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Armenia SABER Country Report EARLY CHILDHOOD DEVELOPMENT 2012

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Armenia SABER Country Report EARLY CHILDHOOD DEVELOPMENT 2012 Armenia SABER Country Report EARLY CHILDHOOD DEVELOPMENT 2012 Policy Goals Status 1. Establishing an Enabling Environment The Republic of Armenia (RoA) has established strong national laws and regulations to promote the provision of ECD services. The National Program on the Protection of Children's Rights for 2004-2015 is a multi-sectoral ECD policy that comprises the education, health, and social protection sectors, and serves as an overarching umbrella to guarantee access to essential ECD services through national laws and regulations. 2. Implementing Widely The RoA has established national programs in all essential sectors of ECD. These efforts have resulted in increased equitable access to ECD services provided to young children and mothers, particularly in the area of health, but access to nutrition remains inequitable as reflected in the high stunting rate. In the education sector, the preprimary enrolment rate remains low. The net enrolment rate in preprimary school for children 3-6 years of age is only 33.9% countrywide, with significantly lower levels in some regions and particularly in rural areas. 3. Monitoring and Assuring Quality Child outcome indicators are collected in the health sector, but not in other relevant sectors. Armenia has well established minimum quality standards and requirements in health and education sectors. Compliance should, however, be enforced. There is a need to develop a comprehensive child development tracking system across sectors. THE WORLD BANK ARMENIA ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2012 Armenia: Assessment of the Early exclusively breastfed from 35 percent to 60 Childhood Development Policies and percent by 2018. Develop a plan to provide regular antenatal care Programs for an increased percentage of pregnant women; Summary of Policy Recommendations reduce the percentage of pregnant women with The National Program on the Protection of Children’s Rights anemia from 39 percent to 20 percent by 2018. 1 for 2004‐2015 is a multi‐sectoral Early Childhood Identify causes for a high percentage of stunting Development (ECD) policy in Armenia that comprises the among children under five‐year old and develop a education, health, and social protection sectors, and serves strategy to reduce stunting from 19 percent to as an overarching umbrella to guarantee access to essential below 10 percent by 2018. ECD services. As the program period will soon end, it would Ensure young children an access to health care be timely for the government to review and assess the and increase the percentage of children below results of this program together with other sectoral ECD five‐year old with suspected pneumonia taken to programs and develop new, comprehensive multi‐sectoral an appropriate health care provider from 57 ECD policies and programs. percent to above 80 percent by 2018. Ensure access to key health and nutrition Based on the multi‐sectoral analysis of ECD policies and interventions focused and targeted towards low‐ programs in Armenia, this report proposes the following income and vulnerable children. Overall, out‐of‐pocket priority reform areas for the government’s consideration. expenditure (formal or informal) as percentage of total health expenditures is very high in Armenia. For Multi‐sectoral issues – monitoring and evaluation instance, there have been some reported instances of out‐of‐pocket informal payments for hospital care, Review the existing ECD data collected by line mainly for drugs because reimbursements from the ministries and develop a comprehensive ECD database government are insufficient to fully cover the cost of to be managed collectively among the relevant the drugs. This applies to ECD services as well. ministries, or consolidated by the National Statistical Fortunately, it appears that the introduction of the Service or any other suitable body. Ensure that a Child Health State Certification Program has improved comprehensive ECD database include essential child access to pediatric inpatient care for children under outcome indicators in all ECD sectors. seven‐year old, which needs to continue being Establish an improved Monitoring and Evaluation monitored. system that would help guarantee that eligible beneficiaries receive the appropriate services Education Wherever possible, develop an impact evaluation of interventions on cognitive, linguistic, physical, and Continue on the expansion of the coverage of the socio‐emotional development of children to one year National School Readiness Program to measure the effectiveness of interventions. achieve a 90‐percent enrollment rate by 2017. In addition to the lower requirements of community Health and nutrition contribution for poor communities that the government is currently considering, analyze the financial capacity of Review and improve the existing prenatal communities without a single preschool and develop a healthcare, infant immunization, and childhood subsidy mechanism, if needed, to support the wellness and growth monitoring programs as some establishment of a preschool for the most disadvantaged key ECD indicators suggest weaknesses in those communities. programs. In particular: Promote exclusive breastfeeding and increase the percentage of children under six‐month old 1 Since this report was prepared, the government adopted a new National Programme on the Protection of Children’s Rights for 2013‐2016 dated December 28, 2012. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 2 ARMENIA ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2012 Child protection Almost one‐third of the population lives below the poverty line; rural poverty is higher, where an Strengthen interventions to provide care for estimated 40 percent of the population lives below the children with special needs. While this report did not poverty line and 28 percent of the labor force is discuss this topic in detail, it is advisable that the unemployed. government collaborate with other development partners where they have strong advantages in supporting in this area. SABER – Early Childhood Development This report presents an analysis of the ECD programs SABER – ECD collects, analyzes and disseminates and policies that affect young children in Armenia and comprehensive information on ECD policies around the recommendations to move forward. This report is part world. In each participating country, extensive of a series of reports prepared by the World Bank using multisectoral information is collected on ECD policies and the SABER‐ECD framework and includes analysis of early programs through a desk review of available government learning, health, nutrition and social and child documents, data and literature, and interviews with a protection policies and interventions in Armenia, along range of ECD stakeholders, including government officials, with regional and international comparisons. service providers, civil society, development partners and scholars. The SABER‐ECD framework presents a holistic Armenia and Early Childhood Development and integrated assessment of how the overall policy environment in a country affects young children’s The Republic of Armenia (RoA) is a landlocked development. This assessment can be used to identify how mountainous country in the South Caucasus region of countries address the same policy challenges related to Eurasia, bordered by Turkey to the west, Azerbaijan to ECD, with the ultimate goal of designing effective policies the east, Georgia to the north and Iran to the South. for young children and their families. Armenia is a lower middle‐income country with a Box 1 presents an abbreviated list of interventions and population of 2.9 million people, ranked 86th in the policies that the SABER‐ECD approach looks for in UNDP Human Development Index table and, a GDP per countries when assessing the level of ECD policy capita (PPP) of 5,829 USD (2011). Despite a severe development. This list is not exhaustive, but is meant to economic recession in 2009, when GDP declined by provide an initial checklist for countries to consider the more than 14 percent, the economy is quickly key policies and interventions needed across sectors. recovering, registering 4.6 percent growth in 2011. Snapshot of ECD Indicators in Armenia with Regional Comparison Armenia Georgia Kyrgyzstan Russia Federation Ukraine Infant Mortality (deaths per 1,000 live births) 18 20 33 9 11 Under‐5 Mortality (deaths per 1,000 live births) 20 22 38 12 13 Moderate and Severe Stunting (under‐5) 19% 11% 18% No data No data Net Preprimary/kindergarten Enrollment Rate 38.7% 33.9% 17.2% 72.9% 75.1% (36 to 59 months of age) (2006) Birth registration 2000‐2010 96% 92% 94% No data 100% Source: UNICEF Country Statistics and TransMONEE Data Set, 2010 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 3 ARMENIA ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2012 Box 1: A checklist to consider how well ECD is promoted at the country level. Three Key Policy Goals for Early Childhood What should be in place at the country level to promote Development coordinated and integrated ECD interventions for young children and their families? SABER‐ECD identifies three core policy goals that Healthcare countries should address to ensure optimal ECD Standard health screenings for pregnant women outcomes: Establishing an Enabling Environment, Skilled attendants at delivery Implementing Widely and Monitoring and Assuring Childhood immunizations Quality. Improving ECD requires an integrated approach Well‐child visits to address all three goals. As described
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