Situation Analysis of Children and Women in Kosovo Table of Contents
Table of Contents:
List of Tables
Acronyms
Map of Kosovo
Executive Summary
1.Introduction......
1.1Population Changes
1.1.1Post-Conflict Demographic Data
1.1.2Ethnic Breakdown
1.1.3Age and Sex Distribution
1.1.4Rural/Urban Migration Patterns
1.2Political-Administrative Context in Kosovo
1.2.1Transitional Government (PISG) and Administrative (UNMIK) Institutions
1.2.2Implications for Social Development
1.2.3Municipal Government
1.2.4The Role of Civil Society
1.3Economic Overview
1.3.1Structure of the Economy
1.3.2Employment
1.3.3Structure of Unemployment
1.3.4Youth Unemployment
1.4Public Expenditures and Policies
1.4.1The Health System
1.4.2The Education System
1.4.3Social Welfare
1.4.4Youth
1.4.5Administration of Justice
1.5UNICEF's Medium-Term Strategic Plan and the Millennium Development Goals
1.5.1Why are the Millennium Development Goals relevant to Kosovo?
2.Early Childhood Development
2.1Antenatal Care
2.1.1Quality of Care
2.1.2Maternal Nutrition and Health
2.1.3The Situation of Minorities
2.1.4Maternal Mortality
2.2Infant Mortality
2.2.1Perinatal and Neonatal Mortality
2.2.2Breast Feeding
2.2.3Nutrition
2. 3 Immunisation
2.3.1EPI Reporting and Surveillance System
2.3.2Social Mobilisation and Communication
2.3.3Epidemiology of Vaccine Preventable Diseases in Kosovo
2.3.4Common Childhood Illnesses
2.3.5Safe Drinking Water
2.3.6Under-Five Mortality Rate
2.4Care and Development
2.4.1Care within the Home
2.5Early Childhood Development Programmes
2.5.1Kindergarten
2.5.2Community-Based Education Centres
2.5.3Pre-Primary Classes
2.5.4Increasing Coverage
2.5.5Girls and Minorities
2.5.6Training
2.5.7Preschool Curriculum
2.5.8Parental Awareness
2.6Policy Agenda for Early Childhood Development
3.Children and the Education System
3.1Enrolment: Who’s in School?
3.1.1Primary and Lower Secondary School
3.1.2Upper Secondary School
3.1.3Retention Rates
3.1.4Relevance
3.2Ensuring a Quality Education
3.2.1Learning Environment
3.2.2Learning Content
3.2.3Learning Process
3.3Girls' Education
3.4Policy Agenda
4.Young People
4.1Young People's Health
4.1.1Tobacco consumption … time to kick the habit?
4.1.2Alcohol and Drugs
4.2Sexual and Reproductive Health
4.2.1Low Contraceptive Use
4.3HIV/AIDS
4.3.1Knowledge and Behaviour
4.3.2More Needs to be Done
4.4Youth and Participation
4.4.1“Democracy” in the Family
4.4.2Youth and Society
4.4.3The Role of Youth Organisations
4.4.4The Need for Space ….
