledge on SRH. The resulting respective analytical reports (for each region) demonstrated high effectiveness of sexuality education in raising awareness on SRH issues among students ● Awareness of more than 50 representatives of decision and policy makers and representatives of media were raised about the high effectiveness of Sexuality Education in improving the students’ knowledge on SRH and safe behavior and the importance of ensuring access of young people to quality SRH services and contraceptives through advocacy and communication events. ● UNFPA used the platform of an International Conference "Child Friendly Kazakhstan" organized by the National Child Ombudsman and UNICEF to bring to policy and decision makers' attention which problems adolescents face and how often these relate to their RH status and what adults should do to ensure the realization of their Reproductive Rights. ● UNFPA supported two back to back training courses for teachers of colleges and one in depth training for trainers in order to create pool of trainers capable to provide back to back trainings for their peers in Turkestan region. ● UNFPA identified the need for development of Methodological and Teaching complex for Valeology course with enhanced reproductive health component, consisting of 3 parts: teaching program, methodological guidelines for teachers and a course book for students and supported the development of such methodological and teaching complex for further submission to the Ministry of Education and science of Kazakhstan for introduction in the technical and vocational education system of the country. ● UNFPA supported conducting a survey of adolescents’ SRH status and sexual behavior among YP aged 15-19. The results of the survey show that the situation of sexual and reproductive health awareness among young people aged 15-19 is extremely critical, and if action is not taken, it is likely that such low awareness will lead in the future to high-risk behavior.
Indicator 2: Percentage of regions of Kazakhstan with Y-peer presence UNFPA concentrated important efforts in the actions related to adolescents and youth component. Significant results were achieved the field of reproductive rights for young people, improved access to information, empowerment and leadership of young peple. Nevertheless, confronted with the planned targets, there are some outputs which could not be fully achieved. The CP intention was to extent the YPEER network to a stage when it covers 60% of the country’s regions. Until 2019 – 47% (8 out of 17 regions) of the target value was achieved, Y-PEER networks being established in some Oblasts: Akmola, Aktobe, East Kazakhstan, Kyzylorda, Mangystau, Turkestan, Almaty Oblast, Almaty and Astana. Despite there are issues related with ownership and leadership of the networks.
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● Y-PEER network successfully expanded in Mangystau region, three resource centers are fully furnished and equipped in Aktau and Zhanaozen cities’ colleges and in Beineu youth center. The three days training were conducted in Kazakh language for young local activists of Aktau and Zhanaozen cities. Young people had been certified as YPEER trainers. ● Two ToT courses in Russian were conducted in Almaty for 30 participants, as the result two of newly trained Y-PEER activists participated in PETRI School in Sofia, Bulgaria on project management and implementation who were certified as International trainers. ● Y-PEER activists of Kyzylorda region and Shymkent provided to adolescents and young people with quality information on Reproductive health issues through trainings, mini sessions and discussions. ● In the frameworks of 16 days of activism against gender based violence campaign, Y-PEER volunteers jointly with local authorities and Women’s league for creative initiatives NGO conducted mini sessions on gender issues and prevention of violence for 10 secondary schools. In total more than 500 students were sensitized. ● The events ranged from providing trainings courses, organizing public events dedicated to UN celebrations, such as World Population Day, World AIDS Day, International Volunteer Day up to holding a special event during the EXPO-2017 “Youth and the Energy of the Future”. ● UNFPA provided support to organizing and holding a Y-Peer Summer School in Aktau with involvement of Y-Peer volunteers from all parts of the country where Y-Peer was established. UNFPA support TOTs for Y-PEER network in Aktobe and Mangistau. ● In 2018, Y-PEER Annual Summer Leadership School for youth and adolescents was successfully held in Turkestan region. 40 participants aged 12-20 representing different parts of Kazakhstan, including Shymkent, Turkestan, Kazygurt and Aktobe.
Indicator 3. Existing legislation is revised to decrease age from 18 years to 16 years in receiving sexual and reproductive health services without parental consent ● Decreasing the age of voluntary agreement for healthcare services without parental consent from the age of 18 to the 16 years of old was included in the Health Code on Health of the Population and the Healthcare System of the Republic of Kazakhstan. The amended Health Code was agreed within the Ministry of Health and will be further widely discussed with public and civil society and then will be send to the Parliament for approval before end of 2019.
National policy and ● Development of a new long-term ● UNFPA assistant ● Document review and analysis institutional national policy document on gender equality to representative ● Group meetings with NCFWC, NGOs, oncerned municipalities (women’s units) mechanisms for incorporate recommendations of the universal ● UNFPA gender ● Interviews with UNFPA gender focal points promotion of gender periodic review and define obligations of the focal point and/or team ● Interviews with government implementing partners equality and country with regard to reproductive rights of working on gender equality ● FGD/Interviews with diverse groups of organizations – including implementing prevention of people of Kazakhstan with a focus on vulnerable ● Parliamentary partners gender-based groups, including adolescents and young people, Committee violence and improvement of access to SRH services and ● MoH damaging practices appropriate information, prevention of gender-● MoSE /customs have been based violence and early/forced marriages ● Ministry if Internal strengthened ● Strengthening coordinated institutional Affaires mechanisms to ensure inter-sector response to ● NCFWC gender-based violence ● Relevant NGOs ● Strengthening partner relationships of ● Relevant government, civil society and religious implementing partners organizations in order to facilitate gender equality ● Gender focal and prevent gender-based violence and points in concerned early/forced marriages ministries and municipalities ● Promoting approaches to change gender relations and engage men and boys into solving problems of gender inequality and gender-based violence
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● National Commission for Families, Women and children (NCFWC) members trained in life skills Gender. Output 1. The action plan of the gender equality strategy reaches a greater number of women and is fully implemented
Indicator 1: Gender equality law and domestic violence law are adopted. ● A responsible attitude towards the development of gender equality is observed at the highest level of the state apparatus of Kazakhstan. Among the key achievements, the adoption of two important laws can be singled out: the Law on State Guarantees of Equal Rights and Opportunities of Men and Women, the Law on Prevention of Domestic Violence in 2009, as well as the adoption of the National Strategy for Gender Equality for 2006 –2016. There have also been important shifts in the participation of women in the socio-political life of Kazakhstan, however, women are still not well represented in key political posts. Currently, in the Parliament the proportion of women is 27.1% in the Mazhilis and 6.38% are in the Senate (3 out of 47)148. Nevertheless, according to experts, many of the planned elements of the Gender Equality Strategy for 2006-2016 were only partially implemented, which was often due to the uneven implementation of indicators and the lack of government capacity to evaluate the results of work to ensure gender equality. ● Representatives of Kazakhstani government and civil society strengthened on issues related to prevention of violence against adolescent girls, early and forced marriages and protection of human rights in the course of ICPD PA and MDGs progress in CA countries by conduction of international conference in Kazakhstan technically and financially supported by UNFPA in 2013. ● The conference was led by the National Commission on women affairs and family-demographic policy under the President of the Republic of Kazakhstan and the government was represented by concerned ministries and agencies and the Committee of Child rights protection of the Republic of Kazakhstan. ● UNFPA initiated development of national protocols on sexual violence. Draft protocol was discussed by working group with participation of the Ministry of Health, Center for Forensic Medicine, Republican Center for Healthcare Development, Republican AIDS Center, National Institute on Traumatology, National Center for Obstetrics, Gynecology and Perinatology, professional lawyers and NGOs. Finalized protocols presented to Government at the beginning of 2014. ● UNFPA initiated and supported, both technically and financially, a Survey “Gender Based Violence prevalence in Kazakhstan and its impact on Sexual and Reproductive Health of GBV victims”. The survey methodology foresees in-depth interviews with 20 medical experts who work with GBV victims on regular basis and face-to-face interview of 200 clients of traumatology centres and gynecological clinics who might be considered as GBV and sexual violence victims. The final analytical report presented in the beginning of 2014 at a National Event. ● UNFPA supported the National Commission on Women Affairs and Family-Demographic Policy under the President of the Republic of Kazakhstan jointly with ADB, NGO “Women’s League of Creative Initiatives” (WLCI), SOROS Foundation and Friedrich Ebert Foundation the International Conference on Prevention of Violence against Adolescent Girls, Early and Forced Marriages in countries of Central Asian and Caucasus within Millennium Development Goals. The conference participants developed and agreed on Recommendation to the countries of Central Asia and Caucasus on activities to prevent such harmful practices149. ● The IEC materials developed for followers of Sunni Islam and Orthodox Christianity includes information on prevention of Early Marriage, Early Pregnancy and GBV. ● With technical assistance of UNFPA the National Strategy on Gender Equality up to 2016 was developed and adopted by the Government. ● UNFPA is seen in the country as the agency as the one which strongly stands for rights of women and adolescent girls. Therefore the National Commission of Women Affairs and family- demographic policy under the President of the Republic of Kazakhstan strongly considers UNFPA’s presence in all national events on gender equality issues. ● Translation of Valeology manual to Kazakh language to cover both Kazakh and Russian speaking students. ● Report on implementation of CEDAW in Kazakhstan was presented at the 57th CEDAW (Combined third and fourth periodic reports) session on 13-15 February 2014 in Geneva, Switzerland by the Government and national NGO for which UNFPA provided support (technical and financial) to one of the Kazakh delegate (NGO representative). ● UNFPA together with the Statistics Committee conducted the first in Kazakhstan national research on prevalence of violence against women in 2015 and analysis of the data collected during the research for submission to the Government of evidence-based data for the development of effective policies in gender-based violence prevention and response. In total, 14,342 women participated in the quantitative survey. The survey was conducted in four regions: Akmola, Mangistau, South Kazakhstan and in Astana. The quantitative survey was planned as an interview of women of respective age (18-75 years of age) who were selected randomly. Women were asked questions on whether they experienced violence or abusive treatment, as well as a number of other questions about their health and events in their lives, about their current or past partner.
148 Inter-Parliamentary Union, http://www.ipu.org/wmn-e/arc/classif010514.htm, 2019 149 http://ru.soros.kz/press_center/press_releases/child_marriage 96
● UNFPA organized the first national research on the “Generations and Gender” program that is the first research in the Central Asian region, too. It improved understanding of demographic and social development of the country and factors determining it; identify and explain the reasons of demographic trends; determine necessary support for families to have a desired number of children and strengthen intergenerational relations; effectively support the quality of elderly people’s life; and determine the factors affecting the demographic behavior of people, including migration processes. ● Findings of the survey on access to reproductive health services (2011) allowed conducting an advocacy campaign. In 2012, state social contracting was opened on lot “Reproductive Health of Women with Disabilities” that resulted, in the minister’s opinion, in reduction of a number of complaints in 2013.
Challenges The main constrain was lack of interest of Ministry of Healthcare to insure reproductive health commodity security in the country including supply for all the people in need with contraceptives. One- year ahead-of-schedule and unexpected dissolve of Mazhilis (lower house of Parliament) made the involvement of influential members of National Commission for Human Affairs and Family- Demographical Policy in discussions impossible. The legislation environment in the country is not conducive to universal access of the population to family planning. Young people under 18 have no legal capacities to seek for family planning without consent of their parents or legal guardians; importing of contraceptives with marking and packages not registered by Ministry of Healthcare including as humanitarian needs is strictly prohibited by the law regardless of sizes of unmet needs to family planning; availability of contraceptives at pharmaceutical market is fully dependent on decisions of private entrepreneurs to sell contraceptives; no legal mechanisms to insure availability of contraceptives for free or at reduced costs at least to vulnerable population groups are in place; the policy of the government is patarnatalistic.
4th UNFPA Country Program 2016-2020 Gender: Output 3. Strengthened national laws, policies and programmes to prevent gender-based violence and harmful practices
Indicator 1: New long-term national policy document on gender equality that integrates UPR recommendations and obligations related to sexual and reproductive rights, prevention of gender- based violence and early marriages ● A new National document - The “Concept of Family and Gender Policy till 2030” was developed, thoroughly discussed at different levels and approved by the Government’s Decree 384 of 6 December 2016. In partnership with Parliament, government, CSOs, FBOs and UNCT, UNFPA actively participated in the development of the document and ensured ICPD Agenda, UPR recommendations and obligations on SRHR and prevention of GBV and early/forced marriages are reflected in the Final Document and its Action Plan. ● Models of multi-sectorial response to gender-based violence (MSR to GBV) based on the Global Essential Services Package (ESPs) and Standard Operating Procedures (SOPs) for frontline services, such as health, psychosocial and police sectors were shared with the technical level government representatives of the Ministry of Health and Social Development, the Ministry of Interior, the General Prosecutor Office) and the experience of Eastern Europe on identification of GBV survivors, documenting, registration and reference of violence survivors to other services/sectors was presented.
● Indicator 2: Regional UNFPA guidelines are integrated into the national health system response to gender-based violence ● UNFPA supported the piloting of the system of multi-sectoral response to domestic violence in the South Kazakhstan region and the testing of standard operating procedures (SOPs) on provision of basic services to GBV survivors by specialists of health, social support and police sectors. ● UNFPA provides technical support to the Government of Kazakhstan in developing mechanisms of interdepartmental response to gender-based violence provided by the Concept of Family and Gender Policy until 2030 led by the National Commission on Women Affairs and Family Demographic Policy under the President of the Republic of Kazakhstan and “Kazakhstan without Family Violence” Program initiated by the Prosecutor General’s Office of the Republic of Kazakhstan.
● Indicator 3. Number of civil society and faith-based organizations that have supported the institutionalization of programmes to engage men and boys on gender equality (including gender-based violence), sexual and reproductive health and reproductive rights ● The General Prosecutor Office initiated a new National Programme “Kazakhstan Without Violence in a Family” where one of the main priorities is the establishment of MSR to GBV. Regional FBOs of Islam and Orthodox Christianity are willing to collaborate with government on the promotion of maternal and reproductive health, gender equality, combating GBV and prevention of early/forced marriages. 97
● UNFPA provided technical assistance to FBOs on development of Educational course on MH, SRH and GBV for theological institutions of Orthodox Christianity and Islam communities in Kazakhstan. ● Within the framework of the global campaign of 16 days without violence, UNFPA supported TEDxAbayStWomen conference devoted to Gender issues.
Challenges The new Concept on Family and Gender Policy till 2030 was approved by the Government but a challenge remains as to ensure proper and adequate implementation and funding both from national and regional levels. Those areas promoted by UNFPA, such as introduction of sexuality education into formal education, universal access to quality family planning services and counseling and purchasing of contraceptives for vulnerable groups of population should be considered by the Government as priority areas and to be closely monitored.
Adoption of the Standard Operating Procedures (SOPs) on the provision of services for GBV survivors by health, psychosocial and police sectors (SOPs) in Kazakhstan requires development of protocols and regulations with detailed description of steps, procedures and functions, which are very specific in each related sector. Therefore, for proper adoption of SOPs into the practice of these sectors, there is a need to develop comprehensive operational documents with regulations and procedures to be approved by the related ministries, which would need to be applied by service providers. It is a long enough process that requires a participatory approach involving all related ministries and significant resources.
National data ● Strengthening institutional capacity in ● UNFPA P&D ● Annual reports from MoNE, MoH, need assessment, evaluation and monitoring reports systems and demographic analysis and population projections section CPAPs ● Planning and programming documents issued during the reference period improved access and as the basis for sound development and ● P&D project ● Inputs to and deliverables of the information systems availability of monitoring of policy in the fields of sexual and reports ● Interviews with ministries, and municipalities staff to review the implementation evidence-based reproductive health care, gender equality and ● Ministry of modalities of P&D component and achievements analysis of gender-based violence, linkage of population and National Economy staff and ● FGD/interviews with diverse groups of implementing partners working with population flows and development considering for particular needs of publications communities linkage to vulnerable and target population; ● MoH staff sustainable ● Evidence that comprehensive population ● United Nations development for policy has been developed Statistics Task Force terms of policy-making based ● Evidence for measures to undertake well-reference on protection of organized census in 2020 and to ensure availability ● Implementing human rights have of census data for users at different levels partners working at the strengthened ● Comprehensive system of population state/district/community registries has been developed level P&D. The 3rd CP outputs were as follows: ● Output 1: Policymakers employ evidence-based data to develop policies on gender equality, young people, sexual and reproductive health, and HIV and AIDS; ● Output 2: Social-sector stakeholders are better able to plan, implement and monitor social and health services for the elderly, migrants and people with disabilities.
● The 4th CO output was formulated as follows: ● Output 4: Strengthened national data systems and increased availability and accessibility of evidence-based analysis on population dynamics and their links to sustainable development for the formulation of rights-based policies.
