MDGs in Kazakhstan
Millennium Development Goals (MDGs) stem from the Millennium Declaration, which was signed by 191 states, including Kazakhstan, and captures the common aspiration of all nations to build a better and safer place for the twenty-first century. The MDGs are set of clear, numerical targets with assigned indicators to which the international community has subscribed - by 2015 to halve poverty, reduce child and maternal mortality, expand educational opportunities for all, promote gender equality, halt the spread of HIV/AIDS and other major dieseases, and improve the environment.
Kazakhstan has achieved the first three Millennium Development Goals and has set more ambitious ‘MDG+’ goals and targets: halve poverty among the rural population; achieve universal secondary education; ensure gender mainstreaming in national planning and budgeting; prevent violence against women; and increase women’s representation in legislative and executive bodies.
Goal 1: Reduce poverty
Target 1: Reduce by half the proportion of people whose daily consumption is below USD 4.30, measured in average PPP (parity purchasing power), as compared with 2001
Kazakhstan achieved Target 1 in 2004. However, poverty is still a serious issue for the country, especially in rural areas. For this reason, the 2007 Report proposed a new MDG 1+: to halve the proportion of people in rural areas whose income is below the subsistence minimum. Notwithstanding some progress in the reduction of income poverty, there is a certain risk for a quite considerable proportion of the population living near the poverty line to fall into poverty. Virtually 80 percent of the population in the country have an income twice the level of the subsistence minimum. Earned income remains at a level insufficient for a decent income, thus reducing the attractiveness of productive employment. Regional differences in poverty remain and rural poverty is deeper in all regions. Levels of rural poverty are still almost twice as high as urban poverty. Public social policy for the protection of vulnerable categories should be an effective mechanism of a poverty reduction strategy. The strategy should be designed to further enhance the system for protection of the most vulnerable categories, especially those living in rural areas, the self-employed, large and incomplete families, old people, disabled people and migrants. Achievement of this target by 2015 will require an enabling environment in rural areas for the development of entrepreneurship, an enabling legislative framework for the employment of migrants and their access to entrepreneurship activities. This will also require enhanced access for disadvantaged people, especially women, migrants, refugees, young and old people and disabled people, to the social safety system and development of social services involving NGOs as service
Target 2: Reduce the share of the poor by one third (based on the nationally defined poverty level) This goal in its original version was achieved in Kazakhstan already in 2004.
Target 2 has now been achieved. For Kazakhstan, the issue of hunger is no longer urgent. Therefore, Target 2 was adapted in 2007 to a national target of halving the proportion of people having no access to balanced nutrition. A substantial proportion of the population, especially those from risk groups including children and women of reproductive age, need to have better nutrition. Particularly, some children under five, who are under-weight and under-height, factors which characterise nutrition quality. Deficiency of some micro-nutrients remains high among risk groups; such deficiency is called ‘hidden hunger’. The reduction and eradication of micro-nutrient deficiency will help to significantly improve health and reduce child and maternal mortality, which is a contribution to the achievement of MDG 4 and 5. This will require preparation, government approval and implementation of a comprehensive programme on balanced nutritition for children under five and prevention of malnutritition and nutritional status abnormalities.
Goal 2: Achieve universal primary education
Target 3: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
Following on from the MDG 2002 and 2005 reports, MDG 2 in its original version has already been achieved in Kazakhstan. Based on the analysis of national priorities, statistics and state education programmes, and given other countries’experiences, it was decided that there is a need for the assessment of the secondary education system as a whole, with a focus on the quality of education and the enrolment of children with special needs and students from socially vulnerable groups. The MDG 2007 report takes into account this conclusion and determined Target 3+, ensuring universal secondary education, for further monitoring of the achievement of the expanded version of MDG 2. The review demonstrated that at present, in ensuring universal secondary education, there have been considerable achievements, but there remain unresolved issues related to educational policies, quality of education, statistical support, and institutionalisation, human resources capacity and the financing of education. To overcome the existing barriers the Government and other relevant stakeholders should implement a number of strategic actions, including the renewal of educational substance, development of a uniform standard of national educational statistics and enhancement of teachers’ training.