4.4.5Relationship with Governmental Institutions
4.4.6 The Source of Decision-Making Power.
4.4.7Media and Youth
4.5Policy Agenda for Youth
5.Protection from Violence, Abuse, Exploitation and Discrimination
5.1The Concept of Child Rights
5.2Policies and Legislation
5.3Child Labour
5.3.1Nature and Extent
5.3.2Ethnic Differences
5.3.3Access to Education
5.4Commercial Sex Work and Trafficking
5.4.1Extent
5.4.2Awareness
5.5Domestic Abuse
5.5.1Extent
5.6Children without Parental Care
5.7Juvenile Justice
5.7.1Children Deprived of Liberty
5.8 Children with Disabilities
5.8.1Extent
5.8.2 Access to Education
5.8.3Special Schools
5.8.4Teacher Training
5.9Minorities
5.9.1Ethnic Composition
5.9.2Access to Services
6.0Gender Discrimination
6.1 Policy Agenda
List of Indicators
Conceptual framework
Bibliography
February 2004
Situation Analysis of Children and Women in Kosovo Acronyms
List of Tables
Table 1 Census Data 1948 – 2003
Table 2 Estimated Current Population
Table 3 Breakdown by Ethnic Group
Table 4 Population Growth Indicators
Table 5 Urban/Rural Population Ratio
Table 6 Structure of Output by Sector
Table 7 Employment by Sector
Table 8 Employment Rates
Table 9 Youth Unemployment Indicators for Selected Countries
Table 10 Government of Kosovo Budget Allocations (million €)
Table 11 Health Expenditures by Category (million €)
Table 12 Education Resources at Municipal Level (million €)
Table 13 The New Education System in Kosovo
Table 14 Perinatal Indicators in Kosovo (PEPC 2002)
Table 15 Causes of Neonatal Deaths
Table 16 KOSOVO EPI SCHEDULE
Table 17 Primary and Lower Secondary School Coverage
Table 18 Primary and Lower Secondary School Enrolment
Table 19 Upper Secondary School Enrolment
Table 20 Education Enrolment (per cent)
Table 21 Children without Parental Care
Acronyms
February 2004
Situation Analysis of Children and Women in Kosovo Acronyms
AAK Alliance for the Future of Kosovo
ANCAntenatal Care
ARIAcute Respiratory Infection
BFHIBabyFriendlyHospital Initiative
BMI Body Mass Index
CBCCommunity Based Centres
CEDAW Convention on the Elimination of All Forms of Discrimination Against Women
CRCConvention on the Rights of the Child
CRS Catholic Relief Services
CSOCivil Society Organisation (s)
CSWCentres for Social Work
DHS Demographic Health Survey
ECDEarly Childhood Development
EMIS Education Information Management System
EPIExtended Programme of Immunisation
EUEuropean Union
FAOFood and Agriculture Organization
FHHFemale Headed Household
FRYFormerRepublic of Yugoslavia
GDIGender Development Index
GDP Gross Domestic Product
GOKGovernment of Kosovo
HDI Human Development Index
HBVHepatitis B Virus
HIVHuman Immunodeficiency Virus
IDPInternally Displaced Person
IOMInternational Organization for Migration
IMF International Monetary Fund
IMR Infant Mortality Rate
IPH Institute of Public Health
IRCInternational Rescue Committee
KAP Knowledge Attitudes and Practice
KCB Kosovo Consolidated Budget
KECKosovoEducationCenter
KFORKosovo Forces
KLA Kosovo Liberation Army
KPSKosovo Police Service
KYNKosovo Youth Network
LDKDemocratic League of Kosovo
LFSLabour Force Survey
LMSLabour Market Survey
LSMSLiving Standards Measurement Survey
MDGMillennium Development Goal(s)
MEST Ministry of Education, Science and Technology
MMR Maternal Mortality Rates
MNSS Micronutrient Status Survey
MTSMother Teresa Society
MTSP Medium-Term Strategic Plan (UNICEF)
NATO North Atlantic Treaty Organization
NGOs Non-Governmental Organisation
OB/GYNObstetrics and Gynaecological
OCHAOffice for the Coordination of Humanitarian Affairs
OECDOrganization of Economic Cooperation and Development
OHCHROffice of the High Commissioner for Human Rights
OSCE Organization for Security and Cooperation in Europe
PDK Democratic Party of Kosovo
PEM Protein-Energy Malnutrition
PEPCPromoting Effective Perinatal Care
PISG Provisional Institutions of Self- Government
PSIPopulation Services International
RAE Roma, Ashkalia and Egyptian
SITANSituation Analysis
SGPP School Grant Pilot Project
SMESmall and Medium Enterprise
SOKStatistics Office of Kosovo
SRSGSpecial Representative of the Secretary-General
STISexually Transmitted Infection
TBTuberculosis
TTRBTeacher Training Review Board
UNDPUnited Nations Development Programme
UNFPAUnited Nations Population Fund
UNHCRUnited Nations High Commissioner for Refugees
UNICEFUnited Nations Children’s Fund
UNIFEMUnited Nations Development Fund for Women
WHO World Health Organization
February 2004
Situation Analysis of Children and Women in Kosovo Map of Kosovo
Map of Kosovo
1
February 2004
Situation Analysis of Children and Women in Kosovo Executive Summary
Executive Summary
One of the legacies of the conflict, and the years of neglect that preceded it, has been a dearth of reliable data and analysis on the status of children and women in Kosovo. This report, commissioned by UNICEF, attempts to fill this gap by drawing on a large body of research (existing and new) that looks at a number of key issues impacting on the basic rights of children and women in Kosovo. The Situation Analysis represents an opportunity to take stock of the considerable achievements of the last four years and to set out an agenda and vision for the post-conflict era in Kosovo and the new generation of young people. This vision is rooted in the principles of the UN Convention on the Rights of the Child (CRC) and the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) which form the basis for UNICEF’s mandate.
