28 Logo signature RECOMMENDED VERSIONS The ideal treatment for our logo is inside a cyan container . This helps reinforce the relationship between our logo and our brand colour and enhances legibility when placed over photographs and graphics. Logo signature aligned from bottom Logo signature centred of container suitable to be anchored in circular container at the top right corner (see next page) ALTERNATIVE VERSIONS Logo signature Logo signature Logo signature Horizontal logo signature centred in container aligned from top of centred in container centred in short container container UNICEF Brand Book l May 2018 Situation Analysis of Children in the Marshall Islands © United Nations Children’s Fund (UNICEF), Pacific Office, Suva December 2017 This report was written by Kirsten Anderson, Ruth Barnes, Awaz Raoof and Carolyn Hamilton, with the assistance of Laura Mertsching, Jorun Arndt, Karin Frode, Safya Benniche and Kristiana Papi. Maurice Dunaiski contributed to the chapters on Health and WASH. Further revision to the Child Protection chapter was done by Shelley Casey. The report was commissioned by UNICEF Pacific, which engaged Coram International, at Coram Children’s Legal Centre, to finalise the Marshall Islands Situation Analysis. The Situation Analysis was managed by a Steering Committee within UNICEF Pacific and UNICEF EAPRO, whose members included: Andrew Colin Parker; Gerda Binder (EAPRO); Iosefo Volau; Laisani Petersen; Lemuel Fyodor Villamar; Maria Carmelita Francois; Settasak Akanimart; Stanley Gwavuya (Vice Chair), Stephanie Kleschnitzki (EAPRO); Uma Palaniappan; Vathinee Jitjaturunt (Chair); and Waqairapoa Tikoisuva. The contents of the report do not necessarily reflect the policies or views of UNICEF. UNICEF accepts no responsibility for error. Any part of this publication may be freely reproduced with appropriate acknowledgement. Suggested citation. United Nations Children’s Fund, Situation Analysis of Children in the Marshall Islands, UNICEF, Suva, 2017 Cover Image: © UNICEF/UN0202412/Sokhin Situation Analysis of Children in the Marshall Islands 2 Situation Analysis of Children in the Marshall Islands Table of Contents Executive Summary .................................................................................................................. 4 Acronyms ................................................................................................................................... 8 1. Introduction .................................................................................................................. 10 1.1. Purpose and scope ................................................................................................. 10 1.2. Conceptual framework ........................................................................................... 11 1.3. Methods and limitations ........................................................................................ 13 1.4. Governance and validation .................................................................................... 14 2. Context.......................................................................................................................... 15 2.1. Geography and demographics ............................................................................... 16 2.2. Main disaster and climate risks .............................................................................. 18 2.3. Government and political context ........................................................................... 19 2.4. Socioeconomic context .......................................................................................... 20 2.5. Legislative and policy framework ........................................................................... 22 2.6. Child rights monitoring ........................................................................................... 24 3. Health and Nutrition .................................................................................................... 25 3.1. Child mortality ........................................................................................................ 26 3.2. Child health, immunization and communicable diseases ....................................... 27 3.3. Maternal health ...................................................................................................... 30 3.4. Violence against women ........................................................................................ 31 3.5. Adolescent health .................................................................................................. 32 3.5.1. Fertility and contraceptive use .................................................................... 32 3.5.2. HIV/AIDS and sexually transmitted infections ............................................. 34 3.5.3. Substance abuse......................................................................................... 36 3.5.4. Mental health .............................................................................................. 37 3.6. Nutrition ................................................................................................................. 38 3.6.1. Child stunting and wasting .......................................................................... 39 3.6.2. Anaemia ...................................................................................................... 39 3.6.3. Low birth weight and underweight ............................................................. 39 3.6.4. Obesity ....................................................................................................... 40 3.6.5. Breastfeeding .............................................................................................. 41 3.7. Key barriers and bottlenecks .................................................................................. 42 3.7.1. Transportation ............................................................................................. 42 3.7.2. Climate and disaster risks ........................................................................... 43 3.7.3. Myths and misperceptions ......................................................................... 44 3.7.4. Health financing .......................................................................................... 44 3.7.5. Health workforce......................................................................................... 46 3.7.6. Service delivery ........................................................................................... 47 Table of Contents 3 4. Water, Sanitation and Hygiene ................................................................................... 48 4.1. Access to improved water sources ........................................................................ 49 4.2. Access to improved sanitation facilities ................................................................. 53 4.3. Hygiene practices ................................................................................................... 57 4.4. WASH in schools, menstrual hygiene management and disabilities ...................... 59 4.5. Barriers and bottlenecks ......................................................................................... 59 4.5.1. Geography ................................................................................................... 59 4.5.2. Climate and disaster risks ........................................................................... 59 4.5.3. Financial and human resources ................................................................... 60 4.5.4. Community awareness and gender norms ................................................. 61 5. Education ...................................................................................................................... 62 5.1. Context ................................................................................................................... 64 5.2. Early Childhood Education...................................................................................... 66 5.3. Primary and secondary education .......................................................................... 66 5.3.1. Access ........................................................................................................ 67 5.3.2. Quality ......................................................................................................... 69 5.3.3. Barriers and bottlenecks .............................................................................. 70 5.4. Tertiary education ................................................................................................... 71 6. Child Protection ............................................................................................................ 74 6.1. Child protection risks and vulnerabilities ................................................................ 77 6.1.1 Nature and extent of violence, abuse, neglect and exploitation of children .... 78 6.1.2. Community knowledge, attitudes and practices ......................................... 81 6.1.3. Drivers of violence, abuse, neglect and exploitation of children ................. 82 6.2. The child protection system .................................................................................. 84 6.2.1. The legal and policy framework for child protection ................................... 84 6.2.2. Child protection structures, services and resourcing .................................