Child Health and Development
UNICEF has initiated dissemination of the global initiative of Baby Friendly Hospital (BFHI) and supported its decentralization, which resulted in an increase in the number of maternity hospitals certified as baby-friendly from four in 2001 to 77 in 2006. As a result, the number of infants receiving a better start in life increased from 2.6 per cent of all newborns in 2001 to 32 per cent in 2006. While expanding the Initiative, baby friendly and family friendly requirements were also disseminated to antenatal clinics, children hospitals and policlinics as it is indicated in the Sectoral Programme of Breastfeeding Support in Ukraine for 2006-2010, developed by the Ministry of Health with UNICEF support. Despite high positive results achieved in the maternity hospitals where 98% of women coming out of the hospitals feed their children exclusively by breast, the level of exclusive breastfeeding in the country remains extremely low – 6%. This is because of the International Code of Marketing of Breast Milk Substitutes that is not yet ratified in Ukraine and its requirements are not following. Results from monitoring of International Code of Marketing of Breast Milk Substitutes following, conducted with UNICEF assistance at the request of the Ministry of Health in April 2004, show that baby food producers market their products in 65% of medical institutions in Ukraine, taking advantage of state control absence in this sphere, a lack of awareness of medical workers, and the difficult financial situation of health system. According to number of researches of Ukrainian Institute of Social Researches a quarter of parents are not satisfied with their knowledge regarding baby and child care and development. 93% consider that they need specific information on child care, development, and upbringing so that they can take care of their child more effectively and ensure its all-round development. A formal system of parent education does not exist. But Ukraine is one of the few countries in the region which has a state law regarding pre-school education, and national standards regarding young children's development as stipulated in the National Programme 'The Grain' (a programme for the development of children from birth to three years of age, developed with UNICEF assistance). The legal and operational conditions for successful programmes on young children's development have already been established in Ukraine. However, little has been done to improve parents’ awareness. Despite obligation of Government of Ukraine to provide access to pre-school education and upbringing for all children, only 21% of children living in rural areas have possibility to visit children kindergartens. Besides, inadequate the knowledge and skills of parents about creation of secure environment for child development are proved by appropriate researches and state statistics. Indicators of domestic traumas, accidents or poisoning due to inadequate parental care remain very high. UNICEF's Child Health and Development Programme is aimed that every child develops in supportive and secure environment that ensures its survival, physical and mental health, emotional stability, social competency and ability to learn. To overcome micronutrient deficiency and to ensure adequate and enough food for young children is one of the necessary conditions of this goal achievement. OUR RESPONSE Action on infant health: This programme is designed to contribute to a reduction in maternal and infant morbidity and mortality by improvements in national capacities in providing of quality primary health services, that are oriented not only to mother or child, but for all family, and also improvement of family child care practices. Ministry of Health of Ukraine is doing this work. Implementation of family friendly approach and parents’ preparation to child birth and care also has to promote prevention of social orphanage. UNICEF is placing strong emphasis on introducing evidence-based prenatal practices and promoting and protecting exclusive breastfeeding for the baby's first six months and continued breastfeeding with adequate supplementary feeding up to two years of age. In Ukraine annually World Breastfeeding Week is being celebrated with support from UNICEF. One result of UNICEF's efforts in this area is a reversal in the spread of pyoseptic and gastrointestinal illnesses in newborns, and a reduction in post-delivery complications in mothers. Special attention has been paid to access and quality of health services for mothers and infants living with HIV-infection. Substantial efforts have been made to raise public awareness on this issue. Action on child development: UNICEF provides assistance to the Ministry of Education and Science and civil society organizations in parents’ training and ensuring the implementation of national standards for young children's development and standards of parents’ competencies. The Centers for Young Child Development on the base of medical institutions are established with UNICEF assistance and successfully operating in Lviv and in Donetsk. Special attention is also given to young children living in rural areas of Ukraine. A comprehensive Child Health and Development project ‘Carpathian Blossoms’ is also being implemented in some remote mountain villages in the Ivano-Frankivsk region, and is directed to health care and development of young children. Within this project, UNICEF is assisting the government of Ukraine to develop operational norms and standards for counseling centers for parents and family type preschool institutions. The quality and effectiveness of parental education is impossible without good training materials for parents, and without education, social and health workers involved in the training. Thus UNICEF continues to support interagency cooperation in development and distribution of information and education materials for parents’ education. Action on iodine deficiency disorders (IDD): UNICEF advocates for and supports efforts to achieve universal salt iodisation (USI), pushing for the adoption of USI legislation. UNICEF is supporting the social marketing of iodised salt, the mobilization of consumer demand for iodised salt, and strengthening the production of properly iodised salt. We have supplied salt iodisation equipment to Ukraine's major salt producers which has enabled them to produce more than enough iodised salt for all domestic consumption, and have worked with them to improve quality control and monitoring. Production of iodised salt has steadily increased during the last five years, and in the last year the amount supplied to the Ukrainian market was 78,000 metric tons. This, however, is far from sufficient, and we continue to work with the public, the Ministry of Health, salt producers, and other partners to overcome IDD. More than 3,000 health workers have been trained to communicate messages on IDD to their patients. Seven oblasts in western Ukraine, Kharkiv oblast and the Autonomous Republic of Crimea have already introduced IDD messages into the secondary school curricula. Information about IDD and salt iodisation has been included in school curricula and adopted by the Ministry of Education. Some 80 journalists have been trained to report on IDD issues, while more than 400 shopkeepers in Kharkiv and Lviv oblasts and in Crimea have learned how to promote the sales of iodised salt. Lviv oblast administration developed local programme 'IDD Free Region' which includes preventive measures as well the system of IDD monitoring. As a result of the efforts of UNICEF and its partners, iodised salt consumption increased from 5% of households in 2000 to 32% in 2003. Action on immunization: UNICEF is one of the Government's main partners on immunization. Our technical and supply assistance aims to maintain good routine immunization rates and implement disease control activities. A national policy and plan of action on safe injections and immunization waste management has been developed with UNICEF support, backed by the creation of a National Working Group on injection safety. Starting in 2003, UNICEF has supported the introduction of the new Hepatitis B vaccine. In 2007 UNICEF will provide support in improvement of public immunization against measles.
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