Following the UN General Assembly Special Session on Children held in May 2002, UNICEF prepared a five year Medium-Term Strategic Plan (MTSP) and identified five corporate priority areas that would contribute to making the world a better place for children. These five priorities are closely related to the Millennium Development Goals (MDGs) agreed upon at the Millennium Summit in 2000:
- Girls' education
- Integrated early childhood development
- Immunisation "plus"
- Fighting HIV/AIDS
- Protecting children from violence, abuse, exploitation and discrimination
These five priorities guide UNICEF programming in Kosovo.
This report focuses on children, young people and, to a lesser extent, on women in the context of the importance of women's health, well-being and development if they are to adequately care for and nurture their children. It also addresses the role of women within civil society. It examines a number of conditions that lead to shortfalls in the realisation of human rights at different stages of childhood and youth. The report is divided into five main chapters. The introductory chapter provides an overview of key demographic, political, economic and social developments in Kosovo in the post-conflict period. Drawing on existing data, this chapter attempts to provide a context for the subsequent analysis on the current status of respect for the rights of children and women.
Chapter two examines early childhood survival, development and a healthy start to life - including the essential aspect of maternal health before, during and after pregnancy. There are critical data shortages that have precluded the accurate determination of infant and maternal mortality in Kosovo which need to be addressed. However, it is clear that both maternal and infant mortality rates are high compared with other countries in the region. Some progress has been made in decentralising the healthcare system to make it more responsive to the needs of the communities.The emphasis,however, remains focused on treatment rather than prevention. As a result, although most pregnant women have access to antenatal services, it is not easy to obtain advice, counselling and guidance on how to ensure a healthy pregnancy. The majority of women attend antenatal services infrequently and mainly for ultrasound examinations. Most mothers (more than 95 per cent) give birth in a health facility but maternal mortality is high (rate unknown – estimates vary from 509 to 12 per 100,000 live births). There is a need to raise awareness among women as to the quality of health service they should both expect and demand.
Infant mortality is high at an estimated 35 per 1000 live births mainly due to poor delivery practices and quality of newborn care. Perinatal mortality is 29 per 1000 live births. Recent improvements in practices in health facilities have led to five maternity clinics/hospitals in Kosovo being certified as "baby-friendly". Among new mothers, 95 per cent initiate breastfeeding while still in the maternity clinic but only 12 per cent go on to breastfeed exclusively for the first six months of life. Under-five mortality is not recorded by the current health information system but, for young children, overall immunisation coverage is quite good at around 90 per cent. However, between the BCG dose given while newborns are still in the health facility (99.5 per cent coverage) and the MMR vaccine given when the child is 12 to 18 months old (67 per cent coverage), a considerable reduction occurs. This indicates the need to increase parental awareness of the importance of immunisation. There is also a need to identify the small number of children not being vaccinated at all – almost certainly from the Roma, Ashkalia, Egyptian (RAE) communities, as it is these mothers who are least likely to give birth in a health facility and thus miss the opportunity even for BCG immunization.
Pollution is high in Kosovo (industrial pollution, traffic and ubiquitous cigarette smoke) as is the incidence of acute respiratory infections among children. Water quality and waste management is poor, and there is a high incidence of diarrhoeal disease. Many women smoke during pregnancy and there is a high incidence of low birth weight babies. There is a need for greater awareness of health, nutrition and environmental issues among parents, children and the general public.
In the area of early childhood development, including socialisation, much more could be achieved. Most young children are cared for within the home and only a fraction of three to six year olds attend any form of kindergarten or pre-school programme. As a result, they are missing the opportunity to mix with other children and to understand other cultures and practices among their peers from other communities. For the child this can make the transition from home to primary school quite traumatic and can be detrimental to learning achievement. Participation in good quality early childhood programmes before primary school make children much more at ease with each other, more tolerant of differences between them, and more eager and ready to learn.
