79931 Tajikistan SABER Country Report EARLY CHILDHOOD DEVELOPMENT 2013 Policy Goals Status 1. Establishing an Enabling Environment Recent efforts by the Government of Tajikistan (GoT) have strengthened national laws and regulations to promote appropriate dietary consumption by pregnant women and young children and offer parents suitable opportunities to provide care to infants in their early stages of life. Improved coordination amongst Ministries, as well as state and non-state actors, is required. In parallel with greater financial investment, a detailed methodology for calculating ECD expenditures could increase effectiveness of current investment. 2. Implementing Widely There are a number of ECD interventions in education, health, nutrition, and social and child protection. Levels of access and quality vary by intervention, but coverage is low – regardless of geographic location and socioeconomic status – except for immunizations and Vitamin A supplementation. Only 8.9 percent of 3 to 6 year olds attend preprimary preschool, and the level of moderate and chronic undernutrition is high by international standards. 3. Monitoring and Assuring Quality Various data on access to ECD services are available but not on measurement of child development. Stringent standards for preschool service delivery contribute to low enrollment levels. Attention should focus on simplifying the existing input-based standards and shifting towards outcome-based standards for child development, as well as better enforcement of compliance mechanisms. THE WORLD BANK TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 This report presents an analysis of the Early Childhood multi-sectoral coordination, increased and targeted Development (ECD) programs and policies which affect funding, and enhanced public-private partnerships are young children in Tajikistan. This report is part of a key to expanding the coverage and equity of various ECD series of reports prepared by the World Bank using the services in Tajikistan. SABER-ECD framework 1. The Country Report includes SABER – Early Childhood Development analysis of early learning, health, nutrition and social and child protection policies and interventions in the SABER – ECD collects, analyzes and disseminates Tajikistan, along with regional and international comprehensive information on ECD policies around the comparisons. world. In each participating country, extensive multi- sectoral information is collected on ECD policies and Tajikistan and Early Childhood programs through a desk review of available government documents, data and literature, and interviews with a Development range of ECD stakeholders, including government officials, Tajikistan has a population of 7.76 million people, of which service providers, civil society, development partners and 35 percent are below the age of 15. Unlike some countries scholars. The SABER-ECD framework presents a holistic in the region, Tajikistan has a positive population growth and integrated assessment of how the overall policy rate. Tajikistan is ranked 127th in the UNDP Human environment in a country affects young children’s Development Index Table and has a gross domestic development. This assessment can be used to identify product of US$836 per capita in 2011. 2 Policy how countries address the same policy challenges related interventions for early childhood development are to ECD, with the ultimate goal of designing effective emerging, but still require considerable improvement to policies for young children and their families. ensure equal opportunities for all children to reach Box 1 presents an abbreviated list of interventions and their full development potential. Young children and policies that the SABER-ECD approach looks for in pregnant women in Tajikistan lack access to basic ECD countries when assessing the level of ECD policy services, resulting in very high undernutrition, health development. This list is not exhaustive, but is meant to problems, and low preschool enrollment. provide an initial checklist for countries to consider the Long-term government commitment to ECD, stronger key policies and interventions needed across sectors. Snapshot of ECD Indicators in Kyrgyz Russian Tajikistan with Regional Armenia Colombia Kenya Tajikistan Uzbekistan Republic Federation Comparison Infant Mortality (deaths per 1,000 live 18 17 55 33 9 52 44 births, 2010) Under-5 Mortality (deaths per 1,000 20 19 85 38 12 63 52 live births, 2010) Moderate and Severe Stunting 19% 13% 35% 18% No data 28% 19% (under-5, 2006-2010) Net Preprimary/preschool Enrollment 21% 34% 51% 42% 17% 73% 9% Rate (36 to 59 months of age, 2011) (2006/07) Birth registration (2000-2010) 96% 97% 65% 94% No data 88% 100% 3 UNICEF Country Statistics, 2010 1 3 SABER-ECD is one domain within the World Bank initiative, All UNICEF country data can be located at URL: Systems Approach to Better Education Results (SABER), which http://www.unicef.org/infobycountry is designed to provide comparable and comprehensive assessments of country policies. 2 Source: IMF World Economic Outlook, 2012. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 2 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Box 1: A checklist to consider how well ECD is promoted at the country level What should be in place at the country level to promote coordinated and integrated ECD interventions for young children and their families? Health care • Standard health screenings for pregnant women • Skilled attendants at delivery • Childhood immunizations • Well-child visits Nutrition • Breastfeeding promotion • Salt iodization • Iron fortification Early Learning • Parenting programs (during pregnancy, after delivery and throughout early childhood) • Childcare for working parents (of high quality) • Free preprimary school (preferably at least two years with developmentally appropriate curriculum and classrooms, and quality assurance mechanisms) Social Protection • Services for orphans and vulnerable children • Policies to protect rights of children with special needs and promote their participation and access to ECD services • Financial transfer mechanisms or income supports to reach the most vulnerable families (could include cash transfers, social welfare, etc) Child Protection • Mandated birth registration • Job protection and breastfeeding breaks for new mothers • Specific provisions in judicial system for young children • Guaranteed paid parental leave of least six months • Domestic violence laws and enforcement • Tracking of child abuse (especially for young children) • Training for law enforcement officers in regards to the particular needs of young children Three Key Policy Goals for Early Childhood strengthen ECD.4 Strengthening ECD policies can be Development viewed as a continuum; as described in Table 1, countries can range from a latent to advanced level of SABER-ECD identifies three core policy goals that development within the different policy levers and countries should address to ensure optimal ECD goals. outcomes: Establishing an Enabling Environment, Implementing Widely and Monitoring and Assuring Quality. Improving ECD requires an integrated approach to address all three goals. As described in Figure 1, for each policy goal, a series of policy levers are identified, through which decision-makers can 4 These policy goals were identified based on evidence from impact evaluations, institutional analyses and a benchmarking exercise of top-performing systems. For further information see “Investing Early: What Policies Matter� (World Bank, forthcoming). SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 3 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Figure 1: Three core ECD policy goals Table 1: ECD policy goals and levels of development Level of Development ECD Policy Goal Minimal legal Regulations in some Developed legal Non-existent legal Establishing an framework; some sectors; functioning framework; robust framework; ad-hoc Enabling programs with sustained inter-sectoral inter-institutional financing; low inter- Environment financing; some inter- coordination; coordination; sectoral coordination. sectoral coordination. sustained financing. sustained financing. Near-universal Universal coverage; Low coverage; pilot Coverage expanding but coverage in some comprehensive programs in some gaps remain; programs Implementing sectors; established strategies across sectors; high established in a few Widely programs in most sectors; integrated inequality in access sectors; inequality in sectors; low services for all, some and outcomes. access and outcomes. inequality in access. tailored and targeted. Information on Information on outcomes at Minimal survey data Information on outcomes from national, regional available; limited outcomes at national national to individual Monitoring and local levels; standards for level; standards for levels; standards exist and Assuring standards for provision of ECD services exist in some for all sectors; system Quality services exist for services; no sectors; no system to in place to regularly most sectors; system enforcement. monitor compliance. monitor and enforce in place to regularly compliance. monitor compliance. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 4 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Policy Goal 1: Establishing an Enabling WHO. At the time, Tajikistan was the first Central Asian Republic to pass legislation of this magnitude on Environment breastfeeding promotion. While in the hospital, new  Policy Levers: Legal Framework • mothers receive education on best practices for Inter-sectoral Coordination • Finance breastfeeding and specific support to overcome any difficulties. An Enabling Environment is the foundation for the design and implementation of effective ECD policies5. Preschool education is not mandated and enrollment An enabling environment consists of the following: the is extremely low. Article 16 of the Law on Education existence of an adequate legal and regulatory (2004) states that preschool education institutions are framework to support ECD; coordination within sectors required to prepare children for entrance into primary and across institutions to deliver services effectively; school, however it does not mandate enrolment. and, sufficient fiscal resources with transparent and Children can be enrolled from as early as one and a half efficient allocation mechanisms. years of age, and children who qualify from low-income families are entitled to free preschool education. More Policy Lever 1.1: details about the early childhood education system are Legal Framework provided in Policy Goal 2 section of this report. The legal framework comprises all of the laws and regulations which can affect the development of young National laws mandate the provision of healthcare for children in a country. The laws and regulations which pregnant women and young children. In recent years impact ECD are diverse due to the array of sectors which the GoT has taken measures to improve the health of influence ECD and because of the different pregnant women and young children. The Law on constituencies that ECD policy can and should target, Immunization against Infectious Diseases from including pregnant women, young children, parents, and December 29, 2010 – in accordance with WHO caregivers. recommendations – is one example and ensures that all young children receive a complete course of childhood Tajikistan has taken steps to develop and adopt immunizations.6 Young children are required to have national laws and regulations that promote well-child visits as stated in the Guidelines on Integrated appropriate dietary consumption by pregnant women Management of Childhood Illness for Medical and young children. The Law of the Republic of Tajikistan Personnel. As part of well-child visits, there is a referral on Salt Iodization was adopted by the GoT on December 2, process for addressing identified developmental needs. 