In under 5 mortality rate was recorded in the CEECIS region from 1990 to 2011.
Quote of the month
Jo Bourne, UNICEF Associate Director and Global Chief of Education
The situation of children
Uzbekistan has a universal formal education system. Compulsory education in the nation covers twelve years, of which nine are completed at primary and general secondary schools, and three at academic lyceums or vocational colleges. Preschool education is not compulsory.
In 2012 Uzbekistan developed an evidence-based Education Sector Plan for the period from 2013 to 2017, which is on the way to being approved. This initiative is a commitment to the further strengthening of the education sector, as well as involvement in a partnership to improve education globally. The Plan identifies key strategic areas for improvement in policy, infrastructure, staff development, and monitoring throughout the education sector. 
According to 2012 official statistics, preschool education has an enrolment rate of 22.7 per cent. Preschool coverage is higher in Tashkent (53.9 per cent) and other cities, as compared to some rural areas . Joint efforts by the Ministry of Public Education, the Ministry of Finance and the Women’s Committee have been initiated in 2011 in order to analyse the situation and define a financially-viable strategy to facilitate wider access and improved quality.
In 2011 an international model of Early Learning Development Standards was adopted for preschool institutions, which sets standards for early childhood development in the physical, cognitive, social, emotional, and linguistic fields. These standards will provide a basis for the monitoring and improvement of the preschool system of Early Childhood Development. A new national curriculum (Bolajon) was developed by the Ministry of Public Education, providing educators with tools for implementing the new standards. The new curriculum has yet to be assessed for its level of implementation or effectiveness.
Enrolment in primary education is high in Uzbekistan. All sources indicate that gross enrolment stands at least at 95 per cent. At the same time, the Commission on Minors’ Affairs under the Cabinet of Ministers has determined that there are non-attendance issues in general secondary schools (for ages 7 to 15) and colleges (for ages 16 to 19), that need to be addressed for further improvement.
In the framework of quality improvement, the Ministry of Public Education has developed an action plan to monitor and improve quality of education, based on the international model of child-friendly schools. Uzbekistan has its own student evaluation system which is conducted by the Ministry of Public Education and the Ministry of Higher and Secondary Special Education, in cooperation with the State Testing Centre.
National reports indicated that there were almost 87,900 people less than 16 years with disabilities in Uzbekistan in 2011. A Resolution on Procedures for the Introduction of Inclusive Education for Disabled Children was adopted by the Ministries of Health, Public Education, Higher and Special Secondary Education, and Labour and Social Protection in 2010. Starting the implementation of this resolution will facilitate greater inclusion. Students with special needs currently have little opportunity to study beyond Grade Nine, as there are only two colleges designated to accept them.
The healthcare system in Uzbekistan includes facilities that provide, among other services, maternal and child healthcare at national, regional, district and local level, through a system of maternity hospitals and departments, and a network of rural primary care units.
A 2009 Presidential Decree set the further enhancement of Maternal and Child Health as a priority. Progress within the maternal and child health sector is the result of on-going reforms. In 2012 the establishment of the Coordination Council on Maternal and Child Health was an additional important step towards strengthened coordination. In fact this mechanism, led by the Ministry of Health and including government agencies and international partners, allows for an integrated approach to the reforms. It also serves as a platform for policy discussions, and for the exchange of experience and support. The Ministry of Health has prioritised quality improvement of mother and child health services, including the future strengthening of perinatal care, through an Extended Programme on Immunisation (EPI) and the Integrated Management of Childhood Illnesses (IMCI). By signing the ‘A Promise Renewed’ pledge in 2012, the Ministry recommitted its efforts to further reduce child mortality, and to ensure that no child dies fr om preventable causes.
With regards to the nutritional status of women and children, over the last years the country has taken several measures to tackle micronutrient deficiencies, including the supplementation of multivitamins for pregnant women, Vitamin A supplementation for children, and flour and salt fortification programmes. The Law on ‘Prevention of Micronutrient Deficiencies among the population of Uzbekistan’  was passed in 2010, and is one of the key normative frameworks that facilitate micronutrient deficiencies mitigation programmes, including food fortification, multivitamins supplementation, and community-based nutrition interventions. Such measures have so far produced positive results. The continued systematic implementation, monitoring and analysis of achievements should address the remaining challenges, considering that national data has indicated a 33.5 per cent rate of iodine deficiency among the population in 2012 , a 39 per cent prevalence of iodine deficiency disorders among children in 2014, and a 54 per cent  prevalence of anaemia among pregnant women in 2010.
The prevalence of thyroid gland disease (goitre) among children constituted 34 per 1,000 in 2011, while iron deficient anaemia was found in more than 61 per cent of 3-year old children in 1996 (DHS 1996) and in 58.7 per cent in 2002 (DHS 2002). Among these children about 28 per cent suffered fr om moderate anaemia. The overall anaemia rate among the country’s population dropped fr om 51.3 per cent in 2004 to 27.8 per cent in 2007 (GAIN, LC-LQAS Survey report 2013). However, this is average country data which does not show the regional situation. Further countrywide research on iron deficient anaemia is required.
The national exclusive breastfeeding (EBF) rate has increased to 90 per cent on discharge from maternities, but declines to 30-50 per cent in the following months. In this regard, the Ministry of Health has been implementing several promotion strategies, including strengthening the counselling capacity of maternity and primary healthcare professionals. Government monitoring has confirmed that the areas wh ere this approach has been implemented have seen an increase in EBF and continuous breastfeeding practices.
Official figures have indicated a drop in new HIV cases in the country, from 4016 in 2009 to 3584 in 2011.  The proportion of women among those officially registered with the virus has increased. Accordingly, the government has focused on preventing mother to child transmission, has provided counselling and testing for pregnant women in obstetric facilities, and for couples intending to marry. With the support of UNICEF, seven day-care centres have been established in six regions to provide psycho-social support to children, women and families affected by HIV. