PROGRESS IN CHILD WELL-BEING– BUILDING ON WHAT WORKS                 Children around the world are doing better thanNOVEMB...
Progress in Child Well-Being– building on what worksA new report1 commissioned by UNICEF and Save the Children UK, and pre...
There have been some remarkable                          There are fewer people living in poverty. It is                  ...
Moreover, equitable approaches to, for                    gained access to improved sanitation (from 54example, education ...
(15/50), though they have decreased in                   issues being institutionalized as policy prioritiesapproximately ...
impressive increases in exclusive                       are more successful in advancing children’sbreastfeeding, for exam...
focusing on those individuals that are closer to        approach is cost-effective in achieving crucialthe poverty line, o...
with the greatest needs and has been effective            services that can be improved and scaled up. Inin reducing HIV r...
to be done to ensure adequate education                   All actors – governments, civil society, theoutcomes, especially...
provide access to information (and thuseducation, and thus opportunity) to the mostremote and underserved communities at a...
Published by the United Nations Children’s Fundin partnership with Save the Children UKFor more information contact msa@un...
Progress in child well-being
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Progress in child well-being

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Wereldwijd hebben kinderen het beter dan ooit. Vergeleken met een paar decennia geleden overlijden er per dag minder jonge kinderen, leven er minder kinderen in armoede en gaan meer kinderen goed gevoed naar school.
Dit bemoedigende nieuws blijkt uit een nieuw rapport van UNICEF en Save the Children - voorbereid in samenwerking met het Overseas Development Institute. Nog beter nieuws is dat we weten hoe we nog meer vooruitgang moeten boeken; met meer nadruk op de meest kwetsbare kinderen. Daar waar kinderen het grootste gebrek hebben aan basale voorzieningen, kan op een kosteneffectieve en efficiënte manier snel vooruitgang worden geboekt.
Casestudies in het rapport laten zien dat verschillende factoren bijdragen aan de vooruitgang voor kinderen: sterkere en expliciete nationale wil om te investeren in kinderen, ondersteunende programma's en meer ontwikkelingssamenwerking gericht op kinderen.
Het volledige rapport verschijnt binnenkort.

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Transcript of "Progress in child well-being"

  1. 1. PROGRESS IN CHILD WELL-BEING– BUILDING ON WHAT WORKS Children around the world are doing better thanNOVEMBER 2011 ever, according to a new report from UNICEF and Save the Children UK. Compared to just a few decades ago, fewer young children are dying each day, fewer children are living in poverty and more children are well-fed and in school. The good news for decision makers is that there seems to be a path to extending these gains: Evidence suggests that they have resulted from strong, explicit national commitments to invest in children, supportive policies, and greater and well- targeted development assistance. Going forward, efforts will have the greatest impact if focused on the most disadvantaged, where childhood deprivation is increasingly concentrated.
  2. 2. Progress in Child Well-Being– building on what worksA new report1 commissioned by UNICEF and Save the Children UK, and prepared in collaboration withthe Overseas Development Institute, brings encouraging news: There has been remarkable progress inchildren’s well-being throughout the world over the past few decades, and there is a path to extendingthese gains. Greater emphasis on the most disadvantaged children, where childhood deprivation isincreasingly concentrated, offers a cost-effective and efficient way to make even faster progress towardinternationally-agreed goals for children. Case studies examined in the report suggest that variousfactors have been critical in delivering positive outcomes for children: stronger and explicit nationalcommitments to invest in children, supportive policies and programmes at country level, and greaterand well-targeted development assistance.Why invest in children?Investing in children’s well-being is not only resources in the survival, protection andright in principle but also right in practice: It has development of children.significant pay-offs in terms of economic growthand social stability. Such investment develops Some striking signs of progresshuman capital and can lead to greaterproductivity – a critical component of stronger • 12,000 fewer children under five died everyeconomies. There are indirect impacts on day in 2010 than in 1990.economic growth too because girls’ education • Stunting – damage to childrens physical andand women’s empowerment lead to smaller cognitive development caused by malnutritionfamilies, healthier babies and more children in – declined in developing countries from 40 perschool. Focusing resources on the most cent to 29 per cent between 1990 and 2008,marginalized children can also contribute to while underweight prevalence also fell.reducing inequality and foster greater social • Fewer children, are becoming infected withcohesion. Investments in children are essential HIV or dying of AIDS.to not only achieve child rights today but also tounderpin the foundations for more stable and • The number of children enrolled in pre- primary education worldwide increased fromprosperous countries in the future. 