Document analysis and interviews with key informants show that there were two output indicators for the 3rd CP and three indicators for the 4th CP. The following outputs indicators for the 3rd country programme were achieved. Out of five social policy documents that accurately reflect population issues the following were developed, namely:
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1. Through conducted rapid assessment of demographic situation in former nuclear testing site of Semipalatinsk region, data on population analyzed and used to develop Joint UN-Government of Kazakhstan programme on raising competitiveness of the Semipalatinsk region through innovative approaches to regional planning and social services (2010); 2. The National Plan of Actions addressing challenges of the aged population was drafted in compliance with ICPD commitments and Madrid International Plan of Action on Ageing and in line with adapted national requirements and regulations. The document discussed and agreed by the high level meeting with national stakeholders to present to the Government (2010); 3. In 2010 UNFPA provided the technical support to government to sensitize national decision and policy makers on the issues of people with disabilities and obtaining data for improving policies for disabled persons - surveys arrangement, data gathering, analysis and dissemination of information on status of disabled people. UNFPA assisted the National Commission on Women affairs and Family-demographic policy on advocacy and building knowledge on disability issues by assisting in data collection of the status of disabled people gathered through conducted desk-review and national quantitative survey on status of sight-disabled and hard of hearing people. 2 analytical reports based on the assessment were prepared for improvement of policies for disabled persons. Desk reviews on the status of sexual and reproductive health of people with disabilities caused by damages of mental sphere and locomotors apparatus and its social determinants was also developed by national consultants mobilized by UNFPA. Those interventions contributed to formulating National plan of action on supporting disabled person. 4. Poverty linked issues of vulnerable population groups: women-labor migrants, aged people, people with disabilities, were indicated in 1-st chapter of MDG-2010 report. Development of chapter on Goal 1 is supported by PD component of UNFPA Kazakhstan (2010). 5. In 2011 UNFPA supported the Agency on Statistics on 2009 census data analysis and dissemination of census results through the technical assistance provided to the Agency on development of analytical report on 2009 census data and it's dissemination in Russian, Kazakh and English languages. The Agency on Statistics-led analytical report on the 2009 census developed through recruiting by UNFPA of national consultant to draft the document, coordinate its development, facilitate its discussion and reach consensus-based approval by the Agency on Statistics chaired national meeting. Analytical report disseminated in December 2011. UNFPA supported its dissemination through provided translation of the report into the Kazakh and English languages and production of CDs with electronic version of analytical report in three languages. Indicators to measure sexual and reproductive health, family planning issues, GBV and HIV/AIDS at national and sub- national levels measured by MICS were included to the report. 6. In 2012 UNFPA participated in drafting and providing technical assistance to development of the State Programme of Development of Healthcare in the Republic of Kazakhstan for 2011- 2015. Out od three comprehensive analytical studies on emerging population issues the following were conducted, namely: 1. The 2010 second national Multi-indicator cluster survey (MICS) included indicators on Reproductive Health, unmet needs in family planning, the rate of abortions and module on Gender based Violence; 2. The 2010 rapid assessment of demographic situation in Semipalatinsk region and needs on improvement of region’s population statistics; 3. 2010 UNFPA provided the technical support to government to sensitize national decision and policy makers on the issues of people with disabilities and obtaining data for improving policies for disabled persons - surveys arrangement, data gathering, analysis and dissemination of information on status of disabled people. In 2010/11 UNFPA assisted the National Commission on Women affairs and Family-demographic policy on advocacy and building knowledge on disability issues. By provided technical support data on the status of disabled people gathered through conducted desk- review on their issues and national quantitative survey on status of sight-disabled and hard of hearing people. Family planning and SRH issues of disabled people have been investigated by conduction of desk review and quantitative surveys with involvement of the national expert from the NGO of disabled persons, who is closely familiar with the issue and specialist of the Republican Center of psychiatry and psychotherapy. This circumstance benefited the content and findings of the reports objectively reflecting mentioned issues of disabled people and follow up actions required. 4. In 2012 the first sociological survey on the SRH status of adolescents and young people of 15-19 years was conducted with UNFPA technical support which covered a number of the cities and rural settlements of Kazakhstan and allowed to provide quantitative assessment to the corresponding indicators. In 2012 analytical report on results of the survey was developed that presented indicators disaggregated by age and the place of residence (rural/urban.) 5. For the Country Programme document on 2016-2020, UNFPA CO conducted the Country Situation Analysis which includes data on population dynamics, Maternal health, SRH of adolescents, young people and vulnerable and key population groups, HIV, Gender equality and GBV issues. The CSA document identified priorities for policies and development programmes. The document was employed by UNCT while working on PFD formulation. 6. In 2015 the first national survey on domestic violence was conducted against the state budget. UNFPA provided technical assistance to the Committee on Statistics on questionnaire development and methodology of the survey as well as supported capacity building of the Committee on design of sampling, development of the data entry and data processing software through funding the participation of a specialist of the Committee on Statistics at the training on methodology of survey held in Moldova. 7. In 2015 the access of migrants in Kazakhstan to maternal, sexual and reproductive health, family planning and prevention of STI/HIV services and information assessed and findings presented to the Government.
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The status of the achievement of three output indicators for the 4th country programme is as follows: Output indicator - 2016: Multiple indicator cluster survey is completed; data are available and accessible was achieved and national data on SRH, FP, HIV, early marriage collected through 2015 Multiple indicator Cluster Survey (MICS). The Final MICS report was produced in Russian and translated into English and Kazakh. The MICS findings were presented to the Government on 23 November 2016. Output indicator - 2020: Population and housing census is completed; data are available and accessible is not achieved yet, but the following preparation activities were conducted: ● Before a Pilot Census planned in 2018 UNFPA international consultant (Mr. Etienne de Fortier from Geospace International, Johannesburg) conducted an assessment of the Committee on Statistics needs for the use of Geographic Information System (GIS) in the 2020 Population Census. UNFPA facilitated consultancies on GIS introduction and further cooperation on mapping to the Committee on Statistics and the Space System Center of the National Company “Kazakhstan Garysh Sapary”. UNFPA supported the development of the Road Map on GIS introduction that includes short and long-term goals and required external assistance. ● Digital maps produced on two regions for pilot census in 2018 (Burabai and Zyrian raions) ● Professionals of the Committee on Statistics (CoS) trained on methodological issues of population and housing census within the frame of 2020 round (1 specialist - at the UNECE Workshop in Geneva, 4 - at CoS internal training) ● Specialists of the Committee on Statistics are trained on theoretical and practical aspects of Geographical Informational System (GIS) application for electronic/digital mapping for census and geo-referral Population register ● Pilot Census was completed and results analyzed in preparation of 2019 Census and Statistical Office updated with the latest Census standards and technology
Indicator: National integrated system of population registers is in place that provides inter-alia information on vulnerable population groups. So far national integrated system of population registers is not in place. Within this output first national survey on domestic violence (DVS) in Kazakhstan was conducted in 2016. Data on domestic violence prevalence was collected, processed and analyzed. UNFPA provided technical support to the Committee on Statistics on analysis of the data and dissemination of the survey results. Preliminary Report was presented to Government on 29 November 2016.
Indicator: National family and demographic policy document that integrates population projections, reproductive health and rights, and gender equality is developed. ● In 2018 Concept of Family and Gender was approved. ● The report on 2016 national survey on Domestic Violence is finalized and its results presented to Government for formulation of policies addressing Gender based Violence; ● The Population Situation Analysis (PSA) on South Kazakhstan Oblast (SKO) is conducted ● The first wave of Generations and Gender Survey is conducted and data collected EQ 3 (Effectiveness): To what extent did the outputs contribute to the achievement of the planned outcomes (i. increased utilization of integrated SRH Services by those furthest behind, ii. increased the access of young people to quality SRH services and sexuality education, iii. mainstreaming of provisions to advance gender equality, and iv. developing of evidence-based national population policies) and what was the degree of achievement of the outcomes? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed Utilization of ● Maternal mortality ratio ● Reports Document review integrated SRH ● Proportion of birth attended by skilled ● MICS Services has been health personnel for the poorest quintile of the ● Surveys increased by those population ● Operational furthest behind ● Proportion of demand for modern studies contraception satisfied ● HIV surveillance ● HIV prevalence data ● Papers SRH.
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Outcome: Women and young people, especially those in rural areas and from high-risk groups, have improved access to health-care services Outcome indicator: ● Percentage of rural and urban population covered by high-quality maternal and child health services Target: 25 per cent against the baseline ● Percentage of sexually active women aged 15-49 using modern contraceptive methods. Baseline: 49 per cent; Target: 75 per cent ● Outcome: Universal access to high-quality sexual and reproductive health services and services to prevent HIV and sexually transmitted infections is ensured for everyone in need, with a focus on vulnerable population groups ● Outcome indicator: ● Births by girls aged 16-18. Baseline: 22 per 1,000; Target: 15 per 1,000
4th CP Outcome 1: Sexual and reproductive health Increased availability and use of integrated sexual and reproductive health services (including family planning, maternal health and HIV) that are gender - responsive and meet human rights standards for quality of care and equity in access Outcome indicator: Contraceptive prevalence rate (total) Baseline: 51%; Target: 70% Outcome 2: Adolescents and youth Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education and sexual and reproductive health Outcome indicator: Percentage of young women aged 15-24 years who correctly identify ways of preventing sexual transmission of HIV and who reject major misconceptions about HIV transmission Baseline: 36.2%; Target: 70%
3rd CP Percentage of rural and urban population covered by high-quality maternal and child health services Target: 25 per cent against the baseline We can’t find any data in annual and other reports allowing to calculate the base-line and follow-up values of the target. Also the definition is not stated to measure the indicator.
Percentage of sexually active women aged 15-49 using modern contraceptive methods. Baseline: 49 per cent; Target: 75 per cent This indicator is measured among women aged 15-49 who are currently married/in union. The data source for the base-line value is MICS conducted in 2010. MICS 2015 demostrated positive dymanic: from 49% in 2010 to 54% in 2015. However, the target was not achieved.
Births by girls aged 16-18. Baseline: 22 per 1,000; Target: 15 per 1,000 We can only find data that can approximate the birth rate among girls aged 16-18. Demographic reports produced by Committee of Statistics contain birth rates among girls aged 15-19 (2010 – 28.3 per 1,000; 2015 – 30.83 per 1,000). So, we can conclude with high level of confidence the target was not achieved.
4th CP Contraceptive prevalence rate (total). Baseline: 51%; Target: 70% This indicator is measured among women aged 15-49 who are currently married/in union. The data course for the base-line value is MICS conducted in 2010. MICS 2015 demonstrated positive dynamic: from 51% in 2010 to 56% in 2015. The selection of the indicator and the target are questionable, because it considers all contraceptive methods including non-modern ones. In addition, it’s difficult to expect a significant improvement because that depends on many factors including behavioral changes.
Percentage of young women aged 15-24 years who correctly identify ways of preventing sexual transmission of HIV and who reject major misconceptions about HIV transmission Baseline: 36.2%; Target: 70% The data sourse for the indicator is MICS. The base-line value was taken from MICS 2010, because the MICS 2015 report became available in 2017. The most recent value from MICS 2015 is 26.7%, i.e. the percentage of girls with comprehensive knowledge was actually decreasing.
Note: The indicators intending to demonstrate the achievement of the planned outcomes are not very useable, because they are either too narrow to characterize an outcome (e.g. use of 101
contraceptives is a part of the integrated sexual and reproductive health services) or very ambitious to be achieved even with efficient UNFPA contribution (e.g. usage of modern contraceptive methods is planned to increase from 49 per cent to 75 per cent).
As it was indicated, maternal health is the most important priority for healthcare system in Kazakhstan. So, almost all SRH activities are performed under umbrella of ‘maternity health’. Taking this into account, UNFPA contributed to the development of the Operational action plan to reduce maternal mortality in the Republic of Kazakhstan approved by Minister of Health on 29th January 2019. The plan includes many novel approaches promoted by UNFPA, namely: ● Hire regional coordinators for effective perinatal care ● Hire regional reproductive health and family planning coordinators ● Teach 90% of hospital epidemiologists on infection control ● Ensure the implementation of a hand hygiene program in each medical organization ● Provide treatment of diseases detected during screenings to adolescent girls under 17 years of age ● Determine the need for modern contraception for women of reproductive age with social and medical risk factors (including those who have contraindications for pregnancy) ● Provide modern methods of contraception to (vulnerable) women of reproductive age with social and medical risk factors (including those who have contraindications for pregnancy) ● Review and approve clinical protocols ● Analyze family planning services provided in medical organizations to develop recommendations for improving their work ● Introduce a mobile application for prenatal monitoring of a pregnant woman ● Ensure the location of at least one Youth Health Center in a region accessible to adolescents and youth in a separate building or with a separate entrance ● Develop standards for Youth Health Centers (location, number of rooms, equipment, personnel, functional duties, etc.) UNFPA provides support to government partners for successfully embodying some activities of the operational plan, e.g. developing the standards for Youth Health Centers, determining the need for modern contraception, implementing and scaling up successful models of infection control in maternity hospitals.
The access of young ● Adolescent fertility rate ● Reports Document review people to quality ● MICS SRH services and sexuality education has been increased Adolescent & Youth The fourth UNFPA Country Programme, 2016-2020 (ongoing): Outcome 2: Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education and sexual and reproductive health
Indicator 1: Percentage of young women aged 15-24 years who correctly identify ways of preventing sexual transmission of HIV and who reject major misconceptions about HIV transmission Previous initiative on piloting of Valeology course with strengthened SRH component was highly appreciated by Local Department of Education of the Eastern Kazakhstan regions and the directors of pilot colleges recognizing high need in such training for their students. The local education department requested UNFPA to expand the last year experience to more colleges. Following this, UNFPA supporte a three-days training for pedagogical staff of 10 colleges on providing the course of "Valeology" with the strengthened SRH component. Further, the trained teachers taught more than 1,000 students in their respective colleges. The national conference on discussing the ways of introduction of CSE into general school education program in Kazakhstan, was held in 2015. It was led by the National Commission on women affairs and family-demographic policy under the President of Kazakhstan, and facilitated by the member of Parliament who actively supports the issues of young people’s SRH improvement and ensuring their reproductive rights.
Active members of Parliament specified the strong need to improve the awareness of adolescents, specifically female adolescents, on the issues of protection of SRH, prevention of early and unwanted pregnancies and STIs/HIV, safe sexual behavior. Presentations made by the participants of the conference proved the poor SRH status and low level of awareness of adolescents and young people in Kazakhstan on SRH issues due to their limited access to SRH information. The high effectiveness of the course that covers issues of sexual and reproductive health and rights and safe sexual
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behaviour, developed based on available "Valeology" curriculum for colleges’ students and conducted in 2014 in Eastern Kazakhstan demonstrated through presentation of the results of the related pilot project. The resume of all presentations was the necessity of introduction into the school curricula of the comprehensive sexuality education on protection of sexual and reproductive health according to the standards recommended by UNESCO and WHO. After the workshop the active members of Parliament of the Republic of Kazakhstan declared the need of introduction of sexuality education into the state educational system and accepted the Resolution document with recommendations to government on improvement the access of adolescents and young people to SRH services and education.
Gender inequality ● Gender inequality index ● Reports Document review has been reduced Gender. The third UNFPA Country Programme, 2010-2015: Outcome: National institutions have improved capacity to protect human rights and ensure access to justice for women
Indicator 1: Number of legal acts and normative instruments adjusted in line with international standards
UNFPA achieved its goals related to Gender component of the CP 2010-2015. The Parliament of Kazakhstan adopted the Law to counteract domestic violence and by 2012 ratified the ILO Convention concerning Equal Treatment and Equal Opportunities for Men and Women Workers: Workers with family responsibilities.
In 2014, in order to achieve of planned outcome - National institutions have improved capacity to protect human rights and ensure access to justice for women - Report on implementation of CEDAW in Kazakhstan was presented at the 57th CEDAW (Combined third and fourth periodic reports) session in February 2014 in Geneva, Switzerland by the Government and national NGO. UNFPA provided technical and financial support to one of the Kazakh delegate (NGO representative). All national comprehensive sexuality education curricula are aligned with international standards recommendations from international community to the Government of Kazakhstan provide main directions for further improvement protection of human rights, ensuring gender equality and prevention of any forms of discrimination, including GBV, early and forced marriages. In line with UPR recommendations on GBV prevention UNFPA Kazakhstan ensured availability of evidence data on GBV prevalence in the country. The findings of the study demonstrated that out of all women attended to health care facilities 40% were victims of any forms of violence. Those who were victims of sexual violence have never sought help from law-enforcement authorities. The results of the study were used as justification for development of clinical protocol on health sector response to sexual violence. According to CEDAW the Sexual and Reproductive Health and Rights of adolescents and young people should be one of the priorities of a country. Within this area of priorities, the importance of introduction of CSE into school curriculum was underlined during numerous meetings with the Ministry of Health and Social Development and the Ministry of Education and Sciences through provision of evidence on improvement of SRH knowledge among college students in Eastern Kazakhstan (within the pilot project on sexuality education).
