Child Health and Development Programme

Loss of potential during childhood is one of the most crucial contemporary world problems, concerning more than 200 million children. UNICEF recognizes young child development as a priority. One dollar invested in development programmes for young children generates seven dollars saved in social expenditures. Programmes that foster full, healthy young child development are a direct investment in a country’s economic and social welfare, since the children affected will grow up into healthy, intellectually developed and socially integrated adults.

Issue

Eliminating iodine deficiency disorders by means of universal salt iodization, the most effective method, remains an urgent issue in Ukraine.

The quality of primary medical care available to mothers and babies is low and access to such services, especially for socially vulnerable groups and the rural population, is limited. Parents lack knowledge about childcare, nutrition and development as well as the related skills. The exclusive breastfeeding rate in Ukraine is only 18 per cent, one of the lowest in the region.  

There are no national standards for child development in Ukraine. Accordingly, there are no quality standards for parent education or for providing comprehensive basic services to children. These must be based on a country’s adopted child development standards.

The UN General Assembly proclaimed 2006–2016 the decade of recovery and sustainable development in Chernobyl-affected areas. This means, among other things, providing primary medical services and creating the conditions for healthy and full child development in these territories.

According to unofficial data, there are 400,000 Roma children in Ukraine. The majority of Roma families have numerous children and live in extremely poor conditions, suffering from TB and other infections. Access to education and medical services and to development opportunities is limited for Roma children because of poverty, language barriers, segregation, discrimination and stigmatization.

Action

• Achieve sustainable iodine deficiency elimination by universal salt iodization.

• Improve quality of and access to primary medical services for mothers and children through implementation of the Expanded Baby-Friendly Hospital Initiative and introduction of the Integrated Management of Childhood Illness (IMCI) approach. Since the Ukrainian health care system’s imperfections are the major constraint to achievement of this, it is necessary to address reforming the system of maternal and child health care, to apply effective administrative models and to provide appropriate funding.

• Verify the current child development standards in compliance with modern protocols, introduce relevant changes to the available national child development programmes, educatee parents and train specialists.

• Implement the UN Action Plan on sustainable development of Chernobyl areas, including universal salt iodization, increasing the quality of health care services for mothers and children and their access to them, strengthening the responsible parenthood programme and creating comprehensive service models for families.

• Elaborate a national plan for development of the Roma population, with special focus on child health and development. Facilitate educating Roma mediators in maternal and child health issues.

Impact

The draft Decree of the President of Ukraine On Sustainable Combating of Iodine Deficiency in Ukraine and the draft Concept of the State Target Programme On Prevention of Iodine Deficiency Disorders for the Period Until 2013 are under development.

Currently almost half of the children in Ukraine are born in Baby-Friendly Hospitals. These facilities report lower mortality and disease rates than those without that status. To implement the Baby-Friendly Hospital Initiative, national and oblast centres have been created and are operating (http://www.ohmatdet-center.org.ua). Between 2005 and 2007 the national indicator for exclusive breastfeeding grew from 6 per cent to 18 per cent. The exclusive breastfeeding rate is 50.5 per cent in children’s polyclinics which comply with Baby-Friendly Hospital standards. The number of childbirths accompanied by partners increased from 4 per cent in 2005 to 30 per cent in 2008, while in Baby-Friendly Hospital facilities this indicator rose to 52.8 per cent.

The joint efforts of the Ministry of Health Care (MoH) of Ukraine, the Mother and Infant Health Project (JSI) and UNICEF to implement the protocol on healthy childcare based on evidence-based medicine are supported by MoH Order No 149, adopted in 2008. The Order envisages implementing new World Health Organization (WHO) Child Growth and Parent Consulting Standards and modern recommendations on child-feeding. The number of medical examinations during the first three years of a child’s life was considerably decreased while the quality and content of each examination were improved.

UNICEF in Ukraine adopted the leadership role in implementing the Facts for Life project for the population that has suffered from the Chernobyl catastrophe in Russia, Ukraine and Belarus. The worldwide UNICEF publication Facts for Life has been complemented with new sections about radiation, oncological disease prevention, the emotional and social welfare of mothers and children and caring for children with special needs. The publication has been translated into Russian, Ukrainian and Belarusian languages and circulated in these three countries. 

The Guidelines and the Zernyatko (Seed) State Programme on Development of Children from Birth to Three Years were developed with UNICEF’s support. Parents, the general public and pre-school institutions for young children widely use the Programme.  

With UNICEF’s support family centres have been established on the basis of health care facilities in Lviv, Donetsk and Ivano-Frankivsk. These centres advise parents on childcare, and child nutrition and development. Analysis of the results of these projects shows a considerable decrease in disease incidence and the injury rate among children due to improved parental knowledge and practices.  The creation and work of the Schools for Dads network has led to fathers becoming more actively involved in childcare and development.