113 million to 157 million between 1999 and 2009.Reducing child poverty and deprivation is a keycommitment of both governments and the • From 1999 to 2009 an additional 58 million children enrolled in primary school and theinternational community. In the 2000 UN number of out-of-school primary-aged childrenMillennium Declaration, world leaders agreed to decreased by 39 million.work together to reduce poverty and hungerand promote education and health in the • Globally, girls now make up 53 per cent ofdeveloping world. The eight Millennium out-of-school primary-aged children,Development Goals (MDGs) are all directly or compared to 61 per cent in 1990.indirectly relevant to children. With only four • The proportion of adolescents of loweryears left to reach the MDG target date of 2015, secondary age who were out of schooland in the wake of the global financial crisis, it worldwide fell by 21 per cent from 1999 tois critical not to let this commitment falter. 2009.Indeed, this is the time to capitalize on the solid • More children are being registered at birth,progress being made and intensify efforts to and rates of child marriage and child labourreach the finish line. The Convention on the have gone down in many countries.Rights of the Child also commits States Partiesto invest the maximum extent of their available
  3. 3. There have been some remarkable There are fewer people living in poverty. It is estimated that between 2005 and 2010 the totaladvances number of poor people around the world fell by nearly half a billion to under 900 million. ASignificant strides have been made towards particularly positive feature is that this decline isachieving several of the MDGs and in child happening in most regions of the world, thoughwell-being generally as a result of appropriate at different speeds. While this aggregateinterventions resulting from a mix of decline can hide widening disparities, childrengovernment, donor and non-government efforts. generally benefit from falling poverty rates because they are disproportionately likely to beFewer children under five are dying every day – living in poor households (which tend to have12,000 fewer in 2010 than in 1990. The annual more children than non-poor households).rate of reduction globally increased from 1.9 percent in the 1990s to 2.5 per cent in the 2000s; it In many countries, children are doing betterdoubled in sub-Saharan Africa over this period. despite slow economic growth. Achievements inFourteen of the countries with the highest child key areas for child development – such asmortality rates have managed to cut under-five reducing child mortality and severe malnutrition,deaths by half – one of them, Bangladesh, improving access to water and sanitation andachieved a 67 per cent reduction between 1990 increasing the number of children in school –and 2010 (see Box 1). have been made even in countries with moderate poverty reduction and slow rates of Box 1: Improvements in child health growth. Evidence suggests that although in Bangladesh economic growth is a necessary condition of sustained improvement in health and education Between 1990 and 2010 the infant mortality rate in Bangladesh declined by 62 per cent and the indicators and in the quality of social services, under-five rate by 67 per cent. Strong economic the ‘take-off’ in social development is more growth during those years helped boost efforts to closely linked to national commitment, a reduce poverty, somewhat improve nutrition, favourable policy environment and spreading make education more accessible to women and knowledge on effective, targeted and often low- girls, and increase the resources available for cost interventions – such as immunizations or health care. Perhaps more important, though, basic sanitation (see Box 2). has been the sustained commitment of successive governments to improving child health through, for example, integrated Box 2: Progress in water and management of childhood illnesses, increased sanitation in the Lao People’s immunization, vitamin A, de-worming, and water Democratic Republic and sanitation coverage. Another key factor has been efforts to reduce gender inequalities, The Lao People’s Democratic Republic is including government stipends to encourage classified as a least-developed country and is girls’ attendance at school and a large NGO one of the poorest countries in East Asia. Yet microfinance movement that has focused largely between 1995 and 2008 its average yearly on poor women. However, child survival rates lag progress in increasing the share of the behind national averages in some remote and population with access to improved sanitation disadvantaged regions of the country. was the second highest in the world. Some of the initial gains reflected achievements in broadening knowledge about basic sanitation,Reasons for this progress include more and consequent private household investmentseducated girls, greater investment in health- supported by rising incomes. Sanitationcare systems, improved nutrition for mothers, initiatives in the past decade have focused onbetter infant and young child feeding practices, the poorest districts, mostly in rural areas. The Government has also adopted a policy andeffective preventive approaches (including toolkits to better target poorer and marginalizedpreventing mother-to-child transmission of HIV) groups in project design and implementation.and increased access to safe water andsanitation. 2