2002. According to Article 7 of this law, salt iodization is The MoH Order Numbers 280 and 689 from May 23, mandatory and aims to reduce the prevalence of iodine 2011 and December 20, 2011, respectively, mandate deficiency amongst all citizens, with an emphasis on young standard health screenings for HIV and sexually children. Building off this momentum, the Ministry of transmitted diseases (STDs) for pregnant women. Health (MoH) is in the final stage of drafting the Nutrition Action Plan with the support of the World Health Policies offer suitable opportunities for parents and Organization (WHO) and the United Nations Children’s caregivers to provide care to newborns and infants in Fund (UNICEF). Within the framework of this action plan, their early stages of life. The Code of Labor of the Priority Intervention Number 6 will mandate micronutrient Republic of Tajikistan states that maternity leave is fortification of staples, such as wheat, maize, and rice. No available to mothers for 140 days (70 days prior to timetable has been set for government approval. delivery, and 70 days after) and is paid at 100 percent of In December 2006, the GoT passed a law on wages by the GoT. Furthermore, Article 165 of the breastfeeding promotion that includes most provisions Labor Code states that parental leave can be prolonged set forth in the International Code of Marketing of for up to 547.5 days, with a child allowance for the Breast Milk Substitutes – an international health policy additional time period. Paternity leave is included framework for breastfeeding promotion adopted by the 6 Expanded program on immunizations (EPI) complete course of 5 Brinkerhoff, 2009; Britto, Yoshikawa & Boller, 2011; Vargas-Baron, immunizations targets nine vaccine preventable diseases: 2005 tuberculosis; diphtheria; pertussis; tetanus; poliomyelitis; measles; hepatitis B; Haemophilus influenza type b; and yellow fever. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 5 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Table 2: Regional comparison of maternity and paternity leave policies Armenia Kyrgyz Republic Russian Federation Tajikistan 140 days at 100% of wage 140 days at 100% of wage; 140 days at 100% of 126 days at 46% of (more days for child rearing allowance wage, 547 days unpaid; wage; 5 days unpaid complicated births), available to either parent or parental leave for fathers parental leave for unpaid parental leave up extended family member for no widely practiced fathers, up to 3 years to 3 years; no parental up to three years, first 18 unpaid leave for leave for fathers months at 40% of wage and mothers remainder at fixed payment Source: World Bank’s Women, Business and the Law database, 2012 within Article 165 of the Code of Labor, but is not widely Policy Lever 1.2: used. Table 2 shows that the duration of paid maternity Inter-sectoral Coordination leave is comparable to Armenia and the Russian Federation, and more extensive than that of the Kyrgyz Republic. Development in early childhood is a multi-dimensional process.7 In order to meet children’s diverse needs Article 165 also obligates the employer to give the during the early years, government coordination is employee the same job when she returns from maternity essential, both horizontally across different sectors as leave and Article 167 ensures break time is provided for well as vertically from the local to national levels. In nursing mothers. According to the World Bank’s Women, many countries, non-state actors (either domestic or Business and the Law database, there are no laws international) participate in ECD service delivery; for this penalizing or preventing the dismissal of pregnant women. reason, mechanisms to coordinate with non-state actors are also essential. Child protection policies and services are in the process of being established in Tajikistan. Although The GoT does not have an explicitly-stated multi- there are no specialized courts for young children in sectoral ECD policy. A child’s development does not Tajikistan, the national judicial system does require occur in a vacuum. It requires a safe, stimulating judges, lawyers, and law enforcement officers to environment, with access to a multitude of receive specialized training to protect and ensure the interventions in education, health, nutrition, and social welfare of young children. The National Commission on and child protection that are delivered at different Child Rights within the GoT is headed by the Deputy stages. Coordination amongst ministries and all Prime Minister. In addition, there are Commissions on stakeholders is a necessary component to establish an Child Rights within each Oblast and city Rayon body. integrated, effective ECD system. The Law on Registry of Civil Status, last modified June 28, 2011, requires all children to be registered at birth. Historically, the key ministries involved in ECD (see The National Concept Note on Inclusive Education for Figure 2) operate largely-independently from each the period 2011-2015 was adopted on April 30, 2011 other. One exception is the effective coordination and mandates cross-sectoral services and support for regarding the training for preschool teachers, which is children with special needs. discussed in more detail in Policy Lever 2.2 of this report. In this example, stakeholders from different The dominant approach adopted in Tajikistan is to ministries (e.g. MoE, MoH and MoLSP) offer input to provide orphans and vulnerable children with services help shape the design of teacher training to ensure in institutions. Under the Law on Social Services, 2009, teachers are capable in all areas of ECD. Examples the MoH operates baby-homes for infants. The Ministry of effective coordination are few and far between, of Labor and Social Protection (MoLSP) operates and there is little momentum to prepare a multi-sectoral orphanages and the Ministry of Education (MoE) operates boarding schools. 7 Naudeau et al., 2011; UNESCO-OREALC, 2004; Neuman, 2007. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 6 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Figure 2: Key Ministries Involved in ECD in Tajikistan Text box 2 articulates the potential benefits of a multi- sectoral ECD policy and uses Chile as a recent example. There is no established institutional anchor to coordinate ECD across sectors. In 2009 UNICEF helped initiate the process to prepare an ECD inter-sectoral framework and establish a lead coordinator across sectors. At this time the National ECD Forum, Building Strong Foundations, Early Childhood; the Best Investment, was held and included representatives from ECD policy. Even within sectors, children aged 0 to 6 are the MoE, MoH, MoLSP, Ministry of not well addressed in one cohesive, master policy Finance (MoF), Regional and District Governments, the document. The result is that various aspects of ECD are Presidential Cabinet, national and international experts highlighted in a number of strategy documents, with in ECD, and national and international partners. The poor cohesion between sectors, large policy gaps, and outcome was a 10 point plan of action that included the potentially duplicative efforts. The draft National following points: enhance political commitments that Strategy for Education Development for the period up promote ECD and place children on the top of the to 2020 highlights education for young children as a national development agenda; support to integrate ECD priority. The focus is on early learning and development program models into local (Regional and District) in preschools and covers children aged 3 to 6. The development plans with sufficient budget support; and, ambitious aim is to provide coverage to 50 percent of raise interest for international development partners to children aged 5 to 6, and 30 percent of 3 to 4 year olds. invest in ECD8. The National ECD Forum raised The implementation plan is currently under awareness for ECD, but since this time, no concrete development. actions have been taken to establish an institutional anchor. Although not inter-sectoral, it is important to note that the National Program for Early Childhood Learning and There are no defined mechanisms to achieve Development for the period 2012-2016, which collaboration between state and non-state complements the National Strategy for Education stakeholders. A vibrant, effective ECD system typically Development, focuses on expanding community- includes strong linkages between state and non-state supported early learning centers. stakeholders, such as civil society organizations, non- The MoH, through the Integrated Management of governmental organizations, academic institutions, and Childhood Illness Strategy, the National Strategy on communities and families. Establishing a broad alliance Child and Adolescent Health Promotion designed for to encourage all stakeholders to invest in ECD was part the period up to 2015, and National Comprehensive of the 10 point plan of action. As of this date, no Health Sector Strategy 2010-2020 also focuses on alliance to achieve collaboration between state and health and nutrition for ECD aged children. non-state stakeholders has been established. _______________________________ 8 The remaining action points include: enhance legislative and regulatory framework; expand routine health visits; incorporate early childhood care and development information into health and nutrition programs; expand access to early learning programs; support development of new preschool curricula and teacher training; encourage inclusion of ECD in Tajikistan Fast Track Initiative (now known as Global Partnership for Education) application; and support and integrated ECD programs into regional and district development plans. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 7 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Box 2: The Chilean Experience - Benefits of Multi-sectoral Policy Design and Implementation A multi-sectoral ECD policy is a comprehensive document that articulates the services provided to children and key stakeholders involved, including responsibilities of service providers and policy makers. The policy should also present the legal and regulatory framework in a country and address possible gaps. Typically, a policy can include a set of goals or objectives and an implementation plan that outlines how they will be achieved. The benefits of doing so are manifold. The preparation process requires all stakeholders to contribute, which in turns promotes a more holistic, synergetic approach to ECD and identifies possible duplication of objectives by individual stakeholders. Another benefit is that the policy framework clarifies the boundaries within which all stakeholders are to operate and can create an accountability mechanism. Internationally, there are numerous examples of effective ECD policies. One such example is Chile Crece Contigo (“Chile Grows With You�, CCC). The policy was designed in 2005 and is an inter-sectoral and multi-disciplinary approach to achieve high quality ECD by protecting children from conception onwards with relevant and timely services that provide opportunities for early stimulation and development. A core element of the system is that it provides differentiated support and guarantees children from the poorest 40% of households, including free access to preprimary school. Furthermore, the CCC mandates provision of services for orphans and vulnerable children and children with special needs. The creation and implementation of the CCC has been accomplished through a multi-sectoral, highly synergistic approach at all levels of government. At the central level, the Presidential Council is responsible for the development, planning, and budgeting of the program. At each of the national, regional, provincial, and local levels there are institutional bodies tasked with supervision and support, operative action, as well as development, planning and budgeting for each respective level. The Chile Crece Contigo Law (No. 20.379) was created in 2009. Key consideration for Tajikistan:  Cohesive approach to service delivery that leverages the respective competencies of each sector with a focus on achieving holistic child development;  Guaranteed support to the poorest, most in need children; and,  Highly accountable approach that clearly articulates the roles and responsibilities of each sector. There is no clear method or criteria for determining Policy Lever 1.3: Finance and forecasting ECD expenditures. Each of the involved Ministries, in conjunction with the MoF, is tasked with While legal frameworks and inter-sectoral coordination forecasting and financing their respective ECD are crucial to establishing an enabling environment for expenditures. The process is not consistent, nor is there ECD, adequate financial investment is key to ensure that sufficient transparency to gauge the efficacy of the resources are available to implement policies and approaches in response to the diversity of financing achieve service provision goals. Investments in ECD can requirements in ECD. A substantial drawback of this yield high public returns, but are often undersupplied approach is that there are no synergies across sectors, without government support. Investments during the potentially resulting in missed opportunities for early years can yield greater returns than equivalent economies of scale and possible large gaps in service investments made later in a child’s life cycle and can delivery (analysis of program delivery and coverage is lead to long-lasting intergenerational benefits9. Not only provided in Policy Goal 2 of this country report). Further do investments in ECD generate high and persistent analysis is required to evaluate the extent of missed returns, they can also enhance the effectiveness of other opportunities to achieve economies of scale. social investments and help governments address multiple priorities with single investments. There are varying degrees in terms of availability and breadth of financial data. Education disaggregates some 9 Valerio & Garcia, 2012; WHO, 2005; Hanushek & Kimko, 2000; expenditure by age and Oblast, whereas health and Hanushek & Luque, 2003 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 8 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Table 3: Select health expenditure indicators, compared with region Kyrgyz Russian Armenia Tajikistan Uzbekistan Republic Federation Out-of-pocket expenditure as a percentage of all 93% 86% 83% 91% 81% private health expenditure (2011) Out-of-pocket expenditure as a percentage of total 55% 38% 31% 67% 43% health expenditures (2011) Government expenditure on health as a percentage 2.0% 3.5% 5.0% 1.8% 2.5% of GDP (2011) Routine EPI vaccines financed by government, 2010 66% 85% No data 19% No data Source: Source: WHO Global Health Expenditure Database, 2011; UNICEF Country Statistics nutrition do not specify costs and expenditures for Government expenditure on health as a percentage children aged 0 to 6 years and pregnant mothers. of GDP is only 1.8 percent, which is more than half of what the Kyrgyz Republic spends, and below Public sector financial policies are designed to countries such as Armenia and Uzbekistan. promote free access to early childhood health services, however in practice parents make large out-of-pocket According to the MoE policy the ECCE’s Parent Teacher payments; MoE policy states that Parent Teacher Association fees may be levied for tuition, meals, and Association fees may be levied in early childhood care other select services. Fees may not be levied on children and education (ECCE) but data are not available. from low-income families or children with special According to policy, health services related to needs. No data are available to estimate the level of the pregnancy and young children are officially free. This levies in relation to education expenditures. includes a range of health services including well-child visits, antenatal check-up, full immunizations, and The level of public sector financial commitment to ECD treatment for tuberculosis, for example. However, is low in education and difficult to ascertain in other despite well-established policy, individuals bear sectors. The MoE reports allocations for preschool significant costs to receive health services. Table 3 education to be TJS 54.2 million (USD $11.8 million11) shows that out-of-pocket expenditures10 account for 91 for 2011, which accounts for only 4 percent of all percent of all private health expenditures. Although estimated education expenditures, but is a 20 percent these data are not specific to ECD aged children or increase over 2010 preschool expenditures. As shown pregnant women, the high rate of out-of-pocket in Table 4, of the TJS 54.2 million, allocation towards expenditure indicates that, despite policy suggesting salary and social insurance account for approximately otherwise, there are private costs associated 49 percent (TJS 26.45 million, or USD 5.71 million). with health services. At the regional level, only Approximately 45 percent (TJS 24.6 million, or USD 5.3 Armenia has a higher level of out-of-pocket million) and 6 percent (TJS 3.1 million, or USD 670 expenditure (93 percent). As a percentage of the total thousand) are allocated towards material and supply health expenditures, out-of-pocket expenditures are 67 expenses and capital expenditures, respectively. percent in Tajikistan. This rate is more than twice that of Russian Federation and significantly higher than other countries in the region. Furthermore, 10 Out-of-pocket expenditure is any direct outlay by households, 11 including gratuities and in-kind payments, to health practitioners Official exchange rate (2011): TJS 4.61 to USD 1.00 and suppliers of pharmaceuticals, therapeutic appliances, and other goods and services whose primary intent is to contribute to the restoration or enhancement of the health status of individuals or population groups. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 9 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Table 4: Preschool education expenditure by Oblast in Thousand (2011) Total Type of Expenditure Sughd GBAO Khatlon Dushanbe DRS TJS (thousand) USD (thousand) Salary, social insurance, etc 10,446 953 5,194 7,400 2,457 26,451 5,738 Material and Supply expenses 2,362 1,168 4,079 14,460 2,564 24,633 5,343 Capital expenditures 367 25 339 2,122 281 3,134 680 Total Expenditure 13,175 2,146 9,611 23,982 5,303 54,218 11,761 Number of kindergartens 193 19 95 89 53 Source: Ministry of Education and Ministry of Finance (data presented in: SABER-ECD Data Collection Instruments; Seder, R. 2012. “Creating New Mechanisms for Early Learning in Tajikistan�) Determining the amount of financial expenditure and Eastern Europe and The Commonwealth of required to ensure sustainable, high quality preschool Independent States (CEECIS) region. This figure provision goes beyond the scope of this analysis. illustrates that despite having a low GDP per capita, However, it is important to recognize that attaining high countries such as Moldova and Ukraine have a much coverage is not only a product of increased investment, higher preprimary enrollment rate in comparison with but also it is important to ensure that monies are spent Tajikistan. This shows that, alongside countries such as smartly and efficiently. Figure 3 presents the preprimary the Kyrgyz Republic and Uzbekistan, Tajikistan needs to enrollment rate in relation to GDP per capita in Central pay increased attention to preprimary coverage. Figure 3: Preprimary enrollment rate in relation to GDP 2010/2011 Source: TransMONEE 2012 Database, UNICEF Regional Office for CEECIS SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 10 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Table 5: Pay scale for preschool teachers by education Policy Options to Strengthen the Enabling level per month (2011) Environment for ECD in Tajikistan Level of educational qualifications Scale (TJS) per month Specialized secondary education 196 to 218  Legal Framework – One approach to enhance the regulatory framework is to build flexibility into the Higher education 230 to 312 maternity leave policy. Current policy states that 50 Source: Ministry of Finance Pay Scale for Preschool Teachers percent (or 70 days) is allocated prior to birth, which (data presented in SABER-ECD Data Collection Instruments) provides children with just over three months (70 days) of Early childhood education and care teachers and health care post-birth. This is a formative period of a child’s care professionals are compensated using established development, one in which adequate care is essential. pay scales. According to the MoF’s pay scale, Therefore, depending on the individual family remuneration for preschool teachers is calculated using a circumstance, a policy that permits parents to shift days formula based on the qualification grade (years of service post-birth could provide children with enhanced attention and qualification). In 2011 the MoF and MoE increased and care without substantive implications to public policy. the salary scale by 30 percent across the board. Table 5 The GoT should also consider expanding the duration of shows the revised parameters for each level, however the the maternity leave period to ensure that families have formula was not provided. The complete poverty line12 is the time and financial support for effective child rearing. estimated at TJS 4.56 per day (approximately USD $1), or  Inter-sectoral Coordination – The 2009 National approximately TJS 137 per month. Note that the cost of ECD Forum provided a venue to gather key ECD living varies, especially in urban and rural areas, and that practitioners and stakeholders and generated both the salaries and complete poverty line refer to the enthusiasm. The drafting of the 10 point plan of action national average. demonstrates an understanding of the issues at hand, unfortunately the concrete action steps have not been There are four categories that determine the level of acted upon, and sectors continue to operate in silos. To remuneration for nurses and