UNFPA Annual report (2013) mentioned in that SRH and Kazakhstan Code of Health of Population and Health Systems guarantee reproductive rights of citizens of Kazakhstan. Realization of these rights is carried out within the State program health of the Republic of Kazakhstan "Salamatty Kazakhstan" for 2011 – 2015. In the republic, the policy on providing services on family planning is integrated for both urban and rural women. 216 billion KZT is allocated in the republican budget for 2011 - 2013 for realization of reproductive rights of population. However, abortions still remain one of the main regulators of birth and one of the main reasons of maternal mortality. Unmet needs of the total population in family planning are 11.5%. In accordance with the surveys of SRH status of people with different disabilities in 2011-2012 unmet needs on family planning of them come to 60 percent. It is mentioned in the report that 3,3% of abortions in 2010 is registered among adolescents of 15-18 years, childbirth of adolescent girls makes about 1,2% from the total number of childbirth. The access of adolescents and young people under 18 is limited. The legal capacities to take sufficient decisions refer for SRH care, not requesting consent of their parents of legal guardians is granted them after 18 years of age. There are a limited number of the centers for youth friendly services in country (17 centers) where adolescents and young people can receive medico-psychosocial services, including sexual and reproductive health and family planning services. To 2020 these centers will cover 25% of adolescents and young people of 15-18 years.
In 2011 UNFPA supported government on data collection and assessment of emerging population issues and advocacy through conduction of desk-reviews and sociological quantitative national surveys on challenges of people with disabilities for improvement of policies for disabled persons. Desk reviews on the status of sexual and reproductive health of people with disabilities caused by damages of mental sphere and locomotors apparatus and its social determinants developed by national consultants mobilized by UNFPA. During evaluation’s interview there were identified needs, which related with additional technical support from UNFPA in mental sphere. There are needs to get knowledge and experience of Keniya
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The fourth UNFPA Country Programme, 2016-2020 (ongoing): Outcome 3: Advanced gender equality, women’s and girls’ empowerment, and reproductive rights, including for the most vulnerable and marginilized adolescents and youth
Indicator 1: Percentage of the accepted Universal Periodic Review (UPR) recommendations on gender equality and reproductive rights from the previous reporting cycle that are implemented
Religious leaders of Sunni Islam and Orthodox Christianity in Kazakhstan are engaged into advocacy for and dissemination of information on maternal health, SRH, prevention of HIV and GBV and early/forced marriages to their followers and congregations. The active religious leaders of Islam and Christianity, along with national consultants, were involved into the development of Informational, educational and communication (IEC) materials addressing maternal health, women’s and girls’ SRH, FP and prevention of STIs/HIV and GBV, including early/forced marriage. The IEC materials supported by quotations from each religion’s respective teachings and doctrines were developed, discussed and approved by heads of religious organizations, translated into Kazakh language and both Russian and Kazakh versions printed (in total 900 copies of) and brought for pilot dissemination among their followers in the Eastern Kazakhstan.
The fifth Universal Periodic Report (UPR) provides information on the main developments and the progress made by Kazakhstan in ensuring the economic, social, cultural, civil and political rights of women on an equal basis with men during the 2011-2017 reporting period with a view to implementing the Convention. At the end of 2017, in the Global Gender Gap Index of the World Economic Forum (WEF), Kazakhstan was ranked 52nd out of 144 countries. In order to reduce maternal mortality, the Ministry of Health, with the support of UNFPA, conducted a situational analysis of the state of reproductive health of the population of Kazakhstan150. On the basis of the analysis, a framework programme to improve family planning services up to the year 2021 was developed, and a detailed plan of action was prepared. Components of the plan of action to improve family planning services were integrated into the road map of the Ministry of Health, in accordance with which family planning clinics have been established in each region of the country to train public health specialists.
Evidence-based ● Number of evidence-based national ● Strategy and Document review national population population policies developed protocols policies have been ● Monitoring reports developed P&D. The 3rd CP outcome was formulated as follows - vulnerable groups, especially women, migrants, refugees, young people, the elderly and people with disabilities, have improved access to goods, services and social safety nets.
The 4th CP outcome is focused on strengthening national policies and international development agendas through integration of evidence-based analysis on population dynamics and their links to sustainable development, sexual and reproductive health and reproductive rights, HIV and gender equality
Document analysys and key informant interviews shows that received outputs contributed to the achievement of the stated outcomes, however extent of contribution of different outputs varies. (i) Census of 2009 was important to receive important data and serve as base for production of analytical report. However, many key informants noticed low validity of data as used approached and techniques were outdated and produced missed data during scaning and reading paper questionaires. Also, it was mentioned that data analysis took too long. Preparation of 2020 census proceed successfuly and based on lessons learnt fro 2009 census and best international practices. (ii) UNFPA support the second 2010 national Multi-indicator cluster survey (MICS) to ensure its compliance with the ICPD Programme of Action. IMICS included indicators to measure sexual and reproductive health, family planning issues, GBV and HIV/AIDS at national and sub-national levels as well as number of indicators that are not available from the routine national statistics in such areas as Reproductive Health, HIV and AIDS, Sexual Behavior, Attitudes toward Domestic Violence, etc. These information are being used by the Government, NGOs, UN Sister Agencies, international organizations in discussion of existing problems and issues in the country and in the planning of development programmes and projects to improve quality of life of the population in Kazakhstan. In 2015 UNFPA / UNICEF support allowed the Committee on Statistics of Kazakhstan collect appropriate data on key UNFPA indicators disaggregated by age, regions and residence place (urban or rural) including indicators on fertility, mother and newborn health, unmet needs of family planning, use of modern contraceptives, attitudes toward domestic violence, sexual behavior, and HIV/AIDS and
150 Fifth periodic report submitted by Kazakhstan under article 18 of the Convention on the Elimination of All Forms of Discrimination against Women, due in 2018, page 35 104
early marriages. (iii) Separate surveys/study on issues data for which is not available in state statistics allow to produce important for policy work information. Among those surveys: ● the rapid assessment of demographic situation in Semipalatinsk region and needs on improvement of region’s population statistics. Data on population analyzed and used at sub-national level to develop and monitor policies and programme through rapid assessment of demographic situation in Semipalatinsk region and needs on improvement of population statistics in the region. ● UNFPA assisted the National Commission on Women affairs and Family-demographic policy under the President of the Republic of Kazakhstan to develop document of the National Plan of Actions addressing challenges of the aged population. As results, the National Plan document was drafted in compliance with ICPD commitments and Madrid International Plan of Action on Ageing and in line with adapted national requirements and regulations. ● Poverty linked issues of vulnerable population groups: women-labor migrants, aged people, people with disabilities, were indicated in 1-st chapter of MDG-2010 report. Development of chapter on Goal 1 is supported by PD component of UNFPA Kazakhstan. ● UNFPA Kazakhstan provided technical assistance to government in formulation of National plan of action on supporting disabled persons through obtaining data and assessment of status of people with disabilities. ● The first wave of the national “Generations and Gender” survey (GGS) was conducted in Kazakhstan that will will enrich national statistics with essential but missing data. ● In 2014 A Y-Peer Assessment was conducted to review the previous experience of Y-Peer activities in different regions of Kazakhstan since its establishment back in 2003, the existing legislation and experience of nation-wide non-governmental organizations and provided recommendations to the Y-Peer member on possible modalities of legal registration in Kazakhstan. ● In 2014, within the joint UNDP/UNICEF/UNFPA/UNV project “Raising competitiveness of the region through innovative approaches to regional planning and social services (using Semey as an example)” for 2011-2015, UNFPA strengthened capacities of Eastern Kazakhstan regional government agencies on effective planning and budgeting, with the aim to support evidence-based approach to decision-making and monitoring achievement in Eastern Kazakhstan region (EKO). ● The first ever national survey on domestic violence (DVS) in Kazakhstan was conducted in 2016 that produced missing data on DVS. Report on survey results was presented to Government on 29 November 2016. ● Other outputs that contributed to the outcomes include: ● A “Population and Development” course was developed and piloted for civil servants in the Academy of Public Administration under the President of the Republic of Kazakhstan to build institutional capacity for formulation of Demographic Policy and conduction of demographic analysis and population projections. ● Methodical teaching materials for " Demographic analysis and Projections " were developed to introduce the course into the graduate training plan for civil servants of the Academy of Public Administration. Two international experts on demography (Moscow, Russia) were mobilized to provide technical assistance to the Academy of Public Administration on the development of Educational and Methodological Complex (EMC) on the course "Demographic analysis and Projections” (90 academic hours) to be introduced into the Master's Program for civil servants. ● Around 30 civil servants of central and regional governments were trained on demographic analysis, population projections and formulation and monitoring policies and regional development plans, taking into account the linkages between population dynamics and sustainable development. The civil servants were trained at the international training courses provided by the Higher School of Economics (Moscow, Russia) and the Academy of Public Administration (Astana, Kazakhstan) with invitation of international experts from Moscow State University and Higher School of Economics. ● Parliamentarian training on how to consider aging issues in demographic policy; ● The initiative on development of regional databases and population registers, such as register on people with disabilities and adaptation of DevInfo database at regional level, has to use the top- down approach, i.e. from the central level to the local level. The UNFPA CO’s try out on piloting at local level with the aim of further expansion to the national level faced a lot of difficulties and challenges. As a lessons learnt, the approach should involve in parallel both, central and local levels of the statistical offices, the Committee on Statistics as central level and the statistics department at the regional (local) levels. Joining efforts and expertise of UN agencies for supporting the government on national data collection (MICS – UNFPA and UNICEF, Survey on domestic violence – UNFPA and UN Women) makes the process much more effective and results - extensively grounded. ● Throughout all period UNFPA provided technical support to the Agency of Statistics of Kazakhstan, national and local governments to strengthen their capacity on Population and Development interlinkages in policy formulation and integration of demographic data in planning and monitoring of development programs.
At the same time the following challenges were identified: ● Lack of human resources in public administration. There is still a high turnover of the staff of statistical agency trained through national and international trainings supported by UNFPA. At present, the country misses demographic center that would coordinate development of indicators, data collection and analysis, researches and broadcasting in the area of population and keep the organizational memory about mobilization of skills, knowledge and abilities when settling different population problems;
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● No education institutions/departments on demography; ● No state policy on demography; ● No data to explain population aging; ● Family policy is more declarative; ● Need for results verification as it mostly based on quantitative surveys – need qualitative evidence; ● Lack of data bases integration; ● Different level of data details for city and villages; ● No common qualifier for public organizations and statistics to joint data; ● No state body responsible for demography (part of MOE); ● Questionable readiness of state to support demography; ● Need for analytical skills development ● Learning/visiting Russian speaking countries – Belarus, Russia ● There are still gaps exist in the area of statistics. Reliability and sufficiency of statistical indicators in the area of demography and reproductive health is still poor. The national statistics is to be enriched with essential but currently missing data on reproductive rights, reproductive health, family planning and gender equality. The quality of migration statistics is still needs in improvement. ● The evidence-based development of national programmes and policies for people with disabilities requires reliable profiles of persons with disabilities and challenges they experience. However the statistical and administrative data on people with disabilities still are not full and properly disaggregated to be used in the policy formulation. The register of disabled people of the Ministry of labour and social protection being limited by disaggregation by groups of disability and does not provide disaggregation by categories of disability and types of diseases, therefore cannot be used as a proper basis for studies on status and challenges of disabled people. Data bases on disability in regions are not fully actualized. Data on access of disabled people to the reproductive health and family planning services are not covered by the national statistical system. ● Population dynamics and population projections need to be addressed in designing development strategies, policies and programmes. It foresees a need to strengthen national capacities to collect, analyze and utilize population-based data on the linkages between population dynamics and development to promote the sustainability of regional and national development strategies, and ensure that these strategies respond to the changing characteristics and needs of different populations. ● There is low demand for the knowledge and understanding on interlinkages between population dynamics and sustainable development among civil servants, therefore, it is hard to ensure sustainability of the developed Population and Development (PD) course without UNFPA further support. ● There is still no strong national technical capacity in the development of sampling frames for the national surveys. Therefore, technical assistance might be needed for the Committee on Statistics on households sampling for the GGS. There is not enough demand for the understanding on the interlinkages between population dynamics and sustainable development among civil servants, therefore, it ihas been hard to ensure sustainability of the Population and Development (PD) course that was developed without UNFPA further support. Document analysis and key informant interviews
No data for outcome indicators for the 3rd CP was found. As for 4th CP – outcome indicator achievement is in progress.
EQ 4 (Effectiveness): To what extent has UNFPA policy advocacy and capacity building support helped to ensure that sexual and reproductive health (including Family Planning), and the associated concerns for the needs of young people, gender equality, and relevant population dynamics are appropriately integrated into national development instruments and sector policy frameworks in the programme country? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed UNFPA contributed ● Disaggregated data produced, analysed ● UNFPA P&D ● Document review: including of annual reports from ministries, needs assessments, to the development and utilized at national and sectorial levels in a section CPAPs evaluation and monitoring reports of a functional timely manner ● P&D project ● Planning and programming documents (MOSA) issued during the reference period integrated ● Large-scale population surveys are reports ● Inputs to and deliverables of the information systems information system conducted and disseminated ● Ministry of ● Interviews with MoNE, and municipalities staff to review the implementation for the formulation, ● A number of professionals and units are National Economy staff and modalities of P&D component and achievements 106
monitoring and trained to apply integration methods and tools publications evaluation of ● In-depth, policy-oriented ● MoH staff national and (demographic/population) studies released ● United Nations sectorial policies ● Functionality of information systems set Statistics Task Force terms of in place reference ● Database for monitoring the ● Training implementation of public policies established and participants available to the public ● Implementing partners working at the state/district/community level General. UNFPA provides technical assistance to the government to use demographic data for planning, development and monitoring of policies and development programs and to better understand causes behind demographic trends and consistent patterns in the country. UNFPA supports statistical bodies in the development and monitoring of suitable monitoring indicators of SDG achievement adopted by the country in the framework of the new global sustainable development agenda in the next 15 years and implementation of advanced data collection and processing methods. The Program provides international experience on obtainment and use of data in relevant population-related issues through engagement of international experts. Also, UNFPA assists in analysis of data collected in the national surveys – Multiple Indicator Cluster Survey (MICS) and National Domestic Violence Survey and in dissemination of survey results for use in policy and government decision- making and implementation. The Program improves understanding of decision-makers in demographic and social development of the country and factors behind such development; identification and clarification of reasons behind demographic trends.
SHR. Both CEMD and NMCR, which were created with UNFPA support, are currently functioning by using Kazakhstan’s own resources. CEMD and NMCR allowed MoH to identify main causes of maternity deaths that have been addressed in MoH’s programs and plans.
MICS supported by UNFPA is the main source of data for M&E indicators on SRH. It measures 8 reproductive health indicators including 3 MDG indicators (Adolescent birth rate, Contraceptive prevalence rate, Unmet need) abd 5 Maternal and newborn health indicators including 2 MDG indicators (Antenatal care coverage, Skilled attendant at Delivery). The MICS questionnaire allows to calculate other important indicators, e.g. proportion of demand for modern contraception satisfied, Skilled attendant at Delivery for the poorest quintile of the population. UNFPA also provided funds to conduct two national surveys on SRH among young people aged 15-19. Their results have been used in advocacy efforts to decrease age of consent to medical services including SRH services from 18 to 16.
In the 3rd CP, UNFPA supported a number of surveys on SRH among vulnerable populations, namely migrants, sex workers, persons living with HIV, and persons with different types of disabilities. Findings of the surveys were presented to decision-makers and to organizations which might make use of them. Two respondents mentioned that the findings helped them to rise attention to the sexual and reproductive health vulnerability of persons with disabilities and other key populations. Some respondents expressed a desire to repeat studies, because the results of the previously conducted studies are outdated and don’t correctly reflect the current situation.