  4. 4. Moreover, equitable approaches to, for gained access to improved sanitation (from 54example, education and access to land have per cent to 61 per cent). The greatest progressunderpinned later advances in social has been in North Africa. Poor sanitation, waterdevelopment. and hygiene are major factors in child health, with diarrhoea killing as many children underThere has been improvement in children’s five as AIDS, malaria and measles combined.nutrition around the world, though the pace ofprogress has varied. Stunting (damage to More children are in pre-school. The number ofchildren’s physical and cognitive development children enrolled in pre-primary educationas a result of chronic early under-nutrition) worldwide increased from 113 million in 1999 todeclined in developing countries from 40 per 157 million in 2009, mostly because of gains incent to 29 per cent between 1990 and 2008. South and West Asia and, to a lesser extent,Underweight prevalence among children under sub-Saharan Africa and Latin America and thefive also went down – especially in Latin Caribbean. A few countries such as Chile (seeAmerica and the Caribbean where it fell from 11 Box 4) have either universalized services orper cent in 1990 to 6 per cent in 2008. There developed special initiatives to provide earlyhave been successes in tackling micronutrient childhood development programmes in remote(vitamin A, iodine and iron) deficiencies too. rural areas.Fewer people are becoming infected with HIV Box 4: Reducing inequalities in earlyand fewer people are dying of AIDS. Thirty childhood development programmesyears of investment in preventing and treatingHIV is paying off. Further, there has been in Chilesignificant progress in preventing HIV among Chile Crece Contigo (Chile grows with you) is achildren – globally there was a 24 per cent comprehensive protection system for earlydecline in newly infected children and a 19 per childhood set up in 2007 that provides integratedcent decline in children dying from AIDS financial, educational and health support forbetween 2004 and 2009. One success story is children’s development until four years of age. One of its main objectives is to reduce theBotswana, a country with high HIV prevalence effects of socioeconomic inequalities by the time(see Box 3). children finish primary school. It targets children and families from the bottom two income Box 3: Preventing mother-to-child quintiles. Though coverage of young children is not universal, the sustained expansion of early transmission of HIV/AIDS in Botswana childhood development since 1990 reflects the Botswana has pioneered an effective approach to strong commitment from successive preventing mother-to-child transmission of HIV governments. Chile Crece Contigo is and AIDS. It provides free HIV testing to pregnant institutionalized as a Chilean law, thereby women throughout the country – reaching 93 per guaranteeing funding, and continuity over time. cent in 2009 – and free anti-retrovirals (ARVs) to those who prove HIV-positive. In addition, increasing numbers of infants receive More children are in primary and secondary prophylactic ARVs. As a result, the proportion of school – including more girls. There has been children of HIV-infected mothers who were rapid advance towards the goal of universal themselves infected declined dramatically from primary education (MDG2). From 1999 to 2009 20.7 per cent in 2003 to 4.8 per cent in 2008. an additional 58 million children enrolled in primary school and the number of out-of-school primary-aged children decreased by 39 million,More people have access to improved water with 80 per cent of this decline in sub-Saharanand sanitation. Between 1990 and 2008, 1.8 Africa and South and West Asia. Survival ratesbillion more people worldwide gained access to until the last year of primary school have alsoimproved drinking water – an increase from 77 increased in just over half the low- and middle-per cent of the world’s population to 87 per income countries for which there are datacent. Over the same period, 1.3 billion people (26/50) and remained stable in around a third 3
  5. 5. (15/50), though they have decreased in issues being institutionalized as policy prioritiesapproximately a fifth (9/50), and completion and governments being given mandates andrates more generally need to be improved resources to achieve clear goals. In the case ofparticularly for the poor and vulnerable. In Brazil, for example, political will led to well-addition, the global gender gap in school resourced programmes for children. Theseenrolment has narrowed. Worldwide, girls now programmes were considered ministerialmake up 53 per cent of the out-of-school priorities. They had strong accompanyingpopulation compared to 60 per cent in 1990. mechanisms to strengthen accountability toThe proportion of adolescents of lower citizens (see Box 5).secondary age who were out of school fellglobally by 21 per cent from 1999 to 2009. The fact that the fight against HIV and AIDS has mobilized political will and leadershipChildren overall are