doctors. Each category is adopt a more dynamic, cohesive approach to enhancing awarded based on work experience and academic ECD service delivery and achieving high-level ECD achievements. For example, "no category" refers to young outcomes requires a substantive shift from the sectoral specialists who have less than two years of work experience model to a more integrated approach. Potential options or are recent graduates from university. The high category that the GoT could consider include: relates to more than 20 years of experience in combination with specialized qualification or degree. It is noteworthy that • Develop an inter-sectoral ECD working group that the difference between nurse and doctor compensation is consists of state and non-state ECD stakeholders. not significant considering the training and responsibility of For this working group to flourish, it will be the two roles. In September of 2011, there was a 40 percent important to implement a set of mechanisms to increase to all salaries. Table 6 presents the level of ensure open channels of communication and compensation (including 40 percent increase) for each active participation by all. Possible avenues to category. achieve these goals include assigning an ECD champion to chair the group, as well as holding Table 6: Pay scale for health care professionals routine formal and in-formal meetings. The group per month (2011) could focus on information sharing and devising Pay No 2nd 1st High ways to enhance coordination, and as it evolves Grade/Level Category Category Category Category and develops further capacity the working group Nurses 196 to 218 TJS234 TJS 259 TJS 289 could assume a strategic role to guide the establishment of a holistic, high-quality ECD Doctors 230 to 312 TJS 394 TJS 437 TJS 486 system. Source: Ministry of Finance Pay Scale for Health Care Professionals (data presented in SABER-ECD Data Collection Instruments) • The ECD working group should be tasked with 12 The complete poverty line is calculated as 64% food consumption preparing annual reports on the coordination (TJS $2.92) and 36% non-food component (TJS $1.64). This achievements, which could be shared with civil structure is based on the consumption patterns of the population who are just above the complete poverty line. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 11 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 society and other stakeholders for feedback and Policy Lever 2.1: more synergized efforts. Scope of Programs • One main deliverable of the ECD working group could be to draft a multi-sectoral policy that Effective ECD systems have programs established in all clearly articulates the respective roles and essential sectors and ensure that every child and responsibilities of each line ministry and ECD expecting mothers have guaranteed access to the stakeholder, and to develop a costed strategic essential services and interventions they need to live plan to enhance the efficacy of ECD service healthfully. The scope of programs assesses the extent to provision. Developing milestones and clear goals which ECD programs across key sectors reach all will help with the implementation plan. beneficiaries. Figure 4 presents a summary of the key interventions needed to support young children and their  Finance – To fully evaluate the strengths and areas for families via different sectors at different stages in a child’s improvement within an ECD system, it is necessary to life. have a comprehensive, systematic methodology for calculating ECD investment. Currently, it is difficult to ECD programs are established in each of the core areas disaggregate spending in health, nutrition, and social of focus: education, health, nutrition, and social and and child protection by ECD age group. Within child protection. There are programs that target the three education, data are available for inputs of service main ECD groups – children aged 0 to 83 months, delivery and by level of sub-region expenditure, but pregnant mothers, and parents and caregivers. Figure 5 there are not sufficient evaluations to ensure funding presents a selection of ECD interventions in Tajikistan. is being spent efficiently on quality ECE interventions. Many of the programs are sector specific, although some In developing a comprehensive methodology it could interventions do have two components, such as those also be useful to work closely with non-state ECD listed as multi-sectoral, which tend to be highly stakeholders to capture the full spectrum of ECD integrated. investment. This will provide policy makers with detailed information to evaluate and effectively cost One excellent example of a multi-sectoral intervention ECD interventions, and shift financial allocation to the in Tajikistan is the community-based ECD model. interventions with the greatest return on investment. Started in 2009 by the Aga Khan Foundation, UNICEF, and the Institute for Professional Development, the Policy Goal 2: Implementing Widely community-based ECD model aims to increase access to  Policy Levers: Scope of Programs • early learning, improve health and hygiene outcomes Coverage • Equity for young children, and equip parents with the skills and knowledge to actively engage in the development Implementing Widely refers to the scope of ECD programs of their child. The model has been fully endorsed by the available, the extent of coverage (as a share of the eligible MoE as an innovative alternative to the current ECD population) and the degree of equity within ECD service model and provides access to 3,640 children aged 3 to provision. By definition, a focus on ECD involves (at a 7. The model uses underutilized classrooms in schools minimum) interventions in health, nutrition, education, and focuses on the holistic development of children. and social and child protection, and should target The timeframe is manageable (4 hours a day, 5 days per pregnant women, young children and their parents and week), and the program is cost effective to operate. caregivers. A robust ECD policy should include programs However, its affordability for parents should be in all essential sectors; provide comparable coverage and analyzed. An important next step – as addressed in the equitable access across regions and socioeconomic status next phase of the Global Partnership for Education – is – especially reaching the most disadvantaged young to evaluate the community supported model to both children and their families. inform other interventions, and potentially to scale-up this model. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 12 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Figure 4: Essential interventions during different periods of young children's development Figure 5: ECD programs in Tajikistan Source: SABER-ECD Policy Data Collection Instrument and SABER-ECD Program Data Collection Instrument. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 13 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 While Figure 5 displays some of the most important As can be seen in Table 7, coverage is low for many ECD programs in Tajikistan, it does not depict the scale interventions and in some areas no interventions exist. of programs. Table 7 provides a list of essential Specific interventions will be covered in more detail in the interventions operating in Tajikistan. Four categories following section, Policy Lever 2.2. It is important to note are used to classify coverage: low, moderate, that school feeding programs do exist, however no data approaching universal, and universal. Coverage of were provided for this country report. The World Food education and nutrition interventions is low in Program operates interventions in this sphere, including Tajikistan. Specific health and child protection school feeding programs in remote localities that serve to interventions achieve higher coverage. both provide children with nutritional meals as well as promote school attendance. Table 7: ECD programs and coverage in Tajikistan ECD Programs and Coverage in Tajikistan ECD Intervention Scale In how many Pilot sub-regions Coverage programs operating (out of 5) Education State-sponsored preprimary/preschool education 5 Low Community-supported ECCE 5 Low Health Antenatal and newborn care 5 Moderate Integrated management of childhood illnesses 5 Approaching universal Childhood wellness and growth monitoring No data National immunization program 5 Approaching Universal Nutrition Micronutrient support for pregnant women X Food supplements for pregnant women X Micronutrient support for young children X Food supplements for young children X Food fortification No data Breastfeeding promotion programs 5 Low Anti-obesity programs encouraging healthy eating/exercise No program Feeding programs in preprimary/preschool schools No data (*see below) Parenting Parenting integrated into health/community programs 5 Low Home visiting programs to provide parenting messages No program Special Needs Programs for orphans and vulnerable children (OVCs) 5 Moderate Interventions for children with special needs (physical) 5 Low Interventions for children with special needs (emotional) 5 Low Anti-poverty Cash transfers conditional on ECD services or enrollment No program Comprehensive A comprehensive system that tracks individual children’s No program needs and intervenes, as necessary Source: SABER-ECD Policy Data Collection Instrument and SABER-ECD Program Data Collection Instrument SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 14 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Access to essential health interventions for pregnant Policy Lever 2.2: Coverage women varies depending on the intervention in A robust ECD policy should establish programs in all Tajikistan. Table 9 highlights access to a selection of essential sectors, ensure high degrees of coverage and essential health interventions for pregnant women. For reach the entire population equitably – especially the most some interventions Tajikistan performs quite well, yet in disadvantaged young children – so that every child and others coverage levels remain low. For instance, 83 expecting mother have guaranteed access to essential percent of births are attended by skilled attendants, yet ECD services. only half of pregnant women benefit from at least four antenatal visits. The implication is that despite some The level of access to essential health interventions is notable coverage rates, pregnant women are not low for young children. Table 8 presents the level of receiving access to a holistic set of services to ensure the access to a selection of essential ECD interventions for well-being of their child and themselves. No data are young children in Tajikistan. Currently, only 22 percent of available on the percentage of HIV+ pregnant women and children under the age of 5 with diarrhea receive oral HIV exposed infants who receive ARVs (anti-retroviral rehydration and continued feeding and 41 percent of drug) for PMTCT (prevention to mother-to-child children below 5 years of age suspected of pneumonia transmission). A total of 4,500 HIV cases have been receive antibiotics. By international standards, both of reported since 1991, of which, 1,230 are women. In 2012, these figures are very low and underscore the necessity of 313 pregnant women were reported as new cases, and enhanced targeting mechanisms to ensure that children in 240 of whom were covered by an infection prevention need receive the appropriate services. Conversely, 93 program. It is important for the GoT to continue to percent of 1 year olds are immunized against DPT expand the scale of screening for hepatitis, HIV/AIDS and (diphtheria, pertussis, and tetanus vaccine), which sexually transmitted infections for pregnant women. demonstrates the effectiveness of the Law on Immunizations and the MoH capacity to implement targeted interventions. Table 8: Level of access to essential health services for young children and pregnant women Kyrgyz Russian Armenia Tajikistan Uzbekistan Republic Federation Percentage of children under 5 years of age with diarrhea who receive oral rehydration and No data 22% No data 22% 28% continued feeding (2006-2010) Percentage of 1 year olds immunized against 94% 96% 97% 93% 99% DPT (2010) Percentage of children below five years of age suspected of pneumonia who receive No data 45% No data 41% 56% antibiotics (2006-2010) Source: UNICEF Country Statistics Table 9: Level of access to essential health services for pregnant women Kyrgyz Russian Armenia Tajikistan Uzbekistan Republic Federation Percentage of births attended by skilled 100% 99% 100% 83% 100% attendants (2006-2010) Percentage of pregnant women who benefit 71% No data No data 49% No data from at least four antenatal visits (2006-2010) Source: UNICEF Country Statistics, UNAIDS Tajikistan Country Fact Sheet 2011 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 15 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Table 10: Level of access to essential nutrition interventions for young children and pregnant mothers Kyrgyz Russian Armenia Tajikistan Uzbekistan Republic Federation Vitamin A supplementation coverage rate for No data 97% No data 95% 94% children 6 to 59 months of age (2010) Percentage of children who are exclusively 35% 32% No data 25% 26% breastfed until 6 months (2006-2010) Percentage of the population that consumes 97% 76% 35% 63% 53% iodized salt (2006-2010) Percentage of pregnant women who have 12% 50% 21% 45% 38% anemia Percentage of under-fives suffering from 19% 18% No data 28% 19% moderate and severe stunting (2006-2010) Source: UNICEF Country Statistics; WHO Global Database on Anemia, Vitamin A The level of access to essential nutrition interventions development. This can result in diminished human capital for pregnant women and young children is low in and lower lifetime earnings. The GoT, in cooperation with Tajikistan. Table 10 presents the level of access to the World Bank, UNICEF, and World Food Program has essential ECD nutrition interventions for young children developed a pilot intervention to address high and pregnant mothers. The results are varied, indicating undernutrition rates. The main components include: that Tajikistan has some successful interventions, but community-based nutrition monitoring; community others are missing, resulting in poor health and training on management of childhood illnesses; development outcomes for young children (e.g., stunting) educational messages to promote behavioral change; and their mothers (e.g., anemia). distribution of micronutrient supplements; and, monitoring and evaluation. No results on the impact of An important intervention for a mountainous, landlocked this intervention are available. country such as Tajikistan is salt iodization. Iodine, which Only 25 percent of children are exclusively breastfed until is a micronutrient and dietary mineral, is not prevalent in 6 months of age. Breast milk is considered to be the best the country’s soil and as such is not derived from local method to feed an infant during the first six months of food supply (generally natural iodine is more common life, giving the child all the nutrients and calories needed near sea coasts). It is for this reason that the GoT created for proper growth and development. In addition, an the Law on Salt Iodization (2007). Currently, only estimated 45 percent of pregnant women have anemia, approximately 63% of the population consumes iodized which is considered by the WHO to be a severe public salt. This level is below other countries in the region, health problem. In comparison, an estimated 21 percent including Armenia and the Kyrgyz Republic, though higher of pregnant women in the Russian Federation have than the Russian Federation and Uzbekistan. anemia and only 9.3 percent of pregnant women in The level of moderate and chronic undernutrition Norway. The WHO classifies these rates in the Russian (stunting) is 28 percent. This rate is extremely high by Federation and Norway as moderate and mild public international standards and indicates children are not health problems, respectively. Research shows that receiving a sufficient and balanced diet required to babies born to mothers suffering from anemia may not be maximize physical development. The impact of stunting able to store enough iron before birth, are more likely to on a child’s development is immense. The period between be born prematurely, and have lower birth weights. This conception and the age of 2 is a window of opportunity to lack of stored iron may continue well into the baby’s first address and prevent the damage caused by year of life. undernutrition. If not addressed, a child that suffers from The level of access to preschool education is extremely undernutrition will not fully develop physically, which in low. Early childhood education is included in the Law on turn hinders linguistic, cognitive, and socio-emotional SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 16 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Education of the Republic of Tajikistan as one area of service level of access to preprimary school. Countries such as provision by the MoE. The Law stipulates that preschool Belarus and Poland have achieved coverage levels of 93 education is the first level of the national education system. percent and 89 percent, respectively. At the other end of Preschools can be state or non-state operated. the spectrum, countries such as Tajikistan, the Kyrgyz The Preschool Education Department, within the MoE, is Republic, and Uzbekistan have extremely low coverage responsible for setting policies and standards, ensuring levels. In fact, between 2000/01 and 2010/11 enrollment service delivery and access, and monitoring quality. The levels only increased from 5.6 percent to 8.9 percent in Preschool Education Department is supported in these Tajikistan. By comparison, the Republic of Moldova went tasks by the Academy of Education Science working from 44.1 percent to 78.5 percent in the same time group. Under the auspices of the MoE, the working group period. is comprised of representatives from the MoE, Republic Low enrollment in Tajikistan is a result of a collection of Institute for Training and Re-Training of Pedagogical staff, issues and systemic restraints, including: inadequate Pedagogical University, preschool educators, and other availability across the country, especially remote stakeholders with strong pedagogical background. In locations; cost; strict regulations; and a lack of knowledge addition, the working group is able to call upon specialists and awareness amongst parents. Some of these issues are from health, nutrition, and social and child protection to discussed in more detail in other sections of this Country assist with ECD related policy or programming. Report and further analysis beyond the scope of this work Children have the right to be taught in their native is required. Addressing low enrollment requires creative, language in Tajikistan. In 2007, 55,592 children attended cost effective solutions. Text box 3 presents the example preschool education in Tajik, 9,737 in Russian, 2,462 in of Australia. Although Australia and Tajikistan do not Uzbek, and 73 children were taught in other languages.13 share too many similarities as countries, the Australian example highlights that working across levels of Figure 6 depicts Tajikistan’s low enrollment with select government to achieve sustainable financial investments regional comparison countries. The Eastern Europe and is very relevant for Tajikistan. Central Asia region is categorized by a large discrepancy in Figure 6: Net preprimary enrollment rate (as % of children aged 3 to 6 years) 100.0 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/'10 2010/'11 Republic of Moldova Armenia Kyrgyzstan Tajikistan Uzbekistan Source: TransMONEE data set, 2011 13 Tajikistan’s main ethnic-linguistic minorities are Uzbeks (15.3%), Russians (1.1%) and Kyrgyz (1.1%), with others accounting for less than 3%. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 17 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Box 3: Relevant lessons from Australia: sustainable financial investments Education is the responsibility of the State and Territory governments in Australia. In the 2007/2008 academic year, nearly 70% of preschool eligible children attended, and six out of the eight jurisdictions had enrolment rates above 85%. However, enrollment was low for specific sub-groups within the population, especially Aboriginal children. To address this issue and increase enrollment across the country, in 2008, through the Council of Australian Governments, all state and territory Governments in Australia jointly agreed to the National Partnership Agreement on Early Childhood Education. The National Partnership aims to provide all children with access to a quality early childhood education program by 2013, delivered by four-year university-trained early childhood teacher, for 15 hours a week, 40 weeks a year, in the year before formal schooling. Prior to the National Partnership, Australia’s investment in ECD was only 0.1% of GDP, which ranked 30th out of 32 OECD countries, and well below the 0.45% of GDP average. To achieve quality, universal coverage, all parties agreed to increased, sustained financial investment, which was partially aided through additional funding of $970 million (AUD) by the Commonwealth of Australia over a five-year period. The Australia strategy calls for streamlined mechanism for management and finance at the national, state, and local levels. It requires effective accountability mechanisms, with clearly defined roles and responsibilities at each respective level. Key considerations for the Tajikistan:  The Australian example effectively targets underserved sub-groups, which is particularly relevant in remote localities in Tajikistan;  In order to expand coverage and effectively implement services, commitment from the national, Oblast and community levels to maintain financial support to ECD will be essential. significant when looking at the underweight prevalence in Policy Lever 2.3: Equity children below 5 and the number of children below 5 with Based on the robust evidence of the positive effects ECD diarrhea receiving oral rehydration and continued feeding, interventions can have for children from disadvantaged however enrollment is low regardless of socioeconomic backgrounds, every government should pay special status. attention to equitable provision of ECD services.14 One of the fundamental goals of any ECD policy should be to In the 2010/11 school year, 43.8 percent of children provide equitable opportunities to all young children and enrolled in preprimary school were