Adolescent & Youth. In 2017, UNFPA continued efforts on the introduction of sexuality education into the teaching process of colleges in selected regions of Kazakhstan within the frameworks of two Joint Projects between the Government of Kazakhstan and the UN. With UNFPA support, more than 3,500 students of 8 colleges of Aktobe region, 14 colleges of Kyzylorda and 13 colleges of Mangystau regions were trained on SRH and life-skills based education through Valeology course with a strengthened SRH component. Prior to piloting this course, TOT training courses were provided to teachers of the pilot colleges on how to teach this course to students based on a Methodological Guidelines for Teachers that had been developed and printed. To verify the effectiveness of the training courses sociological researches were conducted in all 3 regions - including pre and post-test assessment of students' knowledge on SRH. The resulting respective analytical reports demonstrated high effectiveness of sexuality education in raising awareness on SRH issues among students. The reports in Kazakh and Russian languages are being used for promotion and advocacy for integration of CSE into the education curriculum. The findings of the above mentioned sociological researches that provide evidence data are used for advocacy and communication activities to ensure access to SRH information, education and services for Adolescents and Young People. Awareness of more than 50 representatives of decision and policy makers and representatives of media were raised about the high effectiveness of Sexuality Education in improving the students’ knowledge on SRH and safe behavior and the importance of ensuring access of young people to quality SRH
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services and contraceptives through advocacy and communication events.
UNFPA established collaboration with a well-known singer, Kaliya who came out with a song “Kyz Tagdyry (Adolescent Girl’s Fate)” and a video spot for which UNFPA provided global and national data related to young people’s reproductive health status, prevalence of Finalized Official Report adolescence pregnancy, abortions, sexually transmitted infections and suicide. The official presentation of the song and a video spot was made jointly by UNFPA and the online national magazine “The Steppe” and attracted a lot of public attention.
Given the priority accorded to young people’s reproductive health by the Ministry of Healthcare, UNFPA supported conducting a survey of adolescents’ SRH status and sexual behavior among YP aged 15-19. The results of the survey show that the situation of sexual and reproductive health awareness among young people aged 15-19 is extremely critical, and if action is not taken, it is likely that such low awareness will lead in the future to high-risk behavior. The consequences will lead to increase of STIs, including HIV, unintended adolescent pregnancies and abortions that could result in infertility in the reproductive-age population. It is a matter of concern that, given the low level of sexual and reproductive health awareness among young people aged 15-19, about one third (30%) of young people interviewed in this category reported having had a sexual experience. The median age at sexual initiation was 16.52 years. About half of the sexually active adolescents reported having had more than Finalized Official Report one sexual partner in the last 12 months. It is obvious that it is necessary to respond properly to the results of this study to contribute to the well-being of adolescents in terms of reproductive health.
There were two unplanned additional activities conducted, i.e. Inter-parliamentary Conference “Investing in Youth. Leaving No One Behind” and Youth Pre Conference Meeting of the Global PHC Conference. Both Conferences were successful and UNFPA provided necessary technical support during preparation and implementation. Each Conference produced a declaration that used for advocacy purposes
Challenges. The Ministry of Education does not recognize sexuality education as a priority, therefore it is very difficult to introduce sexuality education in existing educational program and to get an access to schools without legal permission of the respective authorities. The trainings on Valeology supported by UNFPA will not be sustainable unless the MoE integrates them because very much depends on the human factor. If local education authorities understand the importance they continue to provide training to the students. If however there will be a change in the Head of the Education Department than the trainings will be discontinued. UNFPA is making efforts to include the Valeology Course into the curriculum of vocational schools.
There are two challenges in registration of Y-PEER. The first one is a changed legislation. In mid of 2015 the Government of Kazakhstan introduced new requirements for NGOs registration with minimum years of working experience in the field and volunteer work is not considered as such working experience. The second one is lack of willingness and commitment of Y-Peer activists to start working as NGOs and making registration of NGO on their personal names. Even though members of Parliament, Government, the Ministry of Health and Social Development do recognize importance of provision SRH education for adolescents and young people, there is a strong reluctance from the Ministry of Education and Science in neither introduction a new subject on SRH protection nor integration of SRH into existing subjects. This issue could resolved using top-down approach, i.e. a Prime-Minister or Presidential Administration need to issue a special order to the Ministry of Education. The Joint Project of UNFPA and the Government of Kazakhstan has two major components, the one is aimed at reduction of maternal mortality and the second on increasing knowledge and education on SRH of young people through Y-Peer network. The first component is very successful since found full support of the local government and local health sector department. While the second component has not started at all. The reason is absence of appropriate support of the local government and the department of internal policy. They do not recognize importance of SRH education and information for the young people of the region.
Youth health centers are operating only in pilot regions. It is not quite clear how they are developing and to what extent regions (including pilot regions) are ready not only to develop youth centers from local administration but also to develop a sense of ownership among target groups – as a place that youth will be interested to attend and share the information received with peers.
Gender. Models of multi-sectorial response to gender-based violence (MSR to GBV) based on the Global Essential Services Package (ESPs) and Standard Operating Procedures (SOPs) for frontline services, such as health, psychosocial and police sectors were shared with the technical level government representatives of the Ministry of Health and Social Development, the Ministry of Interior, the General Prosecutor Office) and the experience of Eastern Europe on identification of GBV survivors, documenting, registration and reference of violence survivors to other services/sectors was presented. The General Prosecutor Office initiated a new National Programme “Kazakhstan Without Violence in a Family” where one of the main priorities is the establishment of MSR to GBV. Therefore, the General Prosecutor Office was interested in UNFPA proposed models of MSR to GBV and in ESP and SOPs to be adapted in Kazakhstan. Consequently, UNFPA was invited to be a part of the Working Group for implementation of strategic plan for this national program. Upon request of the General Prosecutor Office UNFPA supported analysis of legislation and existing practices in Health Care System on treatment and prevention of drug and alcohol addicts, and psychiatric disorders, which are considered as one of the immediate causes of domestic violence. 108
Regional FBOs of Islam and Orthodox Christianity are willing to collaborate with government on the promotion of maternal and reproductive health, gender equality, combating GBV and prevention of early/forced marriages. Ways of collaboration of religious communities with government and CSOs were identified (at 2 days seminar for 30 FBOs representatives). The Government and FBOs of Islam and Orthodox Christianity agreed on further collaboration to improve maternal and reproductive health, advance gender equality, combat GBV and early/forced marriages by accepted Resolution of the National Conference (held in 2016).
Challenges. An issue of businesses’ interest and involvement in family and gender projects remains outstanding. Such issues should be raised at various dialogue platforms, as well as best practices abroad should be studied and adapted in Kazakhstan.
Besides an overall understanding of representatives of the Ministry of Health, Parliament members, the National Commission on Women Affairs, media representatives as well as local authorities on the need for sexuality education for adolescents and young people, the Ministry of Education does not recognize the need to introduce age-appropriate sexuality education into the national education curriculum.
P&D. Document analysis and interviews with key informants proves that UNFPA advocacy efforts and support in building capacity of the Agency of Statistics of Kazakhstan and national and local governments contributed to development of a functional integrated information system for the formulation, monitoring and evaluation of national and sectorial policies through: ● Conducting and disseminating results of population surveys such as census, MICS that allowed to collect, analyse, disaggregated data produced and utilized at national and sectorial levels in a timely manner; ● Capacity strengthening of key personnel of State Agency of Statistics and producing needed courses on “Population and Development” and "Demographic analysis and Projections” for civil servants in the Academy of Public Administration under the President of the Republic of Kazakhstan and providing assistance to civil servants to participate in training, conferences, study visits in various countries to learn new approaches for further application of integration methods and tools in population and demographic studies; work together with international experts on study preparation, undertaking and data analysis and results dissemination; ● Based on results of in-depth, policy-oriented (demographic/population) studies new government policies concerning specific target / vulnarable groups (women, youth, disable, etc.) were design, discussed and approved; ● Analysing functionality and development / update of information systems of data received from census, MICS, and other studies by providing international experience showed that the national system of regularly updated registries of various population groups enabled separation of socially vulnerable groups with special needs: adolescents and young people, people with disabilities, by type of disability, gender, age and residence, elderly people, etc., for monitoring of socio-economic status and planning efficient special-purpose social support. For this, UNFPA provides technical support to the country in creation of regularly updated population registries which enable separation of socially vulnerable groups in order to use data in the development and implementation of targeted support policy and having record of population in the framework of future population and housing censuses in accordance with international census principles based on population registries.
UNFPA contributed ● Disaggregated data – including on RH and ● UNFPA P&D ● Annual reports from MoH, MoNE, need assessment, evaluation and monitoring reports to the integration of GE – produced and available publically section CPAPs ● Planning and programming documents issued during the reference period population ● Mechanisms established for policy ● P&D, SRH, GE ● Inputs to and deliverables of the information systems dynamics, analysis and dissemination of policy briefs project reports ● Interviews with MoH, MoNE and municipalities staff reproductive health ● Number of national and sectorial plans ● Ministry of and gender equality incorporating population dynamics, reproductive National Economy staff and into development health and gender issues exist publications planning at national, ● Existence of innovative guidelines for ● MoH staff sectorial and local local planning to address priority population issues ● United Nations levels Statistics Task Force terms of reference ● Training
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participants ● Implementing partners working at the state/district/community level General. Document analysis and interviews with key informants show that UNFPA contributed to the integration of population dynamics, reproductive health and gender equality into development planning at national, sectorial and local levels. One of the Government of Kazakhstan pripority is to increase population of the country, leverage distribution of population by regions and support birth rate, as well as enhance quality of human potential, the demographic development, projection of population flows and linkage with sustainable development, reproductive health and reproductive rights, as well as gender equality, support to family and vulnerable population are not organized into the uniform government policy yet. UNFPA is advocating for development of such national document on comprehensive population policy which would contain demographic analysis and would integrate demographic data for planning and monitoring of national and regional development programs with due consideration of the needs of vulnerable population.
SHR. The Concept of Family and Gender Policy in the Republic of Kazakhstan until 2030 was approved by President of Kazakhstan Nursultan Nazarbayev on December 6, 2016. According to the Concept, family is an important social institute, supporting of which creates a base for social policy. UNFPA backed the development of the Concept. First, the government intended to have the Concept of Family Policy (without Gender Policy). UNFPA and other UN agencies insisted the Concept should contain goals, principles, and tools on gender issues including gender equality. Second, the sitational analysis of the Concept was based on data obtained with UNFPA support (MICS, youth survey etc.).
Adolescent & Youth. Majority of Y-PEER activities provided by UNFPA in different regions. In 2018 was earmarked by restarting of Y-PEER activities in Astana. UNFPA provided space for the meeting of Y-PEER volunteers and supported training for future potential volunteers. Having Y-PEER in Astana allows UNFPA to involve Y-PEER activists in various meetings with the Government and Parliament and ensure that the voices of young people have been heard.
UNFPA used the platform of an International Conference "Child Friendly Kazakhstan" organized by the National Child Ombudsman and UNICEF to bring to policy and decision- makers' attention which problems adolescents face and how often these relate to their RH status and what adults should do to ensure the realization of their Reproductive Rights.
Gender. The “Concept of Family and Gender Policy till 2030” was developed, thoroughly discussed at different levels and approved by the Government’s Decree 384 of 6 December 2016. In partnership with Parliament, government, CSOs, FBOs and UNCT, UNFPA actively participated in the development of the document and ensured ICPD Agenda, UPR recommendations and obligations on SRHR and prevention of GBV and early/forced marriages are reflected in the Final Document and its Action Plan.
P&D. UNFPA improves national understanding of demographic and social development of the country and factors behind such development; identify and clarify reasons behind demographic trends, including low birth rate; determine the necessary support to families in having the wished number of children and strengthen inter-generation links, efficiently support quality of life of elderly people; identify factors influencing demographic behavior of people, including migration. UNFPA assists in delivery of the first wave of a national survey on Generations and Gender supported by government that clarify how demographic events influence life of an individual or of a couple, social integration and isolation, and changes in the quality of life which need to be understood for the development of social policy. The Program provides technical assistance, shares successful international practice and engages international expertise for the Statistical Committee to prepare and deliver National Generations and Gender Survey, as well as analyze survey data. Moreover, database for monitoring the implementation of public policies established and available to the public development of new policies (National Plans on Aging Population and Disable, Concept of Family and Gender, etc.) as well as enrich national statistics with essential but missing data. At the same time, availability of important data played a crucial role in raising Government attention to issues that were either inconvenient to discuss (family planning, domestic violence, HIV/AIDs, etc.) or were not considered as important (issues connected to disable people, especially women, youth, etc.). Also, UNFPA managed to approach very closed religious communities such as muslim and orthodox, and focus its assistance on issues such as domestic violence, family planning, etc. All key informants stated that UNFPA contribution was especially important as it provides access to international experts and best practices.
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Ongoing ● Level of budgetary resources allocated ● UNFPA P&D ● Annual reports from MoH, MoNE, need assessment, evaluation and monitoring reports mechanisms for the (by the government) for integrating population section CPAPs ● Planning and programming documents issued during the reference period integration of dynamics, reproductive health and gender in ● P&D, SRH, GE ● Inputs to and deliverables of the information systems population data in development planning project reports ● Interviews with MoH, MoNE and municipalities staff national and ● Level of operationalization and ● Ministry of sectorial institutionalization of policy frameworks, National Economy staff and development standards, guidelines and administrative publications planning are in place procedures for integrating population dynamics, ● MoH staff reproductive health and gender in development ● United Nations planning Statistics Task Force terms of ● Existence of cross-sectoral/cross-ministry reference working groups on data integration ● Training participants ● Implementing partners working at the state/district/community level SHR. The Government of Kazakhstan approved the Action Plan for the first stage (2017-2019) of implementation of the Concept of Family and Gender Policy151. The Action Plan contains 64 items splitted between 16 actors (minsitries and state committees, NGOs, educational organizations, law enforcement organizations, local authorities etc.) The Action Plan specifies sources of funds – special budget programs of the state or local budgets. The Family Planning and Reproductive Health Chapter of the Action Plan includes 5 items, for implementation of which ministry of health, ministry of science and education, local adminisitrations are responsible.
Adolescent & Youth. In 2014-2015 Youth Peer education analysis in Kazakhstan was developed through review of existing legislation, holding interview sessions with representatives of NGOs that use peer-to-peer education in order to reach young people, especially from the marginalized groups. The analysis has driven recommendations for integrating international standards into peer-to-peer education, increasing funding for peer-to-peer education programmes. All the findings were communicated to EECARO and will contribute to the Regional Analysis. Participation of young people, adolescents and members of Y-Peer network (in total 60 person) was ensured in various high national and local level advocacy events where voices of young people were included during formulation of development agenda. The list of events are the following: (1) High level AFPPD and ICPD Beyond 2015 meetings, (2) High level national consultations with Youth, (3) Youth Debates on Future Development Agenda. Under the leadership of UNFPA and UNV a Youth theme group was established and consists of 10 UN Agencies who joined its efforts in assisting UNCT in planning and implementing young people related projects. Advocacy efforts were made among ten government representatives (from the Ministry of Education and Sciences, the Ministry of Health and Social Development, Akimat of Eastern Kazakhstan Oblast) on the need of CSE inclusion into school curricula based on evidence collected within the frame of Valeology pilot project.
Gender. The Government of Kazakhstan approved the Action Plan for the first stage (2017-2019) of implementation of the Concept of Family and Gender Policy. The Action Plan contains 64 items splitted between 16 actors (minsitries and state committees, NGOs, educational organizations, law enforcement organizations, local authorities etc.) The Action Plan specifies sources of funds – special budget programs of the state or local budgets. The Family Planning and Reproductive Health Chapter of the Action Plan includes 5 items, for implementation of which ministry of health, ministry of science and education, local adminisitrations are responsible.
P&D. In the framework of the Country Program the UNFPA provides technical assistance to the government in using demographic data for planning, development and monitoring of policies and better understanding of causes behind demographic trends and consistent patterns in the country, in order to advocate and provide technical support to the government (attract best practices, international expertise) in the development of the conceptual demographic policy paper which would contain demographic analysis, population projection considering for linkage of population and
151 План мероприятий по реализации Концепции по гендерной и семейной политике в Республике Казахстан до 2030 года (первый этап 2017 – 2019 годы). Accessed on August 12, 2019 https://www.enbek.gov.kz/sites/default/files/plan_mer_rus_0.doc 111
development; in drafting national program documents considering for population as well.