better protected. globally has led to significant resources forApproximately three quarters of States have prevention and treatment and to technicalsigned, ratified or acceded to the Optional innovations such as the new generation ofProtocol to the Convention on the Rights of the highly effective drugs. Even more importantly,Child on the involvement of children in armed these resources and innovations have beenconflict, and the Optional Protocol to the used in well-targeted ways. For example, aConvention on the Rights of the Child on focus on critical issues such as preventingthe sale of children, child prostitution and child mother-to-child transmission has been shown topornography, thus demonstrating their official be highly cost-effective.commitment to child protection. The Guidelinesfor the Alternative Care of Children, which have Box 5: A multifaceted approach tobeen endorsed by the UN General Assembly, improving children’s nutrition in Brazilare being aligned with national frameworks andactions to reach children who are in need of or Rates of stunting and underweight have fallenat risk of being in need of alternative care. dramatically in Brazil since 1990, and part of theProgress has been made in several key areas credit goes to Fome Zero (zero hunger), aincluding birth registration, an increase in the package of interventions structured around access to food, income-generating activities, socialmedian age of child marriage and a reduction in mobilization, citizenship education andchild labour in most countries (including those strengthening smallholder agriculture. Fome Zeroof substantial size such as Brazil, India and builds on a personal desire of former PresidentMexico). Support for female genital Lula da Silva that by the time he left office everymutilation/cutting has also declined significantly Brazilian should be able to have three meals ain some parts of sub-Saharan Africa. day. Political will has led to a well-chosen, evidence-based social policy that is well integratedWhat has driven these positive with initiatives in other sectors and includes well- resourced programmes such as Bolsa Familiachanges? (household cash transfers), which is targeted to the poor and extreme poor. Other factors in itsIn 2010 world leaders called for intensified success include an engaged civil society and acollective action on the MDGs and the positive economic environment.expansion of successful approaches. Thismakes it crucial to identify the types of actions A supportive environmentand interventions that have yielded positive In most cases where progress has beenresults, particularly for children. The following achieved on a significant scale and beenare some of the key factors identified by the sustainable over the years, the leading role ofreport as having resulted in long-term, the state has been key, either in terms ofsustainable improvements for children. providing direct policy support, creating an enabling environment, financing initiatives orHigh-level national commitment and leadership allowing the space for NGOs and donors to fillStrong leadership (often from the head of gaps in government provision. There have beengovernment) has led to various children’s 4
  6. 6. impressive increases in exclusive are more successful in advancing children’sbreastfeeding, for example, in countries where rights and needs than countries with piecemealparliaments have passed laws on issues such approaches. For example, it is difficult to helpas maternity protection for working women and children without addressing the challenges ofthe marketing of infant formula – challenging their caretakers and environments. Having aestablished practices and, at times, powerful range of policies in place on different areas ofbusiness interests. As change for children does social well-being for households, particularlynot happen in the very short term, sustainable focused on children, can fuel progress acrosscommitment for continued support to most child well-being indicators – as shown byprogrammes over the medium and long term the example of Viet Nam (see Box 6).needs to be retained across politicalcycles/terms. Box 6: A multidimensional focus on children in Viet Nam yields resultsNon-Governmental Organisations (NGOs) havebeen important in developing innovative One of the world’s sharpest declines in absoluteapproaches to reduce social or financial poverty in recent decades has been in Viet Nam,barriers to service use. When given access, and levels continue to go down despite the globalthey have helped extend service provision – economic slowdown. The country ranks in the top 10 worldwide in both absolute and relativeparticularly in geographically isolated areas and progress toward achieving the MDGs. This is dueto socially marginalized groups. Their advocacy in part to an explicitly child-focused developmenthas played a positive role in making private strategy that has increased budgetary allocationssector services an important part of the overall and set time-bound objectives for children’sservice delivery. health, nutrition, education and access to clean water and hygiene. Child rights were integratedEconomic growth into the 2006–2010 Social-Economic DevelopmentImprovements in child well-being have Plan and there are national programmes in placegenerally occurred during or following periods to address the needs of