female, indicating their families. moderate inequity in access by gender. Perhaps the more worrisome trend is that since 2002/03, the rate of Inequitable access to ECD interventions exists in all participation by girls has gradually decreased from 47.3 sectors and is particularly pronounced for children in percent. preschool. Using data from the UNICEF Multiple Indicator Cluster Survey (MICS, 2005), information on access to Figure 8 uses the same four indicators plus percentage of several interventions and ECD outcomes by socioeconomic population using improved sanitation facilities to test the status and rural/urban location is available in Tajikistan. level of equity by rural and urban locations. Level of birth Figure 7 compares birth registration rates, skilled registration, prevalence of skilled attendants at birth, and attendants at birth, underweight prevalence, and the under-fives with diarrhea receiving oral rehydration and number of children below 5 years of age with diarrhea who continued feeding, are each higher for children in urban receive oral rehydration and continued feeding for the settings. Also, the likelihood of a child below five years of age poorest 20 percent of the population with indicators for being underweight is slightly lower for those living in urban the wealthiest 20 percent of the population. The results locations compared with rural settings. The percentage of demonstrate that there are no socioeconomic disparities population using improved sanitation facilities is very high for birth registration or skilled attendant at birth while overall with little inequity across urban and rural areas. enrollment is also high. The level of inequity is not 14 Engle et al, 2011; Naudeau et al., 2011 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 18 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Figure 7: Equity in access to health and child protection services and outcomes by socioeconomic status 100 80 60 40 20 0 Under-fives with Underweight prevalence diarrhoea receiving oral Birth registration (%) Skilled attendant at birth in children under five (%) rehydration and 2000-2010 (%) 2006-2010 2006-2010 continued feeding (%) 2006-2010 Poorest 20% 89 90 17 20 Richest 20% 86 90 13 26 Poorest 20% Richest 20% Source: UNICEF Country Statistics Figure 8: Equity in access to health and child protection services and outcomes by rural/urban location 100 80 60 40 20 0 Under-fives with Underweight diarrhoea receiving % of population using Birth registration (%) Skilled attendant at prevalence in oral rehydration and improved sanitation 2000-2010 birth (%) 2006-2010 children under five continued feeding facilities, 2008 (%) 2006-2010 (%) 2006-2010 Rural 85 86 16 20 94 Urban 90 95 12 28 95 Source: UNICEF Country Statistics The Law of the Republic of Tajikistan on Social Protection Figure 9 presents the wealth disparities in access to of Disabled People adopted in 2010 affirms the equal preschool. Although coverage levels are very low overall rights of people with disabilities. The National Concept in Tajikistan, there remains high inequity in access Note on Inclusive Education for the period of 2011-2015 between the richest 20 percent and the poorest 20 aims to ensure cross-sectoral services and support to percent. With the exception of Belarus, high inequity in children with special needs. As of this date, the policy has access is an issue throughout the region. not gained traction and has not been fully implemented. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 19 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Figure 9: Wealth disparities in access to preschool (% of children 36 to 59 months currently attending preschool) Policy Options to Implement ECD Widely  Coverage – Increasing coverage for preschool requires a multi-pronged approach. Tajikistan has in Tajikistan achieved near universal primary education, indicating  Scope of Programs – Tajikistan’s ECD system that a combination of factors contribute to low includes a combination of interventions operated by preschool attendance rates. These factors include high state and non-state organizations. As part of the Global cost, concentration of facilities in urban areas, and strict Partnership for Education (if approved), a mapping operating regulations. exercise will be undertaken to develop a database of ECE interventions. This should include interventions in Furthermore, anecdotal evidence suggests that the all sectors and will enable policy makers and ECD importance of education for ECD aged children may not stakeholders to both raise awareness and improve be well understood by parents and guardians. On the targeting mechanisms. supply-side, large scale investment in infrastructure, teacher training, and education materials are required  Scope of Programs – Ensure regular research to realize the ambitious goals set forth in the draft work on the different early childhood development National Strategy for Education Development requires. interventions utilizing modern methodologies and tools; expand the scale of screening for hepatitis, HIV/AIDS  Coverage and Equity – Implementation of the and sexually transmitted infections for pregnant Law on Salt Iodization and subsequent improvements in women. the percentage of households consuming iodized salt demonstrates the power of well-placed policy to inflict  Coverage – Continued focus to address nutrition social change. One method to help reduce the in the first 1,000 days of life through scalable, cost- prevalence of pregnant women with anemia is to effective interventions will provide mothers with the mandate the iron fortification of staple food products education, skills, and access to appropriate feeding and to increase the reach of vitamin supplementation. practices to reduce the prevalence of stunting. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 20 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Policy Goal 3: Monitoring and Assuring Administrative and survey data are collected on access Quality to ECD in some areas. Tajikistan participated in the 2005  Policy Levers: Data Availability • MICS survey and the 2012 Demographic and Health Quality Standards • Compliance with Surveys. Table 11 notes the availability and unavailability Standards of select administrative and survey data in Tajikistan. Administrative data captures the number of children with Monitoring and Assuring Quality refers to the existence of special needs who have access to some ECD services, information systems to monitor access to ECD services number of children who benefit from select health and outcomes across children, standards for ECD services interventions, such as immunizations, and coverage levels and systems to monitor and enforce compliance with of preschool by sub-region. Data are not collected those standards. Ensuring the quality of ECD interventions regarding the number of women receiving prenatal is vital because evidence has shown that unless programs nutrition interventions. As noted in Policy Lever 1.3, are of high quality, the impact on children can be administrative data do not effectively capture the level of negligible, or even detrimental. investment in each sector. MoE and MoH policies state that data are collected annually. Policy Lever 3.1: Data Availability Tajikistan partook in previous rounds of the UNICEF Multiple Indicator Cluster Surveys (MICS) and is scheduled Accurate, comprehensive and timely data collection can to participated in the 2015 version, providing access to promote more effective policy-making. Well-developed adequate resources. Box 4 further expands on the Chile information systems can improve decision-making. In Crece Contigo example (presented in Box 2) to underscore particular, data can inform policy choices regarding the the importance of data availability and how it can be volume and allocation of public financing, staff effectively captured and used in a holistic ECD system. recruitment and training, program quality, adherence to standards and efforts to target children most in need. Table 11: Availability of data to monitor ECD in Tajikistan Administrative Data: Indicator Tracked Special needs children enrolled in ECCE (number of)  Children attending well-child visits (number of)  Children benefitting from public nutrition interventions (number of)  Women receiving prenatal nutrition interventions (number of) X Children enrolled in ECCE by sub-national region (number of)  Average per student-to-teacher ratio in public ECCE X Is ECCE spending in education sector differentiated within education budget? X Is ECD spending in health sector differentiated within health budget? X Survey Data Indicator Tracked Population consuming iodized salt (%)  Vitamin A Supplementation rate for children 6 -59 months (%)  Anemia prevalence amongst pregnant women (%)  Children below the age of 5 registered at birth (%)  Children immunized against DPT3 at age 12 months (%)  Pregnant women who attend four antenatal visits (%)  Children enrolled in ECCE by socioeconomic status (%)  SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 21 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Box 4: Chile Crece Contigo Biopsychosocial Development Support Program Summary: Chile Crece Contigo (“Chile Grows With You�) is a highly integrated approach towards ECD. One of the program’s key accomplishments is the ability to provide timely, targeted service delivery. A core element that makes this possible is the Biopsychosocial Development Support Program, which tracks the individual development of children. The program commences during the mother’s initial prenatal check-up, at which point an individual “score card� is created for the child. Each of the primary actors within the Chile Crece Contigo comprehensive service network – including family support unit, public health system, public education system, and other social services – have access to the child’s file and are required to update it as the child progresses through the different ECD services. If there is any kind of vulnerability, such as inadequate nutrition, the system identifies the required service to address this issue. Through the integrated approach to service delivery and information system management, these services are delivered at the right time and in a relevant manner, according to each child’s need. Key considerations for the Tajikistan:  Streamlined, holistic child monitoring achieved through highly synergetic partnership across sectors;  Responsive system that tailors to the individual child’s need, especially for children at risk; and, Child monitoring is an important consideration to ensure appropriateness and impact of revised learning standards. Clear learning standards are in the process of being Data are available to differentiate access and outcomes established that will apply to state and non-state for special groups. Government-collected data on provision. The ELDS will provide learning standards for education are available to differentiate access and select children aged 0 to 23 months, 24 to 59 months, and 60 to outcomes for the following segments of the ECD 83 months that cover the following areas: literacy, population: gender, mother tongue, sub-national division, linguistic development, motor skills, cognitive and special need. Government data are not disaggregated development, and socio-psychological