EQ 5 (Efficiency): To what extent has UNFPA made good use of its human, financial and technical resources, and has used an appropriate combination of tools and approaches to pursue the achievement of the Results defined in the UNFPA country programme? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed Beneficiaries of ● Evidence that the planned resources ● UNFPA (including ● Document review: annual reports from partner ministries, and implementing partners, UNFPA support were received to the foreseen level in CPAPs finance/administrative audit reports and monitoring report received the ● Evidence that resources were received in departments) ● Document review: financial documents at the UNFPA (from project documentation) resources that were a timely manner ● Partners and interviews with administrative and financial staff planned, to the level ● Evidence of coordination and (implementers and direct ● Interviews with implementing partners (ministry level/secretariat general-level staff) foreseen and in a complementarity among the programme beneficiaries) ● Interviews with UNFPA country office staff timely and components of UNFPA and coherence among ● Working group ● Beneficiaries of funding (including NGOs) sustainable manner government ministries members/multi-stakeholder ● Evidence of progress towards the platforms delivery of multi-year, predictable, core funding delivered to implementing partners General. The UNFPA Executive Board approved funding of the 3rd country programme in amount of USD 5.9 million for the period of 6 years from UNFPA Regular Resources; an additional amount of USD approximately 1.8 million shall be mobilized from other sources. Specific allocations for different programme activities shall be given in details during implementation of the annual work plans. Distribution of funds by years will depend on funds availability. UNFPA funds will be placed by three priority directions as follows: i) reproductive health and reproductive rights: regular resources USD 3.2 million, other resources to be mobilized from other sources, USD 1 million; ii) population and development: regular resources USD 1.6 million, resources to be mobilized from other sources USD 0.6 million; iii) gender equality: regular resources USD 0.4 million, recourses to be mobilized other sources — USD 0.3 million; and iv) programme coordination and assistance in its implementation: USD 0.7 million from regular resources. Executive Board of UNFPA approved financing of the 4th country program equal to 2.65 million US Dollars for the period 5 years from regular resources of UNFPA; another 1.1 million US Dollars should be mobilized from other sources. Special allocations to various activities of the programs will be specified during implementation of annual work plans. Distribution of financing by years will depend on availability of funding. UNFPA resources will be allocated to three priorities as follows: i) Sexual and reproductive health care: regular resources - 1.0 million US Dollars, other resources to be mobilized from other sources – 0.2 million US Dollars; ii) Adolescents and young people: regular resources – 0.45 million US Dollars, resources to be mobilized from other sources – 0.4 million US Dollars; iii) Gender equality and empowerment: regular resources – 0.35 million US Dollars, resources to be mobilized from other sources – 0.3 million US Dollars; iv) Population and development: regular resources – 0.45 million US Dollars, resources be mobilized from other sources – 0.2 million US Dollars; and v) Coordination and assistance to program implementation: 0.4 million US Dollars from regular resources. Because Kazakhstan is an upper-middle-income country, a traditional development assistance model does not apply and traditional donors often cannot provide grants to Kazakhstan. The reality of this is that the UN and UNFPA in Kazakhstan is operating in a resource constraint environment where the Government of Kazakhstan remains the main donor, often requiring several layers and long complicated processes to obtain funding. The current not favourable economic situation has led to many projects from different UN Agencies no longer being considered for funding.
SHR. SRH issues are incorporated in all three-program components – SRH, youth and adolescents, P&D. The Youth Health Center located in Almaty is working closely with Y-peer and offers a venue for its work. The surveys (P&D component) have delivered data for situational analysis, needs assesments, and M&E in an SRH field
Adolescent & Youth. Analysis of commitment and expenditures for 4th country program show that in the 4th country program for adolescents and youth allocated 22,77% from the whole budget. 99,19% were utilized for three years of the program.
Gender. Analysis of commitment and expenditures for 3rd and three years of 4th country programs show that: ● The overall actual allocations of expenditures for the whole period for 3rd CP consisted 28,3% for the Gender as a part of total budget. From $179430,88 were utilized $177372,94, e.a.
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98,85%. ● In the 4th country program there are 12,03% allocated for gender equality from the whole budget. 93,68% were utilized for three years of the program.
P&D. Analysis of commitments and expenditures for 3rd and three years of 4th CP shows that: ● UNFPA financial commitment constitute 28.7% and 17.33% out of overall programme budgets respectively; ● Real budget for 3rd CP for P&D direction was $1,360,888.44 out of $2,200,000 committed and utilization rate is 97,65%; ● Real budget for three years of the 4th CP for P&D direction i$398,779.95 out of $650,000 committed for five years; ● Three year budget of 4th CP constitute 61.02% of financial commitments for the whole 4th CP for P&D direction.
The resources ● Evidence that the resources provided by ● UNFPA (including ● Document review: annual reports from partner ministries, and implementing partners, provided by UNFPA UNFPA triggered the provision of additional finance/administrative audit reports and monitoring reports have had a resources from the government departments) ● Interviews with ministry level leveraging effect ● Evidence that the resources provided by ● Partners ● Document review: financial documents at the UNFPA (from project documentation) UNFPA triggered the provision of additional (implementers and direct and interviews with administrative and financial staff resources from other partners, including other beneficiaries) ● Beneficiaries of funding (including NGOs) donors or INGOs ● Others ● Evidence of coordination and activists/groups working on complementarity among the UNFPA country GBV and gender equality in programme components and the programme’s the same space as UNFPA implementation (that are not implementing ● Evidence of coherence among partners) government ministries and UNFPA mandate areas ● Working group members/multi-stakeholder platforms on gender equality/women’s rights and GBV General. Both UNFPA country programmes support implementation of state programmes of Kazakhstan. The Government honors its commitments in accordance with the provisions of SBAA as of October 4, 1994. In line with this agreement the Government accords to UNFPA and its officials and to other persons performing services on behalf of UNFPA such facilities and services as are accorded to officials and consultants of the various agencies, programmes, funds and specialized agencies of the United Nations. As a contribution to the programme the Government provides support to UNFPA on mobilization of additional resources from international donors with the purpose to adjust the CP funding. In addition, the Government tries to contribute both in-kind and in cash to ensure the successful Implementation of 3rd and 4th CPAPs. Both country programmes envisioned funding from UNFPA Regular Resources and other sources from which additional funding to be mobilized. When in the 3rd CP out of $7,700,000 the amount of $1,800,000 (or 23%) was settled to be mobilized, in practice $1,457,057.88 (or 28%) was mobilized out of $5,204,344.32. In three years of the 4th CP so far $644,213.76 (or 29,7%) mobilized out of $2,167,530.01 budgeted. In addition, it should be mentioned that because Kazakhstan is an upper-middle-income country, a traditional development assistance model does not apply and traditional donors often cannot provide grants to Kazakhstan. The reality of this is that the UN and UNFPA in Kazakhstan is operating in a resource constraint environment where the Government of Kazakhstan remains the main donor, often requiring several layers and long complicated processes to obtain funding. The current not favourable economic situation has led to many projects from different UN Agencies no longer being considered for funding
SHR. Additional resources from the government to scale up activities initially supported by UNFPA were allocated in two ways. First, the government spent money to to continue and expand the models that were introduced by UNFPA. CEMD and NMCR models, trainings on effective perinatal care, sufficient standards and clinical protocols have been implemented nationwide by using
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resources from the state and local budgets. Because of the complexity of the budgeting practice, it is difficult to estimate a leveraging effect of the resources provided by UNFPA. The budgets of State Healthcare Development Programs, Salamatty Kazakhstan 2011-2015 and Densaulyk 2016-2019, are 2,818 mln.USD and 5,394 mln.USD respectively152. Significant amount of the budgets has been spent to strengthen capacity to reduce perinatal and maternal mortality. Second, the government co-financed three joint UN team - Kazakhstan regional programs: Raising Competitiveness of the Region through Innovative Approaches to Regional Planning and Social Services - using Semey as an example (2011 – 2015, total budget - $11 651 365; government of Kazakhstan - $9 816 365); Expanding the opportunities of the Mangystau region in achieving sustainable development and socio-economic modernization (2014 – 2016, total budget - $8 259 333; government of Kazakhstan - $6 769 833); Improving the welfare and quality of life in the Kyzylorda region through innovative approaches to delivering economic, social and environmental services to the local population, including those most vulnerable (2014 – 2016, total budget - $8 743 999; government of Kazakhstan - $6 452 999). UNFPA was a participating UN agency in all three programs and was focusing on achieving universal access to sexual and reproductive health (including family planning) through improved public demand for and provision of high quality education, information, communication, counselling and services to the population with special focus on women and young people. UNFPA has got an experience to perform activities with support from other donors. UNFPA conducted ‘Technical workshop on HIV and migration in Central Asia and Russian Federation’ held in Astana (now – Nur-Sultan) City on 19-20 February 2018. The Embassy of the Kingdom of the Netherlands in Kazakhstan provided financial support to this event.
Adolescent & Youth. Along with the fact that program reports and documents were analyzed, an analysis of resource costs (starting in 2014) is available on an open Internet resource153: In 2014 to increase priority on adolescents and youth in national development policies and programmes, particularly increased availability of comprehensive sexuality education and sexual and reproductive health – total spending was $257274, including by UNFPA $159342 (62%), CSOs $63418 (25%), government $34514 (13%); in 2015 total spending was $269825, including by UNFPA $81507 (30%), civil society $172271 (64%), government $16047 (6%); in 2016 total spending: $120324, including by UNFPA $35100 (29%); civil society $85223 (71%); in 2017 total spending was $108442, including by UNFPA $43752 (40%); civil society $64690 (60%); in 2018 total spending was $184391, including by UNFPA $99939 (54%), civil society $84451 (46%).
In general, it is worth to note that UNFPA financial resources from 20 to 60% of the activities are implemented by partners or together with partners, including civil society and the government. There is even an example when, in 2015, 30% of the resources allocated to adolescents and youth remain in the UNFPA, and most of the funds are distributed to civil society. This indicates a good partnership strategy and the ability to implement programs effectively through long-term partnerships with multiple stakeholders, targeted technical training and strategic policy advocacy.
Gender. Along with the fact that program reports and documents were analyzed, an analysis of resource costs (starting in 2014) is available on an open Internet resource154: In 2014 for the component of advanced gender equality, women’s and girls’ empowerment, and reproductive rights, including for the most vulnerable and marginalized women, adolescents and youth, total spending were $176656, that includes costs of UNFPA $140687 (80%), and of CSOs - $35969 (20%); in 2015 total spending was $233261, including by UNFPA $149489 (64%), CSOs $15772 (7%), government $68000 (29%); in 2016 total spending $72693, including by UNFPA $40581 (56%), civil society $32112 (44%); in 2017 total Spending $90193, including by UNFPA $37882 (42%), civil society $50231 (56%), government $2080 (2%); in 2018 total spending was $80910, including by UNFPA $53210 (66%), civil society $27701 (34%).
In 2016-2017, three joint programmes were implemented in East Kazakhstan, Mangystau, and Kyzylorda regions, involving seven UN agencies (UNDP, UNICEF, UNFPA, WHO, UN Women, UNESCO, and UNHCR) in the case of Mangystau and Kyzylorda. These programmes had a budget total of $29 million, with a majority of the funding ($23 million – 79%) provided by the Government. The MTR stressed out that the joint programmes enhanced cooperation between the UN agencies and were able to deliver higher level results; however, there were some limitations in securing funds for some joint programmes that were prepared but not funded and implemented.
In general, it is worth to note that UNFPA financial resources from 20 to 60% of the activities are implemented by partners or together with partners, including civil society and the government. There is even an example when, in 2015, 30% of the resources allocated to adolescents and youth remain in the UNFPA, and most of the funds are distributed to civil society. This indicates a good partnership strategy and the ability to implement programs effectively through long-term partnerships with multiple stakeholders, targeted technical training and strategic policy advocacy.
P&D. The 3rd CP envisioned $600,000 (or 37.7%) to be mobilized for P&D activities. In total, for P&D activities $48,439.00 (or 8%) was mobilized. Mostly, needed other resources were provided by Government of Kazakhstan for project to increase comepetitiveness of eastern Kazakhstan, as well as from private sector, USAID and Soros/Friedrich Ebert Foundations.
152 We used KZT/USD exchange rates effective on dates when the programs were signed. 153 https://www.unfpa.org/data/transparency-portal/unfpa-kazakhstan 154 https://www.unfpa.org/data/transparency-portal/unfpa-kazakhstan 114
The 4th CP envisioned $200,000 to be mobilized from other resources and in three years only $42,536.19 (or 21.27%) was attracted. Those funds were mobilized from Government of Kazakhstan.
Administrative and ● Appropriateness of the UNFPA financing ● UNFPA (including ● Annual reports from partner ministries, and implementing partners, audit reports and financial procedures instruments, administrative regulatory framework, finance/administrative monitoring reports as well as the mix of staff, timing and procedures) for the departments) ● Interviews with ministry level/secretariat general-level staff implementation implementation of the programme, including ● Partners ● Document review of financial documents at the UNFPA (from project documentation) modalities allow for outputs specifically related to gender and human (implementers and direct and interviews with administrative and financial staff a smooth execution rights as well as those with gender and human beneficiaries) ● Interviews with a diversity of implementing partners of the country rights dimensions ● FGD with beneficiaries of funding (including NGOs) programme ● Evidence of transparent IP selection process ● Evidence of appropriateness of the IP selection criteria ● Evidence of the coordination and complementarity features of the implementation of the country programme UNFPA Country Office consists of Country Director with director of UNFPA Sub-regional Office for Central Asian countries now located in Almaty, currently in charge; UNFPA Assistant Representative and two auxiliary staff under approved country office typology. In addition, UNFPA allocates funds for two national programme staff and one auxiliary staff with the purpose to strengthen the programme implementation. Technical support to the programme is provided by UNFPA Regional Office for Eastern Europe and Central Asia as well as UNFPA Sub-regional Office for Central Asian countries. CPAP implementation is harmonized with UNDAF at the national level. UNFPA office staff gets instructions on realization of results oriented cost-effective approaches. Staff has the opportunity to participate in short-term training on programmatic issues within their terms of reference and under UNFPA training policy. UNFPA participate in UN thematic groups on PFD outcomes and efficient management, as well as multidisciplinary thematic groups on gender and HIV/AIDS and is guided by mutually agreed recommendations with regard to CP implementation. Activities are performed in frames of annual work plans developed by UNFPA in cooperation with partners and in accordance with strategies and outputs indicated in CPAP. UNFPA and implementing partners sign the annual work plans. Results of work plans implementation are reviewed annually during the joint meetings. Annual work plans are developed taking into consideration interrelation between different programme components implemented as a whole. The remittances for implementing partners are based on the Annual work plans agreed with executive partners and UNFPA. The remittance procedures are well developed and clear to all partners. The following challenges were identified: ● Relocation of the UNFPA CO from Almaty to Astana in 2018 that required personnel arrangement. ● Although the BCP was updated there was no time to test it. With a small team it is difficult to assign enough time and resources for all security-related tasks ● The Head of office covers three country offices and needs to travel at least twice if not three times a year to these countries. As such it is not always possible to attend SMT meetings.
EQ 6 (Sustainability): To what extent has UNFPA been able to support its partners and the beneficiaries in developing capacities and establishing mechanisms to ensure ownership and the durability of effects? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed UNFPA interventions ● Planning of interventions has been done ● Project strategy ● Document review have contributed or together with partners, including implementing document ● Interviews with Implementing partners are likely to partners working with affected communities, ● Minutes/reports ● Interviews with health professionals contribute to ensure marginalized and vulnerable communities and final from planning meetings with ● Interviews with teachers partners’ ownership beneficiaries partners ● FGD/interview with diverse groups of service users and the durability of ● Exit strategies to hand over UNFPA-● Field visits effects initiated interventions to (local) partners have ● Partners’ work 115
been developed during planning process plans ● Partners’ capacities have been developed ● Implementing with a view to increasing their ownership of the partners UNFPA-initiated interventions (integrated health services, commodity security, outreach services, youth-friendly services, life skills curriculum and tools) ● A high-quality service culture has been developed among health professionals who benefited from capacity development interventions, including the capacity to address the varied/diverse needs of users ● Life skills education and peer education interventions are sufficiently followed up so that quality education is delivered SHR. 3rd and 4th CP were developed in close consultation with key stakeholders including representatives from government agencies and NGOs. For instance, a working-level meeting was organized by UNFPA on 3-4 December 2015 in Ak-Bulak (Almaty oblast). UNFPA staff members, key stakeholders and partners discussed results of the 3rd CP and implementation of 4th CP. UNFPA has not been directly involved in provision of services. Almost all UNFPA initiatives have been planned and implemented in close collaboration with narional partners. It means the national partners have been connecting to all stages of the UNFPA interventions and playing a leading role in their implementation.