children with specificof economic growth, as periods of growth tend vulnerabilities (such as those with disabilities or living on the street).to make greater resources available overall.Without growth, extending and maintainingaccess to services and quality improvements Understanding how successful programmes arecan become difficult, requiring hard choices in designed and implemented is key to makingallocating limited funds. Yet, while growth tends sure that children benefit from policies aimed atto help foster aggregate progress, it does not improving their well-being such as free or low-always narrow the gaps between the poorest cost basic health-care services, maternityand the richest, and it may leave the very benefits and the availability of affordablepoorest behind. Indeed, as already noted, childcare that enables both parents to work.growth is not sufficient on its own but must be Social protection measures are increasinglyaccompanied by multi-faceted programmes and gaining recognition as tools that can reducethe dedication of both financial and human child poverty as they commonly address socialresources to achieving goals. Governments vulnerability and take into account the inter-may also need to take measures to tap the relationship between exclusion and poverty.increased wealth generated by growth – forexample, by improving the efficiency of revenue Action on reducing inequities, including gendercollection so as to capture a greater share of inequalitythe benefits and use it for social progress. Progress in child well-being has often been greatest where there has been an explicitComprehensive policies for child well-being emphasis on directing resources to andCountries with comprehensive and holistic improving the situation of the poorest and mostpolicies and strategies that address the marginalized groups. While conventionalmultidimensionality of child poverty – including wisdom has been that more lives are saved,their human, social and emotional well-being - protected and enhanced in poor countries by 5
  7. 7. focusing on those individuals that are closer to approach is cost-effective in achieving crucialthe poverty line, or closer to meeting a child development objectives. Progress inparticular development target, there is evidence transparency in the use of public funds and inthat this is not always the case. Important gains the evaluation of interventions has also enabledcan be achieved by focusing on the most a better overall use of resources. For example,vulnerable and marginalized because, for evaluations of conditional cash transferexample, excluded populations within countries programmes, which originated in Latin America,generally have a larger proportion of children have shown them to be effective in helpingowing to higher fertility rates, or a higher people pull themselves out of poverty andproportion of children in these groups die of improving children’s lives. This evidence haspreventable or treatable diseases. Examples in been used for the design of cash transferthe report of equitable development strategies programmes elsewhere.where improvements have been concentratedamong the poorest include Brazil and Viet Nam The role played by development(see Boxes 5 and 6). assistancePromoting gender equality and empowering There is some debate in development circleswomen (MDG3) has also been a driver of child about the causality between developmentdevelopment progress in different ways. Some assistance and economic and social progress.examples include improvements in girls’ The report, however, argues that increasededucation rates, which have been critical to resources allow governments to scale up andimprovements in child health, nutrition and child extend services (as in Ethiopia, the Laoprotection, and preventing childbearing until People’s Democratic Republic, and Botswana);young women are fully grown, which can play a and/or enable quality improvements in servicecrucial role in improving maternal nutrition and delivery to contribute to better policy outcomesreducing low birth weight. (such as in Bangladesh’s health sector).Adequate resources and cost-effective The report’s quantitative analysis furtherprogrammes suggests a positive correlation between aid andProgress has generally required significant positive outcomes for children in some regionsfinancial investment. In most cases, additional and sectors. In the smaller sub-Saharanresources have come from a combination of countries that have been receiving relativelymore investment by national governments and higher levels of aid per capita, an additionalincreased aid. The share of national income annual $0.01 of social sector aid per capita isspent by low-income countries on education, for associated with a reduction in infant mortality ofexample, rose from 2.9 to 3.8 per cent between 0.4 deaths per 1,000. In sub-Saharan Africa1999 and 2009, and per capita spending on more generally, greater aid is correlated witheducation rose in every region. Public spending falling infant mortality rates, reduced numberson education in sub-Saharan Africa increased of children living with HIV and AIDS, and lowerby 29 per cent between 2000 and 2005. Three levels of underweight children.quarters of this increased investment was theresult of economic growth with the rest Development assistance dedicated toattributable to more efficient taxation and a prevention and treatment programmes hasredistribution of budgets in favour of education. contributed to progress in reducing infection and decline in AIDS-related deaths amongEffective programmes need to be affordable in children. This would not have been possiblea sustained manner, and this has to be part of without the strong mobilization of the globaltheir design. Increasingly governments and community and the unprecedented levels ofdonors are seeking to invest resources in funding provided collectively by donors,programmes that can yield positive results governments, the private sector, philanthropicwithin a manageable level of costs. Research organizations and individuals. Developmentcited in the report shows that an equity-based assistance has been well-targeted to countries 6