GOAL 3. To Promote Gender Equality and Empower Women
Target 4. To eliminate gender disparity in primary and secondary education, preferably by 2005 and at all
levels of education no later than 2015
This target has been achieved in Kazakhstan. However, one has to recognise that differences between women and men are still significant in Kazakhstan. Therefore the new targets of 4+, which were adopted in 2007, are:
- To ensure adoption and implementation of measures aimed at increasing representation of women in legislative and executive bodies.
- To ensure legislative and enforcement measures to prevent and eliminate violence against women.
- To ensure sustainable gender mainstreaming of national planning and budgeting, especially aiming at minimising the gender wage gap.
One of the recommendations for achieving the additional targets in the public administration area is to establish effective mechanisms for progressive implementation of the Law ‘On Equal Rights and Equal Opportunities of Men and Women’. Political parties should promote equal representation and participation of women in the governing party’s bodies for meaningful participation of women in the political processes. Although there is on-going progress in improving the legal framework for the protection of women’s rights to a life free of violence, the mechanisms for its enforcement have still not been fully put into practice. Hence, an effective system needs to be put in place for applying protection warrants and government standards of assistance to victims of violence and to persons who have committed violence, using available similar international experience. This work should be supported by Governmental budget allocations for public service delivery.
Goal 4: Improve maternal health and reduce child mortality
Target 5. To reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
MDG 4 progress report has exposed challenges that are governed by corresponding Governmental resolutions and orders of the Ministry of Healthcare. Unfortunately, they are not enforced well enough locally, which may be due to misunderstanding of the essence of the orders due to insufficient awareness of new perinatal technologies and their organisational support by health staff. The findings of the analysis and evaluation of the MDG 4 status in Kazakhstan allow the following conclusions to be drawn, and recommendations on the implementation mechanism be proposed:
- to introduce regionalisation of perinatal care into obstetric practice and to provide full financing of these services;
- to identify financing for the introduction of further sustainable Effective Perinatal Care programmes into obstetric
practice and WHO Integrated Management of Childhood Illness (IMCI) in primary hospitals and primary healthcare
- to undertake research to explore the causes of accidents involving a wide range of ministries (healthcare, education,
road and transport, etc.);
- to conduct a study to assess the true frequency and causes of congenital malformation;
- to amplify usage of the BABIES matrix for proper management decisions in obstetrics throughout the country.
GOAL 5. To improve Maternal Health
Target 6. To reduce by three quarters, between 1990 and 2015, the maternal mortality ratio. By 2015, to
achieve universal access to reproductive health
The relevance of MDG 5 in Kazakhstan has to do with the fact that maternal health indicators in the country are still quite low and the maternal mortality ratio is several times as high as that in the WHO European Region. To achieve MDG 5, Kazakhstan needs to reduce its maternal mortality ratio (MMR) from 55 per 100,000 live births in 1990 to 14 in 2015. Is this achievable? During the next five years MMR needs to be almost halved compared to the current indicator. Over the 19 years since 1990, MMR has been reduced by less than 2 times. It is clear that as the MMR is being reduced, each subsequent reduction will be most probably more difficult to achieve. Nevertheless, progress achieved in recent years in decreasing maternal mortality in Kazakhstan, inspires cautious optimism. Achievement of MDG 5 in Kazakhstan will depend on how fast the legislation will change, how successful healthcare institutional reforms will be, and how efficiently maternal mortality reduction programmes will be managed and financed. Achievement of MDG 5 requires a strengthened multi-sectoral approach to addressing maternal health improvement, for which purpose the education sector, healthcare, mass media and non-governmental sector need to join and coordinate their efforts to achieve a substantial improvement in awareness of the population, primarily youths, about the prevention of unwanted pregnancies, STIs and HIV/AIDS. MDG 5 can only be achieved if investment into sexual and reproductive health is increased, with available resources to be allocated in a way to ensure maximum benefits to a maximum number of people.