Adolescent & Youth. UNFPA efforts in building capacity of the healthcare institutions in providing high quality services are sustained by the national government’s commitment to ensure that all standards of healthcare are compliant with WHO protocols. The sustainability of the outputs was in many respects provided by the Government’s active position in the conducted activities, in ensuring appropriate follow up and implementing mechanisms (i.e. on violence prevention in a series of statutory acts: the Law “On preventing domestic violence”, the “Code on marriage and family”, Strategy of gender equality in the Republic of Kazakhstan etc.) Besides the legislative and institutional background, a positive aspect of sustainability is related to the involvement of the religious leaders and Faith-Based Organizations (FBOs) in the consultation process on SRH, Family Planning, Reproductive Rights, and Early Marriages and Gender Based Violence (GBV) trainings. In the last three years, UNFPA collaborated with FBOs (head religious organizations of Islam and Orthodox Christianity) in successfully change the acceptance of religious heads into involving UNFPA in educating their communities, either directly or by including UNFPA generated knowledge in standard education programmes. As a result, these communities developed a positive attitude towards UNFPA’s goals and activities. The religious groups offer a very stable framework for promoting the SRH, family planning and reproductive rights, if the correct approach is being used – consultations in early stage of implementation in order to seek acceptance.
Gender. Based on the analysis, it can be stated that UNFPA intervention tried to ensure sustainability. Institutionalization of processes was one of the tools used in this sense during the CP implementation. This process contributes to the development of national ownership and therefore strengthens the sustainability of initiatives. For example, the intensive work on capacity building of the Agency on statistics on the SRH and family planning elements, resulted in the incorporation of important indicators in the official data collecting system at national and sub-national level. This approach will be used in the future as well, offering evidence-based support for the policy makers in the related fields.
An important element of sustainability is the involvement of NGOs in the UNFPA activities, through developing their capacity to plan strategically and implement efficiently activities related to SRH and family planning. Nationally active NGOs may channel the information effectively and contribute to the advocacy efforts of the Agency, as in the case of: National Commission on Women affairs and Family-demographic policy under the President of the Republic of Kazakhstan, KMPA (the national association of ”International Planned Parenthood Federation), Centre of Civic Initiatives, or “Aman Saulyk”.
P&D. To ensure sustainability of institutional capacity in analysis of population trends and flows and considering for the absence of demographic education in the country it is necessary to incorporate relevant courses to the curriculum of the Public Administration Academy under the President of Kazakhstan to train and develop skills of civil servants to use knowledge of demographic analysis and
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linkage of population and development, as well as population projections in the development and monitoring of national and regional development programs. UNFPA provides assistance to the Public Administration Academy to implement demographic education into skills development system of central and regional level civil servants to improve national capacity of those who make political and government decisions, assessment of demographic trends and linkages with sustainable development, reproductive health and reproductive rights, as well as strengthening gender equality, support to family and vulnerable population. The program supports improvement of body of knowledge on migration, data collection, capacity building and promotion of policy to support national efforts on efficient response to international and domestic migration, including ethnic and labor migration. The following challenges for P&D sustainability were identified: ● Low as there are no enough of local experts; ● Invite senior citizens to assist; ● No ownership on demographic education; ● No standards, certification for demographist -> no professional association; ● No open survey data for secondary use, except MICS; ● Take too long to access census data; ● Lack of skills to read survey/study reports; ● Lack of follow-up monitoring of studies; ● Need for more express studies;
EQ 7 (Sustainability): To what extent have the partnerships established with ministries, agencies and other representatives of the partner government allowed the country office to make use of the comparative strengths of UNFPA, while, at the same time, safeguarding and promoting the national ownership of supported interventions, programmes and policies? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed Policies, strategies ● Evidence of policies developed in ● Project strategy ● Document review and laws are consultation with diverse stakeholders, including document ● Interviews with Implementing partners institutionalized community and local organizations ● Minutes/reports ● Interviews with health professionals ● National strategies is developed, from planning meetings with ● Interviews with teachers endorsed and operationalized partners ● FGD/interview with diverse groups of service users ● An adequate budget is allocated to ● Field visits ● Annual reports from partner ministries, and implementing partners, audit reports and enable the implementation of policies ● Partners’ work monitoring reports ● A number of new laws are being plans discussed at concerned parliamentarian ● Implementing committees partners ● Evidence that underlying information – ● UNFPA (including including socio-cultural norms and beliefs and legal finance/administrative structures – are considered in the drafting of new departments) legislation and policies
General. UNFPA implement its the country programs in partnership with other organizations in the UN country team as joint efforts for the achievement of Sustainable Development Goals and ICPD Program. WHO, UNECE, ILO, UNDP, UNICEF and UNIFEM are partners for the achievement of results. In addition, to increase coverage with UNFPA-supported activities and ensure synergy with other international and foreign organizations represented in Kazakhstan, the UNFPA office in Kazakhstan supports close contact with the World Bank, IOM, OECE, USAID, CDC and other partners. The UNFPA office works closely with such national institutes as President’s Office, legislative and central executive agencies: President’s Administration, Prime-Minister’s Office, Majilis and Senate of the Parliament, central foreign affairs authority, central interior, health and social development, education, emergencies, national economy, justice, statistics authorities; regional representative and executive agencies; advisory bodies, such as national Commission on Women, Family and Demographic Policy and Human Rights Commission under the President of Kazakhstan, health methodology centers in the field of public health, mother and child health, reproductive health of women and men, development of healthy life style; education methodology centers; strategic studies
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methodology centers; academia, medicine, economics, law academia to start with; civil society, mass media and others. Comparative strengths of UNFPA, both corporate and in-country, particularly in comparison to other UN agencies and the results observed in programmatic areas that have been achieved (and described above) with UNFPA’s contribution show that UNFPA is perceived as the catalyst and one of the key driving force in the demographics and population and development related issues with attention to aging issues, as well as in reproductive health and sexuality education, gender and gender-based violence. The main UNFPA added value in Kazakhstan’s context and instituanalization of policies/ strategies/ laws as perceived by the national stakeholders includes the following.
SHR. There are evidences that UNFPA focuses on development and institutionalization of policies, strategies and laws in partnership with national stakeholders. In past two years, three comprehensive documents with regulatory policies were approved by the government: ● Kazakhstan Family Planning National Framework Program for 2017-2021 ● Operational action plan to reduce maternal mortality in the Republic of Kazakhstan ● Concept of Family and Gender Policy in Kazakhstan until 2030 The new Сode "On the Health of the People and the Healthcare System" is being drafted in Kazakhstan. MoH based on UNFPA advice promotes decreasing the age of voluntary agreement for healthcare services without parental consent from the age of 18 to 16 years of old. The question was put to public hearings and provoked a stormy reaction, escpecially for abortion155.
Adolescent & Youth. The Ministry of Education does not recognize sexuality education as a priority, therefore it is very difficult to introduce sexuality education in existing educational program and to get an access to schools without legal permission of the respective authorities. The trainings on Valeology supported by UNFPA will not be sustainable unless the MoE integrates them because very much depends on the human factor. If local education authorities understand the importance they continue to provide training to the students. If however there will be a change in the Head of the Education Department than the trainings will be discontinued. UNFPA is making efforts to include the Valeology Course into the curriculum of vocational schools.
Gender. UNFPA focuses on development and institutionalization of policies, strategies and laws in partnership with national stakeholders. In particular, on gender isseues there are two UNFPA provided technical assistance to the main policy documents: Kazakhstan Family Planning National Framework Program for 2017-2021; Concept of Family and Gender Policy in Kazakhstan until 2030.
The Concept of Family and Gender Policy has been enacted since January 2017. The essence of the Concept is to approach gender issues from the perspective of a family because when a family becomes free of domestic violence, such issues as equal budget, work distribution and other issues are solved in a different way. Today the gender policy issues have changed as compared with what we had 5-10 years ago. To have the National Committee within the President’s Office is a very good idea because when decisions are taken, then recommendations will be implemented faster. The structure has been institutionalized – there are committees at the regional and district levels. The committee in regions is led by the city/district deputy for social affairs, which adds to strengthening the fulfillment of recommendations of the committee meetings.
P&D. i) the development of geo-information system (GIS) for the national population census and providing trainings on how to use it to the IT-specialists; ii) the development of technical documentation for conducting public procurement related to the national census; iii) UNFPA work in the development of standards for processing micro-data; iv) provision of services to elderly; and v) the preparation of the national ageing strategy. UNFPA established productive relationships with key government partners working in P&D sphere including State Agency on Statistics; National commission on women, family and Demographic policy; Public administration academy under President of Kazakhstan, etc. Partnership with members of Parliament takes place in the framework of the Asian Forum of Parliamentarians on Population and Development that focuses on law making related to fulfillment of obligations in the field of reproductive health, gender equality and population and development arising from international conventions, ICPD Program for Action, SDG and other documents.
EQ 8 (Sustainability): To what extent have some of the results of pilot projects being used to scale up interventions and/or bring relevant evidence to policy-makers to adopt such approaches? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed The results of UNFPA ● Evidence that national funds have been ● NCFWC ● Degree of structural integration within budget and structures/processes in national supported initiatives allocated to continue/scale-up UNFPA-supported ● Relevant ministries
155 «Легализация абортов до 18 лет: плюсы и угрозы». https://zonakz.net/2018/12/06/legalizaciya-abortov-do-18-let-plyusy-i-ugrozy/ accessed August 8, 2019 118
are likely to last pilot projects (once UNFPA funded projects end) government ministries ● Document review of guidelines and tools (including referral pathways, adoption of beyond termination ● Evidence of a handover process from (cross-sectoral) standards of care) of country program UNFPA to the related executing parties regarding ● Partners ● Site visits (e.g., inspection of maintenance of equipment) the related projects. ● UNFPA staff ● Volunteerism ● Extent of ownership of each project by ● Interviews and FGDs with NGOs (implementing partners and non-implementing various collaborating groups/bodies (i.e., national partners) implementing partners, including NGOs and government bodies) ● Evidence of maintenance of equipment (counselling rooms, rape kit, dignity kit) SHR. From the beginning, three pilot projects in SRH - CEMD, Infection Control and Youth Health Centre – were created as models for further scale-up. CEMD, a well-recognized initiative supported by UNFPA, is now working in almost all regions of Kazakhstan. Republican Centre for Healthcare Development is playing a leading role and has got some funds to hire national experts, produce and dissiminate annual reports with CEMD findings. A pilot project for improving infection control in maternity hospitals is being realized in Zhambyl region. Lessons learnt from this project have been already used nationwide as series of recommendations in the Operational action plan to reduce maternal mortality in the Republic of Kazakhstan. Youth Health Centre established this year in Almaty City is the third pilot project in SRH. After piloting, the model will be expanded to all regions of Kazakhstan and will contain not only work procedures, but also financing mechanisms.
Adolescent & Youth. Four-day training for trainers on the Valeology course for teachers of schools and colleges of Turkestan region was conducted in Shymkent. Teachers of Sairam, Keles, Maktaaral districts and the cities of Shymkent, Turkestan and Zhetisay were trained in introducing the Valeology course with an enhanced content on reproductive health and equality of men and women. UNFPA expanded the Valeology course within the project on girls’ empowerment in Turkestan region. The training was aimed at educating teachers to conduct Valeology in own schools and colleges. The updated course has a number of chapters highlighting gender equality, promotion of family non-violence, countering gender-based violence, child and forced marriage. According to the 2015 Multiple Indicator Cluster Survey, Turkestan region is among five regions with the highest number of girls aged 15-19 (9.3%) being in a legal or unregistered marriage. After an underage girl entered into marriage, she often falls into a so-called ‘vicious cycle of poverty’: as a rule, because of a child marriage she has to quit school, does not get proper education, can not find a job, which results in poverty, health problems and ultimately dependence on her partner. Besides, such girls’ children often share the same destinity as their mothers. Adolescent years are the time of risk taking behavior. Unfortunately, sometimes among the consequences of such behavior can be unprotected sex and sexually transmitted infections, unwanted and unintended pregnancy. Sexual and moral education appropriate to the age can provide young men and women with the knowledge on how to protect themselves from such risks. UNFPA focuses much on equality of men and women, boys and girls because girls encounter an additional risk of child marriage that can strongly limit her life opportunities. Previous results of the Valeology course pilot testing in a number of Kazakhstan regions showed that in a class of students where this course was delivered 4.3% of students decided to delay the onset of sexual activity. In a control group where the subject was not delivered a number of students who engaged in early sexual relations increased by 10%.
Challenge. Before successful pilot projects on the development of Y-PEER initiatves are transferred to other regions, it is necessary to thoroughly study capabilites of the region where project implementation is planned. For example, the project development in Ust-Kamenogorsk has failed. It is very important to have specific coordinators who would not only be interested in conducting individual activities but also would be able to continue developing this area.
Gender. The local administrations of Shymkent, Turkestan and Saryagash recognize usefulness and sustainability of the UNFPA programs. Useful are world best practices, sceitnfic research and developments, literature and educational programs. Patriarchal society dominates basically in the south of the country where much is forbidden for teenage girls. In this respect, it was interesting to implement the “Kazakhstan without Violence” project - active work was carried out through schools: parent committees worked with departments of education under the local administrations. Trainings for trainers were conducted on violence prevention, strengthening the role of the father, suicide issues and proper health of boys. The UNFPA activity was effectively covered in mass media and supported not only by the local administrations but also by schools, parents and adolescent. One of the results of the activity carried out in the south of the country was active interaction between the state and civil society organizations. Currently, the National Commission on Women Affairs and Family-Demographic Policy consists mainly of CSOs representatives, and only the chairman of the Commission is an akimat employee.
Challenge. The new Concept on Family and Gender Policy till 2030 was approved by the Government but a challenge remains as to ensure proper and adequate implementation and funding both
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Finalized Official Report from national and regional levels. Those areas promoted by UNFPA, such as introduction of sexuality education into formal education, universal access to quality family planning services and counselling and purchasing of contraceptives for vulnerable groups of population should be considered by the Government as priority areas and to be closely monitored. The Ministry of Health and Social Development developed at the beginning of the current year national standards on social services to domestic violence survivors and trafficking. These standards are currently under revision of the different ministries and agencies of the Government. The new proposed by UNFPA, Essential Package Services and Standard Operating Procedures on MSR to GBV are not welcomed by the Ministry of Health and Social Development since they consider UNFPA proposed SOPs contradict their National Standards. UNFPA should further advocate for revision of the national standards on domestic violence and consider SOPs to be integrated into the national standards and involve the General Prosecutor Office for this advocating exercise.