development. by rural/urban location, or socioeconomic status. The aim of the ELDS is to expand the broad learning areas Data are not currently collected to measure child set forth in the National Curriculum for Preschool development. Currently data are not collected to Institutions. The curriculum was implemented in 2002 and measure cognitive, linguistic, physical, or socio-emotional applies to children under the age of 7. It is designed to development of individual children. The Early Learning focus on Tajik customs, traditions, and culture. The main Development Standards (ELDS), developed by the MoE, aims are to achieve the following: physical development, were approved in 2010 and are in process of being through games and sport classes; development of basic implemented. The ELDS are expected to include collection language skills, through speech and vocabulary training, of some data to measure child development. basic writing skills, and acquaintance with literature; exposure to natural sciences and environment; exposure Policy Lever 3.2: Quality to elementary mathematical concepts and ideas; and, Standards fundamental aesthetic development, with introduction of Ensuring quality ECD service provision is essential. A focus musical education, arts, crafts, and design. on access – without a commensurate focus on ensuring quality – jeopardizes the very benefits that policymakers Requirements for ECCE professionals are set by the MoE hope children will gain through ECD interventions. The and apply to pre-service and in-service training. quality of ECD programs is directly related to better Education policy promotes pre-service training for caregivers cognitive and social development in children.15 and teachers who focus on children aged 0 to 3 years and children aged 4 to 7 years. Preschool teachers are trained at universities in the cities of Dushanbe, Khujand, Kulop, 15 Taylor & Bennett, 2008; Bryce et al, 2003; Naudeau et al, 2011V; Victoria et al, 2003. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 22 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Kurgan-tube, and Khorog, with program duration up to five more flexible, with 10 to 15 children aged 1 to 3 per years. There are also 24 pedagogical colleges, which offer teacher, and 15 to 20 children aged 4 to 7 per teacher. programs that last three years.16 Training includes a Table 12: Established child-to-teacher ratio standards combination of both theoretical and practical preparation. in Tajikistan Teachers study a range of disciplines, including: psychology, Age Child-to-teacher ratio preschool pedagogy, education management, and teaching Children aged 1 to 3 techniques. In-depth analysis of the teacher training system (public centers) 15:1 would identify strengths and areas for improvement, Children aged 1 to 3 including what factors contribute to the low rate of (private centers) 10-15:1 compliance. Data are required to evaluate the number of entrants and completion rate. Children aged 1 to 3 with special needs 6:1 In-service training for caregivers working with children Children aged 4 to 7 aged 0 to 3 focuses on care and child development while (public centers) 20:1 in-service training for preschool teachers focuses on Children aged 4 to 7 teaching skills development. Each of the regions has its (private centers) 15-20:1 own in-service training branch. Depending upon available Children aged 1 to 3 resources and the number of ECD centers, the frequency with special needs 6-12:1 of training per region may vary. For instance, in Rayons of Source: Academy of Education Science, Ministry of Education in SABER-ECD Policy Data Collection Instrument. Republic Subordination, the Republican Institute for Training and Re-training of Education Personnel There are specific ratios for ECD centers for children with Regulations on Qualification and Attestation mandates special needs (such as visual and hearing impairment, that ECD educators and caregivers complete three in- speech disturbance). In these centers, there is a 6:1 child- service training courses per year. teacher ratio for children under 3 years, and a range of 6 to 12 children per teacher for children aged 4 to 7 years. The MoE and MoH set clear service delivery and State kindergartens are required to have a nurse for each infrastructure standards. The MoE Regulations on Public group. Preschool Educational Institutions state that service delivery is for a minimum of eight hours per day. There are no set The GoT Agency on Construction and Architecture is hours for which school must operate, with the guidelines responsible for establishing construction standards for stating that preschools shall not open prior to 6:30AM and preschools. According to the 2008 list of regulatory not later than 8:30PM. The implications of these regulations documents for the construction and operation of ECD are twofold. Firstly, the long duration and potentially facilities, preschools must adhere to numerous standards inconvenient hours of operation can adversely impact the that cover aspects of construction, including the roof, ability of families to send their children to school. Secondly, floor, structural soundness, windows, and type of building the 8 hours of operation are burdensome for some materials. All preschool facilities are also required to have preschool operators. Taken together, these factors can access to functional hygienic facilities, potable water, and contribute to low levels of attendance by discouraging electricity. The MoE has similar infrastructure and service parents from sending their children and preschools from delivery standards. In addition, healthcare providers are operating. required to complete training in early childhood healthcare delivery. The MoE sets the child-to-teacher ratio in the Preschool Education Guidelines (approved by the GoT on August 31, Policy Lever 3.3: Compliance 2007) as follows (see Table 12). In public ECD centers, with Standards there should be a maximum 15:1 child-teacher ratio for Establishing standards is essential to providing quality ECD children aged 1 to 3, and 20:1 child-teacher ratio for 4 to services and to promote healthy development. Once 7 year olds. In private ECD centers the guidelines are standards have been established, it is critical that 16 mechanisms are put in place to ensure compliance with UNESCO, 2005. Tajikistan: Early Childhood Care and Education standards. programs. Country profile prepared for the Education for All Global Monitoring report, 2007 SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 23 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Table 13: Preschool education staff by level of education completed Level of education completed Total Higher Incomplete Secondary Pedagogical Completed education higher education specialized background secondary education Head of ECD Center 584 376 23 87 90 8 Senior educator/Caregiver 486 212 58 120 96 0 Educator/Caregiver 4,942 773 179 2,102 1,309 579 Music teacher 657 183 25 258 127 64 Speech pathologist 28 17 2 9 0 0 Other educators/caregivers 356 106 22 79 65 84 Total 7,053 1,667 309 2,655 1,687 735 Percentage of total 100% 23.6% 4.4% 37.6% 23.9% 10.5% Source: Ministry of Education, 2011 (85-k form) in SABER-ECD Data Collection Instruments The majority of teaching professionals have not attained percent of educators and caregivers, or 773, have higher education. Table 13 presents the total number of completed higher education, which is a five-year preschool staff by the following level of education: university program equivalent to a master degree. 1. Higher (tertiary) education: five years university Many ECD facilities do not comply with established program, equivalent to master’s degree; infrastructure standards; data are not available to fully 2. Incomplete higher education: four year of study, assess compliance with service delivery standards. equivalent to bachelor degree, with a focus on social Inspection of school facilities is conducted by the MoE’s science (one stream of which includes child State Certificate Service every three years. Policy states development); that facilities that fail to meet registration standards will 3. Secondary specialized: pedagogical college with focus be temporarily suspended or shutdown on a long- on child development (usually two years of study); term/permanent basis, depending on the nature of the 4. Pedagogical background: both pedagogical university infraction and timeframe required to resolve the issue. In (four years) or pedagogical college (two years) of regards to service delivery, data are not collected to study; measure compliance with the established child-to-teacher 5. Completed secondary education: completed 11 ratio standards. grades in the secondary school. Upon completion, a certificate of completion of secondary education is Table 14 presents the infrastructure status of public provided. preschool facilities. Approximately 41 percent of ECD In total, there are 7,053 personnel working in preschools facilities require basic repair, and 5 percent of facilities in Tajikistan. Nearly 77 percent are categorized as are in an emergency state of condition. Only 50 percent of educators or caregivers. From this group approximately facilities have access to functional hygienic facilities, and 11 percent, or 579, have completed secondary education 74 percent of facilities do not have access to heating only, which is the lowest level for pre-service systems. requirements. On the other end of the spectrum, 14 Table 14: Infrastructure status of ECD facilities # not meeting % of facilities not Total facilities requirement meeting status Facilities that require basic repair 494 203 41% Facilities in emergency condition 494 27 5% Facilities with access to a potable water source 494 82 17% Facilities with access to functional hygienic facilities 494 247 50% Facilities with access to heating system 494 361 74% Source: Ministry of Education, 2011 (85-k form) in SABER-ECD Data Collection Instruments SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 24 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Policy Options to Monitor and Assure ECD enforced. To this end, inspection could take place on a more regular basis and the GoT could better utilize Quality in Tajikistan enforcement mechanisms.  