The World Health Organization World Health Organization (WHO) is a specialized agency Regional Office for Europe of the United Nations created in UN City 1948 with the primary responsibility Marmorvej 51 for international health matters and DK-2100 Copenhagen Ø public health. The WHO Regional Denmark Office for Europe is one of six regional offices throughout the Tel.: +45 45 33 70 00 world, each with its own Fax: +45 45 33 70 01 Early child development in the European Region: programme geared to the particular E-mail: [email protected] health conditions of the countries it Web site: www.euro.who.int serves. needs, trends and policy development Member States An overview based on five country assessments Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan By: Ramona Velea, Giorgio Tamburlini Early Child Development in the European Region: needs, trends and policy development An overview based on five country assessments By: Ramona Velea, Giorgio Tamburlini ABSTRACT Early childhood is the period of most extensive (and intensive) parental responsibilities related to all aspects of children’s well‐being covered by the Convention: their survival, health, physical safety and emotional security, standards of living and care, opportunities for play and learning, and freedom of expression. Accordingly, realizing children’s rights is in large measure dependent on the well‐being and resources available to those with responsibility for their care. Recognizing these interdependencies is a sound starting point for planning assistance and services to parents, legal guardians and other caregivers. State parties are required to render appropriate assistance to parents, legal guardians and extended families in the performance of their child‐rearing responsibilities (arts. 18.2 and 18.3), including assisting parents in providing living conditions necessary for the child’s development (art. 27.2) and ensuring that children receive necessary protection and care (art. 3.2) (United Nations General Assembly, General Comment No.7, 2005) Keywords CHILD DEVELOPMENT HEALTHCARE SECTOR HEALTH POLICY INFANT DEVELOPMENT PEDIATRICS Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe UN City, Marmorvej 51 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office website (http://www.euro.who.int/pubrequest). © World Health Organization 2014 All rights reserved. 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Contents Page Executive summary ......................................................................................................................... 1 Acknowledgments ........................................................................................................................... 4 List of acronyms .............................................................................................................................. 4 1. Introduction ................................................................................................................................. 5 1.1 Rationale .......................................................................................................................... 5 1.2 Objectives ........................................................................................................................ 8 2. Methods ...................................................................................................................................... 9 3. Results .................................................................................................................................... 10 3.1 Country snapshots: Indicators of ECD status ................................................................ 10 3.2 Policies and programmes ............................................................................................... 14 4. Assessment ................................................................................................................................ 25 4.1 Opportunities and challenges for further ECD policy development at country level .... 25 4.2 Main challenges for improving the health sector involvement in the development and implementation of ECD policies and interventions ............................................................. 34 4.3 Main challenges for strengthening ECD policy development ....................................... 35 Conclusions ................................................................................................................................... 36 References .................................................................................................................................... 40 Annex I – detailed indicators description ...................................................................................... 43 (a) Armenia .......................................................................................................................... 43 (b) Kazakhstan ..................................................................................................................... 51 (c) Republic of Moldova ...................................................................................................... 63 References for Annex I ........................................................................................................ 68 Annex II – Questionnaire .............................................................................................................. 69 Section I – Status indicators ................................................................................................. 69 Section II – Policy actions (relevant legislation approved by government and/or parliament) ........................................................................................................................... 74 Section III – Plans ................................................................................................................ 75 Section IV – Programmes (specific programmes regarding one or more ecd components that may be funded and/or run by the government or by other agencies) ........................... 76 Section V – Assessment ....................................................................................................... 77 Early Child Development in the European Region page 1 EXECUTIVE SUMMARY In recognition of the need to establish a strong early foundation for health, sustainable development, and equity, WHO is emphasizing the need of paying attention to the early years as a crucial period to prevent disease, promote cognitive, social and emotional development and reduce inequity. In the European Region, this is even more important as most countries are successfully addressing the main causes of mortality, while developmental disorders, noncommunicable diseases, mental health problems represent the emerging challenges. Even in member States where there is still an unfinished child survival agenda, investments in the earliest periods of life since conception are the most effective way to further reduce the burden of mortality and disability, reduce health and social inequity and promote the full developmental potential of all children. Although effective investments in the early years require a “whole of government”, multisector approach, the health sector, by ensuring early and universal interventions, can play a crucial role in preventing exposure to risk factors, promoting good parenting