P&D. There are several pilot projects and/or project started with UNFPA support which results were scale up or being implemented by local state institutions and CSOs. ● Pilot 1. School course on valiology was tested in the Eastern Kazakhstan first, and then its effectiveness was measured to improve it before multiplying it throughout Kazakhstan. This course is important as it provides important to youth information on Reproductive Health, HIV and AIDS, Sexual Behavior, concraptives, abortion, etc. ● Pilot 2. In 2015 the first national survey on domestic violence was conducted with support from the state budget. UNFPA provided technical assistance to the Committee on Statistics on questionnaire development and methodology of the survey. UNFPA supported capacity building of the Committee on design of sampling, development of the data entry and data processing software through funding the participation of a specialist of the Committee on Statistics at the training on methodology of survey held in Moldova. This survey laid down ground for development state policy on domestic violence that is supported by data. Moreover, for more better understanding about changes happened in society since the first survey, it is important to conduct monitoring of situation with domestic violence and include girls of 14-18 age range. Follow-up monitoring is important to understand factors influencing violent behavior in families (mentality, economic dependence, mother-in-law, etc.) and to map domestic violence features of each regions of Kazakhstan. ● Pilot 3. The first wave of the national Generations and Gender survey (GGS) was conducted in Kazakhstan during the period of 16 April - 31 July of 2018. Data was collected by the Committee on Statistics using NIDI technologies, software and tablets, and processed by the NIDI data base specialists. NIDI provided the GGS database to the Committee on Statistics after its finalization in January 2019. ● UNFPA support to Kazakhstan was important as it helps to update specialists of the Committee of Statistics on new approaches and methodologies in already ongoing studies. ● At the same time there are some other challenges for sustainability within P&D areas mentioned by key informants that should be considered, including: ● Lack of local experts on demography; ● There is no standards, certification for demographist that can be developed and regulated by a professional organization (such organization might have exist if there is replenishment with new carde from demographic/statistics departments); ● There are no open survey data for secondary use, except MICS; ● It takes too long to access census data after survey conducted; There are lack of express studies and follow-up monitoring of studies. EQ 9 (UNFPA Country programme coordination with UNCT): To what extent has the UNFPA country office contributed to the functioning and consolidation of UNCT coordination mechanisms? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed The UNFPA country ● Evidence of active participation in UN ● Minutes of UNCT ● Document analysis office has actively working groups working groups ● Interviews with UNFPA country office staff contributed to UNCT ● Evidence of the leading role played by ● Programming ● Interviews with other United Nations agencies working groups and UNFPA in the working groups and/or joint documents regarding UNCT joint initiatives initiatives corresponding to its mandate areas joint initiatives ● Evidence of exchanges of information ● Monitoring/evalua between UN agencies tion reports of joint ● Evidence of joint programming initiatives programmes and projects (planning) ● Evidence of joint implementation of programmes 2016-2020 PFD is to implement new approaches to coordination mechanisms, improving joint programming, monitoring and evaluation and reporting among UN agencies. Key elements of the PFD
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management include the establishment of the working and thematic groups. UNFPA representatives take part, directly or indirectly, in all of them including: The Steering Committee, Results Implementation and Management Group, Thematic Sub-groups by six PFD outcomes (Outcome 1.1, Outcome 1.2, Outcome 1.3, Outcome 2.1, Outcome 2.2, Outcome 3.1), SDGs data monitoring group, Gender Theme Group, Joint United Nations TG on HIV/AIDS (JUNTA), UN Joint Communications Group, Operations Management Team
EQ 10 (UNFPA Country programme added value): What is the main UNFPA added value in the country context as perceived by UNCT and national stakeholders? Assumptions to be Indicators Sources of information Methods and tools for the data collection assessed Added value of ● Evidence that the results observed within ● UNFPA team Document review and analysis UNFPA in the the programmatic areas couldn’t be achieved ● Parliamentary country context is without UNFPA support Committee significant ● Evidence and magnitude of benefits ● Ministries added by UNFPA to the results from other ● NCFWC development actors’ interventions. ● Relevant NGOs ● Project reports ● Partners’ work plans and reports ● National reports Key informants’ contributions. SHR. ● New initiatives, approaches further adapted and supported; ● Pressure on government for UN Convention adoption; ● UNFPA recognition by government that co-finance UNFPA programs
Adolescent & Youth. Gender. ● Introduction of new modern concepts; ● Developing ownership for lasting results by working with key stakeholders and vulnerable groups; ● Best practices and success stories (Y-peer); ● Institutionalization of SRH issues into formal education (grouping families in 3 categories: with children under 5; teenagers, elderly) ● Religious leaders
P&D. ● TOT for national experts and their work along with international; ● Experience exchange plus new knowledge; ● Technical support to national experts; ● Emergence of sensitive priorities from survey to address (HIV/AIDs, consent from 16 year old); ● Remind other donors on social issues to be addressed along with economy; ● Promote and consolidate work on SDG; ● Name; ● Joint work with government and government started better understand demograph
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Annex 5. Abstract of the evaluation report
CPE for Kazakhstan (2010-2018) Abstract
Subject of the evaluation. UNFPA support provided to Kazakhstan during 2010-2018
Purpose of the evaluation. The overall purpose of this CPE is to conduct an independent assessment of relevance, performance and sustainability of UNFPA support provided to Kazakhstan during 2010-2018, as well as analysis of various facilitating and constraining factors influencing programme delivery.
Methodology The evaluation was conducted by a three-person team (team leader and two evaluators). The evaluation is based on non-random samples of respondents with qualitative data collection methods. All interviews followed informed consent procedures as required by the UN ethics guidelines for evaluators. The collection of evaluation data was implemented using three main methods: 1) Desk review; 2) Key informant semi- structured group and individual interviews; and 3) Site visits to CP targeted areas in three regions (Nur-Sultan, Almaty, Turkistan region). The analysis is based on a synthesis and triangulation of information obtained from the above-mentioned three evaluation activities. Limitations of the evaluation include the timing of evaluation falling into holiday season, and size of the country. All interviews were done without the presence of UNFPA staff.
Main conclusions Evaluation the 3rd and 4th Country Programmes showed that all programme areas are important for Kazakhstan and address its national interest and needs. UNFPA Kazakhstan approach to use evidence based data on emerging population issues as well as UNFPA position to raise social issues that often are disturbing and inconvenient contributed to relevance of the national policy designed and promoted by UNFPA along with other UN Agencies. UNFPA strategy of programme interventions is responsive to global challenges and national interests and needs. The 3rd UNFPA Country Programme contributed to several of the achievements made by Kazakhstan, including a significant reduction in maternal and infant mortality, ratification of the Convention on the Rights of Persons with Disabilities, changes in the state health-care programme to ensure better access to health services and commodities, such as the inclusion of antiretroviral drugs in the basic benefit package for HIV positive persons. UNFPA Kazakhstan made smooth transition from concentrating on capacity building of its partners to raising awareness, expanded introduction of the national and international best practices, improvement of national potential and promotion of national leadership and ownership of programme outcomes, supporting advocacy and policy dialogue to ensure the principles of human rights observation and protection, with a focus on the most vulnerable. Kazakhstan is an upper-middle-income country where a traditional development assistance model does not apply and traditional donors often cannot support the country. As result, UNFPA in Kazakhstan operates in a resource constraints environment. Given this situation UNCT collaboration and its cooperation with other development partners and national government became more important, especially joint efforts are needed for nation-wide and/or pilot initiatives. UNFPA Kazakhstan positive experience in working with religious Islam and Christian Orthodox leaders of on sexual and reproductive health, gender and gender- based violence and youth will become increasingly important. At the same time, UNFPA Kazakhstan Country Programme documents lack clearly defined output/outcome indicators and their sources. Annual report format do not reflect output/outcome indicators presented in the CP that make difficult to monitor achievement of indicators by country programme as well as annually. As results, the output and outcome indicators were not usable to reflect the achievements of UNFPA. First, as it was mentioned, most of them are not correctly reflecting advocacy goals. Second, the indicators don’t have clear operational definitions to measure and interpret them. Third, it is difficult to monitor progress towards the planned outcomes during the programs, because the output indicators are measured and reported only at baseline and at the end of the programs, but not annualy or bi-annualy.
Main recommendations To increase its effectiveness UNFPA should better promote and provide access to secondary data and reports of surveys/studies/research as evidence base for advocacy and policy work of all stakeholders, including Government and Parliament of Kazakhstan. As Kazakhstan is transitioning from being a recipient to being a donor of official development assistance, a specific attention should be paid to developing resorce mobilization strategy that includes neighbouring countries in order to create new opportunities for UNFPA at regional level where its expertise and support are in high demand and development actors like EU and USAID are more interesting supporting region-wide projects. 122
UNFPA should improve M&E through introducing new output and outcome indicators correctly reflecting advocacy goals, namely: policy development, placement on the policy agenda, policy adoption, policy implementation, policy M&E, policy maintenance.
Sexual and Reproductive Health: Advocacy strategies and objectives should be adjusted over time to account many factors including (sometime negative) changes in political opportunities. If possible, UNFPA should build capacity to challenge opponents and opposing voices. The comprehensive approach to advocacy being used for Youth Health Centers should be extended to other advocacy objectives, for example, improving Family Planning Services.
Youth and Adolescents: UNPFA should develop a long-term strategy and comprehensive approach of working with youth that includes clearly articulated and sustainable results; and continue to advocate the integration of sexuality education into the existing educational program at schools throughout the country with state authorities at national and local levels.
Gender Equality: A proper and adequate implementation of the new Concept on Family and Gender Policy till 2030 in the part related to sexuality education and universal access to quality family planning services and counseling for vulnerable groups of population need to be improved and special attention should be paid to introducing them into formal education. UNFPA should assist to the Government of Kazakhstan with implementation the Concept of Family and Gender Policy by providing technical assistance and involving other UN institutions to effectively address gender equality issues through a prism of family values; continue partnership with the Government of Kazkanshtan and other UN and international institutions and provision of technical support in implementation of SDG 5 and 17, in particular for localization goals related to gender issues; and continue to support the comprehensive approach to combat GBV together with national partners and UN agencies. UNFPA should spread its positive experience of working with Islam and Orthodox religious leaders throughout Kazakhstan and on other religious and neighbouring countries on GBV issues.
Population and Development: UNFPA should assist the Government of Kazakhstan with development of comprehensive population strategy/policy that considers population dynamics, including aging issues; and advocate for formal education in demography and continue education of civil servants on population issues through the Public Administration Academy. At the same time, demography- and population development courses can be introduced at college/school level.
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Annex 6. Stakeholders’ mapping
SRH and Youth Government NGO Donor 2016 2010 - - 2010-2015 2016-2020 2010-2015 2016-2020 2015 2020 Tamara Djussubaliyeva- President of Kazakhstan MoH- department of Esenamanova Svetlana- association on sexual and motherhood and Deputy head of Aktobe reproductive health - Kuralai Bekenova- Chairperson of childhood: Embergenova regional health Implementing partner. Based Business women association of Magripa +77017940237; department; tel in Almaty. Email- South Kazakhstan; tel Birzhanova Kulyaim +77017579852, email: [email protected] , tel +77022455120, +77013925962 [email protected] +77011113437 email:[email protected] IP Master trainer on President of Public Fund Executive Director of Kazakhstan effective perinatal care "Aman-saulyk": Ms. Tumenova Association on Sexual and An Zoya +77015581273 Bakhyt Niyazbekovna - Reproductive Health (KMPA) Implementing partner, Almaty Ms. Grebennikova Galina, Glazebnaya Inna- Head of E-mail: [email protected], Tel.: Almaty, MCH of Shymkent regional +7 707 505 35 39, +7 777 214 Tel:+7(727)3958518 | Mob: health department; tel 53 53, +7 (727) 292 04 85 +77013547706 +77017387485; email: Skype: galina_grebennikova [email protected] Email: [email protected] Director of Center for the Study of Public Opinion Yesmagambetova Aizhan- (CIOM): Ms. Alimbekova Head of public health Gulzhan, e-mail: department of Ministry of [email protected] , tel. Health, tel +77015148623, (+727) 2731475, (+727) Kamilla Tuyakbaeyva- Y-peer Head of CEMD national email 2731401. Mob. + 7 network focal point- commission- Bapaeyva [email protected] 7017828259, + 7 707 7828259 +77780780706, email Gauri +77017462800 .kz Almaty [email protected] Head of Department of Biostatistics and research basics, Kazakh National National Center for Medical University, named Gynecology and Kabylova Saule- Head of after Asfendiyarov - Mr. Perinatology- Almaty regional health Zhussupov Bauyrzhan NGO Aktobe Damuy Implementing partner- department, tel: Sabitovich. E-mail: Zhanna Kadyrova, Director Focal point- Biktasheva +77015252303 email: [email protected] [email protected] Hazina +77051829677 [email protected] m , tel.: +77774822171 Mob.:+7 702 446 28 83 National Center for Chairman of Public Association healthy lifestyle of Women with Disabilities development- "Shyrak", also Deputy of Implementing partner. Almaty Maslikhat (local Sholpan Karzhaubayeva Parliament) - Ms. Kaltayeva Gulzhanat Muratbay, Director +77013706106, email: Lyazzat Moldabekovna. E-mail: NGO Urpak Next [email protected]. Based [email protected] Mob.:+7 775 384 84 42- IP in in Almaty tel: +77017138342 Mangystau Department of Ms. Nadezhda Petukhova, education of Eastern Vice-president of the Eurasian Kazakhstan oblast, Medical Association,
deputy head - Ms.Ms. [email protected] Sadykova Aizhan. Ust- Kamenogorsk +7232 Zhakyp Shaimukhambetuly, NGO 700224 Orkenietti Kazakhstan center_tipo_metod@ma Mob.: +7 708 706 00 87 IP in il.ru Kyzylorda Kulyaim Birzhanova- Unzhakova Irina , Deputy, MCH Department of Parlament of RK Mob.: +7707 Ministry of health; tel 331 97 10 (Larisa-assistant) she +77013925962 was head of IP in East Kazakhstan Mukusheva Saule- Deputy head of East Kazakhstan Regional health department, tel +77761318757
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Gender Government NGO Donor 2010- 2010-2015 2016-2020 2010-2015 2016-2020 2015 2016-2020 Head of Secretariate Head of Secretariate of Director of Center for Head of Business Women East European of the National the National Comission the Study of Public Association of South Institute for Comission on women on women affairs and Opinion (CIOM): Ms. Kazakhstan: Ms. Bekenova Reproductive Health affairs and family- family-demographic Alimbekova Gulzhan, e- Kuralai, Shymkent, e-mail: (EEIRH), Regional demographic policy till policy 2014-2018: Mr. mail: [email protected] Tel.: Initiative 2014: Ms. Naubetova Raiganiyev Erlan [email protected] , +7 702 2455 120 Coordinator - Ms. Rashida Aronovna Telmanovich, tel. (+727) 2731475, Ionela Horga. +77015994605 +77012122244 (+727) 2731401. Implementing Astana Astana Mob. + 7 7017828259, + partner of UNFPA 7 707 7828259 EECARO. E-mail: Almaty [email protected] ; Tel: +40744421742. Tîrgu-Mureș, Romania Head of Secretariate Senior Assistant of Head of the NGO Chief Imam of “Amankul of the National General Prosecutor: Ms. "Center of civil initiatives Ata” Mosque of Medeu Comission on women Tursynbekova Saltanat Partner" Ms. Turganbai district of Almaty city - Mr. affairs and family- Parkhatovna, Zukhra Khussainovna, e- Zhakeev Tolepergen. E-mail: demographic policy +77029106565. Astana mail: [email protected] , tel: 2014-2018: Mr. [email protected] +77021150116 Raiganiyev Erlan , tel.: + 7777 619 17 95 . Telmanovich, Almaty +77012122244 Astana Head of the Office of Lieutenant colonel, Chairman of the Public Hieromonk of Russian Statistics for Senior Inspector for Association "League of Orthodox Church - Mr. Sustainable Special Assignments of Women of Creative Kenesarin Seraphim. E-mail: Development Goals: the Women's Protection Initiative", also Member [email protected] tel: Ms. Dossanova Ainur Unit of the of the National +77052877321 Seyidgalikyzy, Administrative Police Commission for Women +77019924636, Committee, Ministry of Family and Demographic +77019924640. Astana internal affairs Ms. policy - Ms. Khairullina Bekisheva Rosa Assia Ukeevna. E-mail: Mukhamediarovna [email protected] +77756025427, Astana u , [email protected] . Tel.: +77018017220. Almaty Chief Inspector of the Naib Imam of the Republican department of Mosque Khazret Sultan, organizational work and Astana - Mr. Sultanov Ruslan. regional development of E-mail: tel: +77015142978; the apparatus of the +77776714004 Akim of the Turkestan region; Secretary of the Commission for women affairs and family- demographic policy under the Akim of the Turkestan region - Ms. Boranbayeva Gulmira Zharylkasynovna. tel.: +77022102350. Turkestan city Head of the service of social and psychological support for domestic violence victims under the Akimat of Saryagash district of Turkestan gerion: Mr. Tarakhtiyev Marat Mamyrtaiyevich, tel. +77017157651
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PDE Government NGO Donor 2010-2015 2016-2020 2010-2015 2016-2020 2010-2015/ 2016-2020 Head of the Head of the Office of Head of the NGO Head of Business Women Deputy Director of the Institute Department of social Statistics for Sustainable "Center of civil initiatives Association of South of Demography, Head of the and demographic Development Goals: Ms. Partner" Ms. Turganbai Kazakhstan: Ms. Bekenova Department of Demography at statistics of the Agency Dossanova Ainur Zukhra Khussainovna, e- Kuralai, Shymkent, e-mail: the Institute of Demography, on Statistics - Ms. Seyidgalikyzy, mail: [email protected] Tel.: High School of Economics - Mr. Kukanova Gulnar +77019924636, [email protected] +7 702 2455 120 Denissenko Mikhail Borisovich. Zhakayevna, Tel.: +77019924640. Astana , tel.: + 7777 619 17 95 . Implementing partner of +77013992706; Almaty UNFPA EECARO. E-mail: den- +77056460324 . [email protected] . Tel: Astana +74957729590 Moscow, Russian Federation Expert of the Head of the Department Committee on of social and Statistics - Mr. demographic statistics Mussabek Yerbolat of the Committee on Nygmanovich. Tel.: Statistics, Ministry of +77017508046. e-mail: national economy - Ms. [email protected] Karaulova Gulmira Astana Sailaubekovna, Tel.: +77773085555. Astana Deputy Director of the Head of the Department Center for Analytical of Preparation and Research and Implementation of Forecasting of the National Censuses Mr. Institute on Economic Kozhakov Nurlan Research - Ms. Akremkhanovich, e-mail: Akmoldina Batzhan [email protected] Nuralievna. Astana. E- ov.kz , tel.: +7 7172 74- mail: [email protected] 91-62 (office). Astana , tel: +77757857404 Chief Inspector of the department of organizational work and regional development of the apparatus of the Akim of the Turkestan region; Secretary of the Commission for women affairs and family- demographic policy under the Akim of the Turkestan region - Ms. Boranbayeva Gulmira Zharylkasynovna. tel.: +77022102350. Turkestan city
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Annex 7. UNFPA Intervention logic for 3rg and 4th CPs by programme components
SEXUAL AND REPRODUCTIVE HEALTH
In 3rd CP, UNFPA had two outcomes of the Reproductive health and rights component. The first and second outcomes were women and young people, especially those in rural areas and from high-risk groups, have improved access to health-care services and universal access to high-quality sexual and reproductive health services and services to prevent HIV and sexually transmitted infections is ensured for everyone in need, with a focus on vulnerable population groups. These outcomes were planned to be achieved through four outputs (Figure 7).