Data Availability – As the importance of ECD has become better understood and gained prominence Preliminary Benchmarking and International internationally, countries have made developing and Comparison of ECD in Tajikistan implementing a detailed information system for young children that includes monitoring child development Table 15 compares select policies with related outcomes. outcomes a priority. To date, Tajikistan has developed an The existence of laws and policies alone do not guarantee adequate data collection system in this area, but there is a strong correlation with desired ECD outcomes. In many room to improve data collection so that policy makers countries, a disconnect exists between policies on paper and ECD stakeholders have a complete picture of the and the reality of access and service delivery on the state of ECD. In particular, the government could ground. The results in Tajikistan are mixed. The complement the MICS data set by collecting data by implementation of the Law on Salt Iodization in 2002 has rural/urban location in health and nutrition and by contributed to an increase from 28 percent of households socioeconomic class for all sectors. Also, the GoT should consuming iodized salt in 2003 to 63 percent in 2009. look to implement the ELDS including collection of data However, there is still a substantial portion of the to measure child development in a timely manner. population who are not consuming iodized salt. Furthermore,  Quality Standards – The regulatory framework, recent reports indicate that more stringent compliance and in particular long operating hours for the full-day mechanisms are required to ensure that salt is being centers, impact the supply and quality of centers. Service iodized in accordance with the regulations. A second delivery standards should place greater emphasis on the example relates to the steps taken by the GoT to development of the child as opposed to only the care of adhere to the International Code of Marketing of the child. Less stringent operating requirements may Breast Milk Substitutes and promote exclusive facilitate expansion of centers, especially in rural areas breastfeeding and health amongst the child and mother. that are currently underserved. The most substantive disconnect exists between  Compliance with Standards – Further to the education policy and level of access. Although the draft above point, the GoT could improve the quality of these National Strategy for Education Development for the services, greater flexibility could be built into the period up to 2020 highlights preschool education as a standards so that they are both achievable yet sufficient priority and aims to increase access to 50 percent for to ensure the well-being of children, while also allocating children aged 5 to 7, currently the enrollment rate is 8.9 greater resources to ensure these standards are actually percent. Table 15: Comparing ECD policies with outcomes in Tajikistan Policy Outcomes Health and Nutrition � Tajikistan’s policy adheres to elements of the Rate of exclusive breastfeeding until International Code of Marketing of Breast Milk the age of six months: 25% Substitutes � Young children are required to receive complete Children with DPT course of immunizations (12 to 23 months): 93% Child Protection � National policy mandates the registration of children at birth Birth registration rate: 88% Education � Preschool education is a priority, but not Preschool enrollment: 8.9% compulsory SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 25 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Table 16: Comparing ECD policies to outcomes in the Tajikistan and select countries Armenia Kyrgyz Republic Russian Tajikistan Federation Salt Iodization Salt Iodization Policy Mandatory Mandatory No policy Mandatory Population Consuming Iodized Salt 97% 76% 35% 63% Appropriate Infant Feeding and Breastfeeding Promotion Compliance, Code of Marketing of Law Law No policy Law Breast Milk Substitutes Exclusive Breastfeeding (6 Months) 35% 32% 40% 25% Preprimary Education Not Compulsory; Not compulsory; Not compulsory; compulsory; Preprimary School Policy largely State mainly State mainly state State and non- provision provision provision state provision Preprimary School Enrollment Rate 34% 17% (3-6 years) 72.9% (3-6 years) 8.9% (3-6 years) Birth Registration Birth Registration Policy Mandatory Mandatory Mandatory Mandatory Birth Registration Rate 96% 94% No data 88% Table 16 compares ECD policies to outcomes in Tajikistan, 72.9 percent. As noted in this Country Report, the level Armenia, Kyrgyz Republic, and Russian Federation. Each of of enrollment in Tajikistan is very low, as it is in Kyrgyz Tajikistan, Armenia, and the Kyrgyz Republic mandate salt Republic, too. Each of the four countries mandates iodization and have established laws that comply with the birth registration. Data are not available for the Russian International Code of Marketing of Breast Milk Federation. In Tajikistan, 88 percent of children are Substitutes until 6 months of age, however the registered. This rate is 94 percent and 96 percent in the percentage of the population that consumes iodized salt Kyrgyz Republic and Armenia, respectively. ranges from 63 percent to 97 percent in these three countries, and none have achieved high rates of exclusive Preliminary Benchmarking and International breastfeeding until 6 months. The Russian Federation Comparison of ECD in Tajikistan does not have a policy for salt iodization and only 35 percent of the eligible population consumes iodized salt. The SABER-ECD initiative is designed to enable policy Conversely, the Russian Federation also does not have a makers and ECD stakeholders to compare ECD systems law or policy that comply with the International Code of within regions and internationally. By using a consistent Marketing of Breast Milk Substitutes, yet at 40 percent, approach, it is possible to draw comparisons and identify the rate of exclusive breastfeeding until 6 months is areas for improvement across each of the nine policy higher than in the other countries. levers and policy goals. The SABER-ECD classification system does not rank countries according to any overall In Armenia and the Russian Federation the score; rather, it is designed to share information on how Governments are required to provide preschool different systems address the same policy challenges. education, however attendance is not compulsory. Table 17 reviews the classification of Tajikistan’s ECD Russian Federation has the highest enrollment level at system. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 26 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Table 17: Benchmarking Early Childhood Development Policy in Tajikistan Level of Level of ECD Policy Goal Policy Lever Development Development Legal Framework Establishing an Enabling Inter-sectoral Coordination Environment Finance Scope of Programs Implementing Widely Coverage Equity Data Availability Monitoring and Assuring Quality Standards Quality Compliance with Standards Latent Emerging Established Advanced Legend: Table 18 depicts the classification of Tajikistan alongside aiming to achieve universal preschool school by 2013, has regional and international comparisons. As can be seen, a strong Enabling Environment and also performs well Sweden is amongst the top performers, and receives within the Implementing Widely policy goal. Tajikistan’s advanced classification for each policy lever. Australia, level of development is comparable to Armenia and the which recently adopted a national ECD policy and is Kyrgyz Republic. Table 18: International Classification and Comparison of ECD Systems Level of Development ECD Policy Goal Policy Lever Kyrgyz Russian Armenia Chile Tajikistan Uzbekistan Republic Federation Legal Framework Establishing an Enabling Coordination Environment Finance Scope of Programs Implementing Coverage Widely Equity Data Availability Monitoring and Quality Standards Assuring Quality Compliance with Standards Latent Emerging Established Advanced Legend: SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 27 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Conclusion concrete steps to improve the legal framework for young children and pregnant mothers. Considerable efforts are This country report presents a framework to benchmark required to develop coordination across sectors, and Tajikistan’s ECD system; each of the nine policy levers are ensure a holistic approach to ECD. Table 19 summarizes examined in detail and some policy options are many of the discussion points and policy options that recommended. In recent years, Tajikistan has taken have been identified through this analysis. Table 19: Summary of policy options to improve ECD in Tajikistan Policy Policy Options and Recommendations Dimension • Strengthen coordination between key government stakeholders and service providers. • Develop an inter-sectoral working group consisting of state and non-state ECD stakeholders; provide annual reports on achievements of working group. Establishing an • Develop a multi-sectoral policy to ensure holistic approach to ECD, including a costed Enabling Environment implementation plan. • Develop methodology to effectively measure and track financial investments in ECD. • Consider increasing financial commitment to ECD sector, with particular focus on improving access to quality preschool. • Undertake stocktaking exercise to document and map existing interventions. • Continue to expand the scale of screening for hepatitis, HIV/AIDS, and sexually transmitted infections for pregnant women. • Reach children 0 to 3 years old with multi-sectoral services and reach their parents with education messages, including focus on raising the rate of exclusive breastfeeding, and Implementing introduction and take-up of complementary feeding interventions. Widely • Increase coverage of preschool; support various modalities for service delivery that meet the diverse needs of parents and children. • Consider alternative methods to increase prevalence of ECD interventions, including use of conditional cash transfer programs. • Facilitate implementation and development of modern information databases on the national level. • Enhance data collection systems, including more robust access data and mechanisms to measure child development. Monitoring and • Revise regulatory framework for preschool education institutions to promote participation and Assuring Quality to foster a more flexible environment for early childhood education and care centers to operate. • Evaluate qualifications of ECD workers on an ongoing basis. • Develop mechanisms to ensure compliance with service delivery and infrastructure standards. SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 28 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 Acknowledgements external sources. The report was prepared in consultation with the World Bank Human Development ECA team, the This Country Report was prepared by the SABER-ECD team at UNICEF Tajikistan Country team, and the Government of World Bank headquarters in Washington, DC. The report Tajikistan. For technical questions or comments about this presents country data collected using the SABER-ECD policy report, please contact the SABER-ECD team and program data collection instruments and data from (helpdeskecd@worldbank.org). SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 29 TAJIKISTAN ǀ EARLY CHILDHOOD DEVELOPMENT SABER COUNTRY REPORT |2013 www.worldbank.org/education/saber The Systems Approach for Better Education Results (SABER) initiative produces comparative data and knowledge on education policies and institutions, with the aim of helping countries systematically strengthen their education systems. SABER evaluates the quality of education policies against evidence-based global standards, using new diagnostic tools and detailed policy data. The SABER country reports give all parties with a stake in educational results—from administrators, teachers, and parents to policymakers and business people—an accessible, objective snapshot showing how well the policies of their country's education system are oriented toward ensuring that all children and youth learn. This report focuses specifically on policies in the area of Early Childhood Development. This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. THE WORLD BANK SYSTEMS APPROACH FOR BETTER EDUCATION RESULTS 2