GOAL 6. To combat HIV/AIDS and Tuberculosis
Target 7. To halt, by 2015, and begin to reverse the spread of HIV/AIDS
As at 1 January 2010, there were 13,784 cases of HIV infection registered in the Republic of Kazakhstan. Since 1987, there has been an increase in new HIV infection cases every year other than 2009. The HIV incidence rate among population aged 15-49 is 0.15 percent. As before, intravenous drug use is a dominant transmission mode accounting for 67.5 percent of cases, with sexual transmission accounting for 24.4 percent. HIV infection is concentrated among injection drug users (incidence rate is 2.9 percent). The situation analysis shows that though Kazakhstan does manage to restrain the HIV epidemic at its initial stage (HIV is concentrated primarily among injection drug users), there remains the possibility for deterioration. This is because the behaviour practiced, in the first instance, by drug injectors is not safe, the level of awareness of young people about HIV transmission modes and ways to avoid HIV infection is not always sufficient and access to treatment is not secured in full. Despite significant progress in combating the HIV epidemic, the following efforts need to be reinforced in order to achieve
- The strengthening political commitment to HIV and AIDS;
- Providing access to ARV therapy for all patients in need;
- Raising of youth awareness;
- Ensuring sustainable prevention programmes for the most vulnerable groups;
- Further improvement of the epidemiologic tracking system;
- The strengthening of cooperation with NGOs.
Target 8. To halt, by 2015, and begin to reverse the incidence of tuberculosis
In Kazakhstan, tuberculosis is considered to be an established disease, determined by social factors and remains a serious problem for public health. According to WHO official data, Kazakhstan leads in terms of the incidence of registered tuberculosis (TB), and is one of 18 priority countries for TB in the WHO European Region. In addition, multi-drug resistant tuberculosis (MDR TB) incidence is one of the highest in the world. Though the epidemiological situation is difficult, Kazakhstan can progress towards the target, provided that the Government will take measures to achieve the target. This will require the Government:
- to make further efforts for the high-quality introduction of and improvement in all components of the basic DOTS
- to ensure universal application of International Standards for Tuberculosis Care in defining tuberculosis cases and
treatment results in order to improve the quality of services and monitor their performance;
- to secure TB infection control measures at all healthcare levels;
- to raise awareness of governmental, non-governmental and donor organisations about importance of the tuberculosis problem including spread of drug-resistant TB forms;
- to strengthen intra- and inter-agency integration of the TB control programme with the general healthcare network,
HIV/AIDS prevention and control programme, rehabilitation service for timely detection, treatment and management
GOAL 7. To Ensure Environmental Sustainability
Target 9. To integrate the principles of sustainable development into the country’s policies and programmes
and reverse the loss of environmental resources
The lack of an ecosystem approach in developing and implementing economic and social programmes, and non-compliance with the principles of comprehensive and balanced environment quality management have been named as the main issues in achieving the environmental sustainability. However, Kazakhstan has achieved some progress across a number of indicators during the reporting period. Specific measures undertaken to improve the regulatory framework include; optimisation of the bio-diversity management structure and regulation processes; an active involvement in the international projects, which will allow us to predict whether this target will be achieved, provided there are continuous positive dynamics in the indicators. In the future it is necessary to continue the efforts undertaken to improve the legislation related to nature and resources, in compliance with the accepted international conventions and regional documents; to put in place sustainable mechanisms for cooperation with the Central Asian States to develop a regional environmental policy to help address transboundary environmental issues. Studying the international experience with environment insurance and off-budget environment funds is important with the view of potential implementation in Kazakhstan.
Target 10. To halve, by 2015, the proportion of people without sustainable access to clean drinking water and main sanitary technical facilities
In terms of water supply, Kazakhstan is one of the Eurasian countries suffering from water deficit. The main issue is related to the safe water supply and waste management, which are the key factors that impact public health. As of today, at least 10 percent of households do not have running water and about a quarter of the population has no access to a proper sewage system. To mitigate the above institutional challenges, it is necessary to give statutory authority to the Water Resources Committee of the Ministry of Agriculture to approve the technical requirements for the rural water supply facilities at the stage when the TOR for design engineering are issued. The other issue that needs to be addressed, is the implementation of the National Programme on Integrated Water Resources Management in Kazakhstan. The quality of water supply networks can be improved through the use of the state-of-the-art energy and resource saving technologies, equipment, materials and water consumption metering devices. It is necessary to review and reduce the water consumption rates for both the urban and rural population and to enhance the mechanisms for drinking water supply subsidies.