  8. 8. with the greatest needs and has been effective services that can be improved and scaled up. Inin reducing HIV rates among children. Analysis addition, donors often foster knowledge sharingin the report suggests that (outside Southern and provide technical support – such as inputsAfrica, where the HIV burden is highest) an for design and impact evaluations – that canadditional cent per capita in aid dedicated to contribute positively to programmefighting HIV results in an annual decrease of implementation beyond financing.0.2 infected children per 1,000 of population. What still remains to be done?Another example where it is clear thatdevelopment assistance has made a difference While the report shows significant progress,is that 63 countries now have 90 per cent there are continuing challenges. The world isimmunization coverage for major preventable off-track to meet the MDGs and the targetschildhood diseases, as compared to 12 in 1990. could be missed without intensified efforts.The formation of the GAVI Alliance in 2000 has Child mortality rates globally remain very high –led to the mobilization of substantially more 7.6 million children under 5 died in 2010 – andfunds for the introduction of new vaccines and 67 million primary-school-age children are stillincreased coverage of longer-standing out of school. While stunting and underweightvaccination programmes. International support are on the decline, there are still 180 millionhas also been important in enabling developing stunted children around the world, andcountries to expand educational provision, train continued progress is needed in tacklingand deploy more teachers, abolish school fees, nutrition and micronutrient deficiencies.enact curriculum reforms and improve quality – Moreover, 2.6 billion people still lack access toas in Ethiopia (see Box 7). improved sanitation, with major implications for child health. Box 7: Rapid and equitable expansion in primary and secondary education in Forty per cent of under-five deaths in Ethiopia developing countries (and half of all child deaths in South Asia) now occur in the first More children are attending school in Ethiopia due month of life and 71 per cent in the first year. to increased spending, a massive increase in school facilities, the abolition of school fees, Three quarters of newborn deaths could be programmes to reach disadvantaged children, prevented through a package of improved action on gender inequalities and efforts to antenatal, obstetric and postnatal care and improve quality. Net enrolments in primary community outreach. Other interventions that education increased from 37 per cent in 1999 to pay off in better child survival rates include 84 per cent in 2009, with girls’ rates only 5 per increasing rates of girls’ education, promoting cent below boys’. Secondary school enrolment, other programmes focused on women’s though low, also increased over the same period empowerment, reducing poverty and extending and is expected to rise sharply as the greater immunization coverage. An estimated additional numbers of children now attending primary school $60 billion is needed between 2009 and 2015 to transition to secondary. The Government-led expansion of education has been supported by implement a full package of maternal, newborn external assistance. and child health interventions in the 68 countries with the highest child and maternal mortality levels.Overall, it is clear that national investment inseveral aspects of child well-being, either in There is still a lot to be done as well to improvesequence or simultaneously, is key and has school retention and completion rates. Thehad strong pay-offs. But external assistance majority of children not attending primary schoolcan catalyse progress and strengthen live in conflict-affected countries or in remoteoutcomes. Indeed, development assistance rural areas, sometimes among mobile or ethnicworks best in contexts where there are national minority populations where mainstreamlevel commitments to pursue child development education does not necessarily accord withand there are functional programmes and cultural practices. Moreover, there is still much 7