The education level of mothers has been shown to be important for early childhood development. In Kosovo, 14 per cent of rural women are illiterate (compared with four per cent of men). Some studies show as much as 26 per cent of young women aged 16 to 19 to be relatively illiterate with 9.5 per cent totally illiterate. This has direct implications for parenting knowledge and skills
Chapter three analyses the interaction between children and the education system in Kosovo. Globally, UNICEF has committed itself to ensuring that all girls complete a quality primary education. In Kosovo, enrolment rates are high but there is a need to address disparities - both ethnic- and gender-based. Primary enrolment is 97.5 per cent for Kosovo Albanians, 99 per cent for Kosovo Serbs but only 77 per cent among the non-Serb minority communities (Roma, Ashkali, Egyptian, Turkish, Bosniak, Gorani, etc) and for them drop out is also high. Girls from Roma and Ashkalia communities often do not enrol at all, although statistics are lacking. In terms of retention, there is a pressing problem especially among girls. At the start of Grade 5 (age 11), around 10 per cent of girls leave the school system and between 8th and 9th Grade (age 14/15) this rises to 30 per cent. (In Kosovo, there has recently been an increase from eight to nine years of compulsory education). Almost half of all girls from the Kosovo-Albanian community and 60 per cent of girls from the non-Serb minority communities drop out before upper secondary (Grades 10-12). There are indications that illiteracy rates are increasing for girls among the non-Serb minority communities, as it has been more difficult for these children to access school since the conflict and the resulting tensions - and preference is given to boys. In the Kosovo Serb community there is traditionally a greater importance given to education – including for girls – and both enrolment and retention rates are higher.
Children with special needs tend to be kept at home and not benefit from any sort of education. Of those few with special needs who do go to school, approximately 70 per cent are boys.
Other issues affecting children within the education system include the existence of a separate parallel system for children from the Kosovo Serb community, run from Belgrade by the Serbian government. Also, after the war, many international agencies reconstructed destroyed or damaged schools – rebuilding them on their original sites. In 1999, however, there was a huge population shift from rural to urban areas in search of security and jobs. Now many rural schools are underused while urban schools are grossly overcrowded and forced to run up to four shifts a day - to the detriment of the children who in consequence receive greatly reduced hours of teaching. The quality of the learning environment also remains a problem. Teaching methods traditionally are fairly rigid with little interactive teaching or learning. Materials are outdated and teacher's salaries are extremely low. A comprehensive education reform programme is underway addressing curriculum development, teacher training and other key issues. The challenges however remain considerable.
Chapter four examines the specific situation of teenagers and young people in Kosovo. According to population estimates, 50 per cent of Kosovars are under 25, 40 per cent of whom are under 18. This age group grew up during a period of tremendous instability and change. They are the generation mostly educated under the parallel system in the 90s and – then as well as now – with little expectation of future jobs and opportunities. Whereas young Kosovars previously lived in relative isolation within the culture and traditions of their own communities, young people today have access to satellite TV and the internet – both of which have fundamentally transformed attitudes and behaviours, particularly among urban youth. These changes are manifested in a number of different ways relating to how young people view their rights and responsibilities within society. Although this is the generation that will provide the future parents, decision makers and leaders of Kosovo, they feel marginalised and excluded from broader discussions about the future of Kosovo and neglected by a system that is failing to address their needs and expectations. With a 57 per cent overall unemployment rate in Kosovo and an even higher rate of 71.2 per cent for 16 to 24 year olds, there is an urgent need for better and different education and skills training for young Kosovars. Despite this, the majority continue to feel positive about the future and ready to put their energy and talents into making Kosovo a better place.
There are many concerns, not least the fact that knowledge and awareness about sexual and reproductive health in general, and HIV/AIDS in particular, remain worryingly low. Less than 50 per cent of 14 to 19 year olds surveyed knew that HIV could be transmitted through shared needles and less than 41 per cent of sexually active young people use condoms on a regular basis. Young people are frustrated by the inability to discuss these issues within the family or to have them addressed at school. The health system does not lend itself to providing "youth-friendly" services where young people can feel comfortable going for advice or information and the education system does not yet provide a grounding in life skills. The problems of unwanted pregnancies, high rates of abortion, abandonment of newborn babies and the increased risk from sexually transmitted infections and HIV will not go away until and unless fundamental changes in policies and practices are introduced. On a positive note, surveys of young people show that almost all information on such matters comes to them through the media, especially television, and this is becoming a powerful tool, enabling young people to voice opinions and share views.
Chapter five deals with the promotion and protection of children's rights. Overall in Kosovo, there is a need for greater awareness about the rights and responsibilities of children and youth and of those who are there to care for and protect them. There are a number of serious child protection issues that need to be addressed. For example, the growing incidence of child labour. While most children are not engaged in hazardous forms of work, and most manage to attend school as well, the sheer number of working children, some as young as ten, needs to be monitored, regulated and understood. There is also evidence of a fairly dramatic increase in the reported cases of children being trafficked into and through Kosovo as it becomes a major transit route and destination for victims of trafficking across Eastern Europe. Other concerns such as children with special needs, children in conflict with the law, children affected by domestic violence, neglect and abuse, all need to be much more comprehensively understood and addressed.