Figure 7. Logic Model of SRH Programme, 2010-2015 Women and young people, especially those in rural areas Universal access to high-quality sexual and reproductive and from high-risk groups, have improved access to health- health services and services to prevent HIV and sexually care services transmitted infections is ensured for everyone in need, with a focus on vulnerable population groups Outcomes Percentage of rural and urban population covered by high- Births by girls aged 16-18. quality maternal and child health services Percentage of sexually active women aged 15-49 using modern contraceptive methods. Outcome Outcome indicators
1. Maternal health strategies 2. Health-care providers have 3. Women and young people 4. Women and young people are approved and action plans the capacity to expand the are equipped with high-quality have improved access to high- are developed and delivery of high-quality family information to prevent and
implemented planning and reproductive quality sexual and reproductive reduce the risk of unwanted health services, with a focus on health and services to prevent pregnancies and HIV vulnerable groups, including HIV and AIDS transmission Outputs rural populations and the poor Percentage of health-care Number of trained health-care Percentage of services certified Percentage of young people institutions implementing as youth-friendly aged 15-24 who are aware of providers. effective perinatal technologies. sexual and reproductive health Training programme is and HIV prevention issues. incorporated into the curricula Percentage of regions of the of all tertiary and secondary country involved in youth peer
Output indicators medical schools. network.
Focus on: Focus on: Focus on: Focus on: (a) providing access to high- (a) providing family planning (a) incorporating the (a) providing advanced training quality maternal health services; reproductive rights of young for young people in peer services, including in (b) ensuring reproductive people in national policies; education;
Activities emergencies; health commodity security; (b) improving the access of (b) promoting the collaboration (b) strengthening reproductive (c) integrating family planning women and young people, of young people with youth- health services in primary services into primary health especially girls, to HIV oriented mass media and health-care units, including care; prevention services, including in celebrities; services to prevent unwanted (d) strengthening partnerships emergencies; (c) developing and maintain pregnancies, sexually with communities. (c) updating HIV policies, websites in the official language transmitted infections and HIV emphasizing the needs of of the country; and AIDS; women and girls; (d) providing training to (c) updating evidence-based (d) integrating HIV and AIDS and maintain partnerships with clinical protocols for perinatal sexual and reproductive health authorities and health care and the management of policies and practices; professionals; obstetric conditions and (e) improving the monitoring of, (e) provide training to mobilize reproductive health diseases; access to and utilization of resources for youth and services for young people on programmes. (d) developing a modern sexual and reproductive health, maternal mortality monitoring HIV and sexually transmitted system. infections.
The 4th on going CP concentrates on (a) ensuring the realization of reproductive rights and universal access to integrated maternal, sexual and reproductive health services, with a focus on the most vulnerable; and (b) empowering young people and ensuring their access to comprehensive sexuality education to reach 2016-2020 Partnership Framework for Development outcome: improved equitable access to quality integrated social services, 127
including for socially vulnerable and disadvantaged groups (Figure 8). To achieve planned outcomes, UNFPA works with National Commission on Women Affairs and Family-Demographic Policy under the President of Kazakhstan, Ministries of Health, Labour and Social Development, Education and Sciences, Parliament, NGOs, regional authorities, United Nations agencies (WHO, UNICEF, UNESCO), schools and universities.
Figure 8. Logic Model of SRH Programme, 2016-2020 1. Sexual and reproductive health 2. Adolescents and youth
Increased availability and use of integrated sexual and Increased priority on adolescents, especially on very young reproductive health services (including family planning, adolescent girls, in national development policies and maternal health and HIV) that are gender-responsive and programmes, particularly increased availability of meet human rights standards for quality of care and equity comprehensive sexuality education and sexual and Outcomes in access reproductive health
Contraceptive prevalence rate (total) Percentage of young women aged 15-24 years who correctly identify ways of preventing sexual transmission of HIV and who reject major misconceptions about HIV cators transmission Outcome indi
Output 1: Strengthened policy framework and institutional Output 1: Strengthened national laws, policies and
mechanisms to deliver integrated sexual and reproductive programmes that include adolescent and youth and their health services, with particular focus on the most human rights and needs vulnerable and key populations Outputs • Percentage of health service providers at primary health • United Nations Educational, Scientific and Cultural care and hospital levels practicing the newly adopted Organization standards on comprehensive sexuality clinical protocols and standards education are integrated into national standard curricula • Contraceptives included in the list of basic benefit • Percentage of regions of Kazakhstan with Y-peer package for vulnerable and key populations presence • Number of key facilities in all 16 regions of Kazakhstan • Existing legislation is revised to decrease age from 18 that use in their routine work the ‘near-miss cases’ years to 16 years in receiving sexual and reproductive review approach of confedential audit ‘beyond the health services without parental consent numbers’
Output indicators
Focus on: Focus on: (a) increasing investment in reproductive health and family (a) incorporate the rights of young people in national laws planning services; and policies; (b) developing and implementing additional national (b) introduce comprehensive sexuality education in clinical protocols and standards on sexual and reproductive national education curricula; health; (c) better institutionalize Y-peer as a partner and expand (c) strengthening the national system of confidential its community-based information and education services enquiry into maternal deaths; on leadership, sexual and reproductive health, HIV and (d) establishing an enabling environment for access to gender;
services, particularly for vulnerable and key populations; (d) ensuring better data on young people transmitted (e) assisting in the preparedness to deliver sexual and infections. reproductive health services in emergencies; Activities (f) ensure better data on health status, needs and services.
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ADOLESCENT AND YOUTH, GENDER
In its 3rd Country programme the UNFPA activities in the field of gender were focused on technical support to the national commission on women and family demographic policy to implement the action plan on gender-based violence, emphasizing reproductive rights and sexual and reproductive health. The programme provided technical assistance and trained decision makers to: (a) develop policies to prevent and mitigate the consequences of gender- based violence, including in emergencies; (b) integrate a course on preventing gender-based violence into the undergraduate and postgraduate training of health-service providers; and (c) improve gender-based violence monitoring systems. The programme also helped to improve the access of the population to the Government on gender-related issues, through better use of information and communication technology. The 3rd CP did not have separate programme component aiming at adolescent and youth. However, Outputs 3 and 4 of the Reproductive health and rights component specified ‘young people’ as target group.
Figure 9. Logic Model of Gender equality Programme, 2010-2015 Outcome 1: Gender equality and the human rights of women and adolescent girls, particularly their reproductive rights, integrated in national policies, development frameworks and laws. Outcome 2: Gender equality, reproductive rights and the empowerment of women and adolescent girls
2011
- promoted through an enabling sociocultural environment that is conducive to male participation and the elimination of harmful practices. Outcome 3: Human rights protection systems (including national human rights councils, ombudspersons, and conflict-resolution mechanisms) and participatory mechanisms are strengthened to protect the reproductive
OUTCOMES rights of women and adolescent girls, including the right to be free from violence. Outcome 4: Responses to gender-based violence, particularly domestic and sexual violence, expanded through UNFPS 2008 SP, UNFPS improved policies, protection systems, legal enforcement and sexual and reproductive health and HIV- prevention services, including in emergency and post-emergency situations.
Outcome 2: Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education 2017 - and sexual and reproductive health services Outcome 3: Advanced gender equality, women’s and girls’ empowerment, and reproductive rights, including for UNFPS SP, UNFPS 2014 OUTCOMES the most vulnerable and marginalized women, adolescents and youth
-
Outcome: National institutions have improved capacity to protect human rights and ensure access to justice for women.
CP, 2010 2015 OUTCOME
Output 1: The action plan of the gender equality strategy reaches a greater number of women and is fully implemented CP OUTPUTS
a. develop policies to prevent and mitigate the consequences of gender-based violence, including in emergencies; b. integrate a course on preventing gender-based violence into the undergraduate and MAIN postgraduate training of health-service providers; ACTIVITY c. improve gender-based violence monitoring systems.
In the 4th Country programme the UNFPA activities in the field of Adolescent and Youth are focused on engagement in evidence-based policy dialogue, advocacy and knowledge transfer to (a) incorporate the rights of young people in national laws and policies; (b) introduce comprehensive sexuality education in national education curricula; (c) better institutionalize Y-peer as a partner and expand its community-based information and education services on leadership, sexual and reproductive health, HIV and gender; and (d) ensure better data on young people.
In the 4th Country programme UNFPA activities in the field of gender equality and women empowement employed evidence-based policy dialogue, advocacy and knowledge transfer to (a) develop a new long-term national policy 129
document on gender equality that integrates Universal Periodic Review recommendations and obligations related to sexual and reproductive rights, prevention of gender-based violence and early marriages; (b) strengthen coordinated institutional mechanisms for providing a multisectoral response to gender-based violence; (c) strengthen the partnerships between government, civil society and faith-based organizations to promote gender equality, and prevent gender-based violence and early marriages; and (d) promote gender transformative approaches and engagement of men and boys in addressing gender inequality and gender-based violence.
Figure 10. Logic Model of Adolescents, Youth and Gender Programme, 2016-2020
Outcome 2: Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education 2017 - and sexual and reproductive health services Outcome 3: Advanced gender equality, women’s and girls’ empowerment, and reproductive rights, including for UNFPS SP, UNFPS 2014 OUTCOME the most vulnerable and marginalized women, adolescents and youth
Outcome 2: Every adolescent and youth, in particular adolescent girls, is empowered to have access to sexual and reproductive health and reproductive rights, in all contexts 2021 - Outcome 3: Gender equality, the empowerment of all women and girls, and reproductive rights are advanced in development and humanitarian settings UNFPS SP, UNFPS 2018 OUTCOME -
Outcome 2. Increased priority on adolescents, especially on very young adolescent girls, in national development policies and programmes, particularly increased availability of comprehensive sexuality education and sexual and reproductive health Outcome 3. Advanced gender equality, women’s and girls’ empowerment, and reproductive rights, including for CP, 2016 2020 OUTCOME the most vulnerable and marginalized women, adolescents and youth Outcome: Rights holders benefit from improved government policymaking and implementation through
enhanced participation at subnational and national levels PFD PFD OUT COM E
Output 2: Strengthened national laws, policies and programmes that include adolescent and youth and their
human rights and needs.
Output 3: Strengthened national policies and institutional mechanisms to promote gender equality, and to prevent gender-based violence and harmful practices CP OUTPUT
Adolescents and youth a. incorporate the rights of young people in national laws and policies; b. introduce comprehensive sexuality education in national education curricula; c. better institutionalize Y-peer as a partner and expand its community-based information and education services on leadership, sexual and reproductive health, HIV and gender; d. ensure better data on young people.
Gender equality and empowerment a. develop a new long-term national policy document on gender equality that integrates Universal Periodic Review recommendations and obligations related to sexual and reproductive rights, prevention of gender-based violence and early marriages;
MAIN ACTIVITY MAIN b. strengthen coordinated institutional mechanisms for providing a multisectoral response to gender-based violence; c. strengthen the partnerships between government, civil society and faith-based organizations to promote gender equality, and prevent gender-based violence and early marriages; d. promote gender transformative approaches and engagement of men and boys in addressing gender inequality and gender-based violence.
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POPULATION AND DEVELOPMENT
In its 3rd Country programme the UNFPA activities in the field of Population and development (P&D) were focused on improving access to goods, services and social safety by vulnerable groups, especially women, migrants, refugees, young people, the elderly and people with disabilities. The work of the Fund was focused at achieving the following results: 1) Policymakers employ evidence-based data to develop policies on gender equality, young people, sexual and reproductive health, and HIV and AIDS; and 2) Social-sector stakeholders are better able to plan, implement and monitor social and health services for the elderly, migrants and people with disabilities (Figure 11). In order to achieve planned results the UNFPA worked with parliamentarians, deputies of regional representative bodies, and members of the National Commission for Women Affairs and Family-Demographical policy under the President of the Republic of Kazakhstan and appropriate regional commissions, staff of labor, social protection and health authorities' bodies, other public administration bodies, religious confession figures and civil society.
Figure 11. Logic Model of P&D Programme, 2010-2015
- Outcome 3: Data on population dynamics, gender equality, young people, sexual and reproductive health and HIV.AIDS available, analysed and used at national and sucnational levels to develop and monitor policies and programme implementation. Outcome 4: Emerging population issues – especially migration, urbanization, changing age structures (transition to adulthood/ageing) and population and the environment – incorporated in global, regional and national UNFPS 2008 SP, UNFPS
2011 OUTCOMES development agendas.
Outcome 4: Strengthened national policies and international development agendas through integration of
2017 evidence-based analysis on population dynamics and their links to sustainable development, sexual and - reproductive health and reproductive rights, HIV and gender equality UNFPS SP, UNFPS 2014 OUTCOMES
- Outcome: vulnerable groups, especially women, migrants, refugees, young people, the elderly and people with
disabilities, have improved access to goods, services and social safety nets
CP, 2010 2015 OUTCOM E
Output 13: Policymakers employ evidence-based data Output 14: Social-sector stakeholders are better able to to develop policies on gender equality, young people, plan, implement and monitor social and health services sexual and reproductive health, and HIV and AIDS for the elderly, migrants and people with disabilities CP OUTPUTS
a. support multiple indicator cluster surveys to a. advocating health services for vulnerable
comply with the Programme of Action of the population groups; International Conference on Population and b. supporting parliamentarians, the national Development; commission on women and the family demographic b. help improve the quality of statistical databases; policy and related ministries and civil society and organizations to strengthen capacity in data c. assist in developing and maintaining national collection, planning and knowledge management MAIN ACTIVITY MAIN registers on vulnerable groups.
In the 4th Country programme the UNFPA activities in the field of P&D are focused on strengthened national policies and international development agendas through integration of evidence-based analysis on population dynamics and their links to sustainable development, sexual and reproductive health and reproductive rights, HIV and gender equality. The work of the Fund is focused at strengthening national data systems and increased availability and accessibility of evidence- based analysis on population dynamics and their links to sustainable development for the formulation of rights-based policies (Figure 12). In order to achieve planned results the UNFPA works with National Commission on Women Affairs and Family-Demographic Policy under the President of Kazakhstan, Committee on Statistics, Ministries of National Economy, Health and Social Development, Education and Sciences, Parliament, United Nations Economic Commission for Europe; United Nations organizations.
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Figure 12. Logic Model of P&D Programme, 2016-2020 Outcome 4: Strengthened national policies and international development agendas through integration of
2017 evidence-based analysis on population dynamics and their links to sustainable development, sexual and - reproductive health and reproductive rights, HIV and gender equality UNFPS SP, UNFPS 2014 OUTCOME
Outcome 4: Everyone, everywhere, is counted, and accounted for, in the pursuit of sustainable development 2021 - UNFPS SP, UNFPS 2018 OUTCOME
Outcome 4: Strengthened national policies and international development agendas through integration of - evidence-based analysis on population dynamics and their links to sustainable development, sexual and
CP, 2016 2020 OUTC OME reproductive health and reproductive rights, HIV and gender equality
Outcome: Right-holders benefit from improved government policymaking and implementation through enhanced
PFD PFD OU TCO ME participation at subnational and national levels
Output: Strengthened national data systems and increased availability and accessibility of evidence- based analysis on population dynamics and their links to sustainable development for the formulation of rights-based policies
CP OUTPUT
a. strengthen the institutional capacities for demographic analysis and projections as a basis for informed policy
formulation and monitoring in the areas of sexual and reproductive health, gender equality and gender-based violence, and population and development interlinkages, and with regard to the specific needs of vulnerable and key populations; b. assist in the development of a comprehensive population policy; c. ensure that the 2020 census is well organized and data are available and accessible; and d. ensure the development of an integrated system of population registers. MAIN ACTIVITY MAIN
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