Target 11. To achieve, by 2020, a significant improvement in the lives of the rural population residing in the
most unfavourable social, housing and ecological environment
Addressing this target seems quite challenging when it comes to rural areas. In spite of a number of programmes implemented by the government to enhance villages and develop the agricultural sector, the living standards of rural population are much lower, compared to those of the urban population. There are reasons for this, including the left-over fund ing applied to the rural social sector (especially true in times of economic downturn), under-developed infrastructure, primarily in the transport and telecommunications networks. Funding of small and remote villages is not economically profitable, which results in their degradation and outmigration and aggravates employment and housing issues. This problem requires conducting a detailed review and taking comprehensive decisions involving all government levels. Special focus should be on awareness, education and advocacy activities. The positive trends in the indicators based on the official statistical data reflect the effective efforts undertaken to address the issues by 2009. However, as the indicators show, the proportion of the rural population with access to improved sanitation systems has not yet reached 50 percent. Some hope can be derived from the implementation of the Road Map Programme, which has commended itself highly in the conditions of downturn both in urban and rural areas.
Goal 8. Develop a global partnership for development
Partnerships at the national and international levels are important factors for achieving development goals and objectives. Kazakhstan continues developing cooperation and partnerships at the international level (including trade, donor and financial institutions), and with private sector and civil society within the country. Kazakhstan is an active player in the international arena as well as in different regional and international organisations. International (external) partnerships where Kazakhstan is involved fully support and promote its development objectives. At this stage the most active relationships are in the areas of trade, investments, finance, IT and communications, as well as regional and international cooperation. Domestic partnerships are different in scope and progress. The partnership with the private sector is gaining momentum whereas the dialogue with civil society has a slower progress. In the future, the domestic partnerships should focus on addressing the most essential development issues: inequality and marginalisation, local level development, employment of youths and women. In partnerships with the civil society the priority should be assigned to enhancing the existing (and creation of new) mechanisms of dialogue and collaboration. One of the promising streams is to involve NGOs into social service delivery.
On 25th of October 2010 Millennium Development Goals in Kazakhstan Report was presented at the Ministry of Foreign Affairs of the Republic of Kazakhstan. This is the fourth Report jointly prepared by the Kazakh Government and the UN Country Team. The 2010 report provides a definition of major issues hindering the achievement of some goals and targets and contains conclusions, including forecasts as to whether these targets can be achieved by 2015, along with practical recommendations and steps to be made by the Government to achieve MDGs by 2015.
The Millennium Development Goals' Report for Kazakhstan was presented on 27 June, 2008 at the Ministry of Foreign Affairs of the Republic of Kazakhstan. The given report is the third related to MDGs in Kazakhstan. The year 2007 is exactly half way toward MDG achievements since they were adopted in 2000 and their coordinated date of implementation is 2015. Given that a number of objectives related to MDGs have already been achieved, the given report includes MDG+ agenda, i.e. additional, more ambitious goals adapted for Kazakhstan, which are based on the analysis of the national priorities, national statistics, related national programmes and also on the experience of other countries.
The second MDGR in Kazakhstan was presented on 10 October, 2005 in the Parliament of the Republic of Kazakhstan. The Report was jointly commissioned by the Government of the RK and UN System in Kazakhstan. The report contains statistical information, assessments and analyses of the main achievements, problems and trends for the MDGs. As the first one, the Report of 2005 was published in 3 languages (Kazakh, Russian, English). Moreover, it also has a shorter version - Millennium Development Goals in Kazakhstan 2005. Overview.
The initial MDG Report was published in 2002 and was the first of its kind in Eastern Europe and the CIS, signifying the country's openness to a frank assessment of national progress towards the MDGs and eagerness to work for their attainment. The Millenium Development Goals Report in words, tables and charts describes the status of 8 Millennium Development Goals in Kazakhstan, the country position in reaching these goals by the year 2015 and what reamins to be done.This report is not about bureaucratic details, voluminous analyses or policy recommendations. It is a user friendly publications for wide sections of civil society and decision makers at many levels.