  9. 9. to be done to ensure adequate education All actors – governments, civil society, theoutcomes, especially for the sort of workplace private sector, international agencies and multidemands and citizenship skills that can deliver and bilateral donors – should draw on theeconomic payoffs and that are typically lessons of how these achievements have beenacquired with high quality secondary education. made, and work to scale up successful approaches. In particular, greater coverage ofChild ill-being is becoming increasingly well-designed social protection policies haveconcentrated among the poorest and most the potential to continue helping to reducedisadvantaged. Worldwide, they are at most poverty and improve other areas of well-being,risk of early death, malnutrition and not especially education, health and nutrition.attending school, and in many countries theyhave been left behind by progress among Successful programmes for children in themiddle-income and better-off groups. They are future are likely to include social safety nets toalso often at the greatest risk of severe prevent households that have broken out ofviolations of their rights, such as abuse and poverty from slipping backwards; the scaling upexploitation. Disparities in progress between of cash transfer programmes focused onurban and rural areas, and problems in slums promoting human development, particularly ofwithin urban areas, remain daunting, and the children and women, and on pulling theneeds of the poorest of the poor – and those extreme poor out of poverty; or programmesdisadvantaged and pervasively discriminated targeted at discriminated minorities or sub-against because of their sex, age, ethnicity or national regions that could miss out on thedisability – must be addressed. rising living standards enjoyed by others. If such interventions address malnutrition, keepProgress for children has been particularly slow children in school, prevent early marriages ofin conflict-affected countries. While only 20 per girls and so on, they can break the inter-cent of the world’s poor lived in fragile states in generational cycle of poverty.2005, this share is now over 40 per cent and isexpected to exceed 50 per cent by 2014. In A greater focus on equity should be key.weak and failed states with governance UNICEF estimates that MDG4 on child mortalityproblems, armed violence and criminal activity could be achieved much more rapidly by(including through gangs) is escalating in focusing attention on the poorest households,rapidly expanding urban spaces and under- which have the highest rates of child deaths. Ingoverned spaces with adverse consequences 15 low-income, high child mortality countries, afor all, including the young. focus on the poorest could reduce up to 60 per cent more deaths for every $1 million investedThe way forward: Sustain than the current approach.2 Save the Children has also argued that if the 42 developingcommitment to reach all children countries that account for over 90 per cent of child deaths all took an egalitarian approach toThere is now a wealth of evidence and cutting under-five mortality, and made progressexperience to help guide our way forward in across all income groups at the same rate asinvesting in children and addressing their rights. for the fastest-improving income group, anThe report makes it clear that progress in additional 4 million child deaths could beachieving children’s rights has been averted over a 10-year period.3accomplished by spending more and bettertargeted resources on key social sectors, often Technology and innovation offer the opportunitywith the leadership of national governments and for multiplied impact, and for greater efficiencieswith technical and/or financial support from the and accountability along the spectrum ofinternational community. Going forward, development work. More children can besustained commitment and improved actions treated if markets are shaped to create moreare vital to narrow the gaps and promote affordable, available vaccines. Technologiesequitable outcomes for all children. like the internet and mobile phone networks can 8
  10. 10. provide access to information (and thuseducation, and thus opportunity) to the mostremote and underserved communities at ascale that was impossible just a few years ago.The growing capacity for local innovation andlocal development of solutions to globalproblems is a true, scalable, driver of change.All this means that greater mobilization ofresources and action is needed – both from amoral and child rights perspective and becausethe economic and social pay-offs are great.Healthy, educated children are key to the futureof all nations; those marginalized and leftbehind will threaten it. With new technologiesconnecting even the most remote communities,the poorest today are acutely aware of beingleft behind, and of missing out on larger societalgains. The goal should be to extend theachievements made to every part of the world,and to each and every child.___________________________1 The draft for public consultation and comment is available at http://www.unicef.org/socialpolicy/index_59577.html. The finalreport will be launched in early 2012.2 Narrowing the Gaps to Meet the Goals (UNICEF, 2010) is available at http://www.unicef.org/publications/index_55927.html.3 A Fair Chance At Life (STC, 2010) is available at http://www.savethechildren.org.uk/en/54_12454.htm. 9
  11. 11. Published by the United Nations Children’s Fundin partnership with Save the Children UKFor more information contact msa@unicef.orgUnited Nations Children’s Fund3 United Nations PlazaNew York, NY 10017, USAwww.unicef.org 10© United Nations Children’s Fund (UNICEF)November 2011

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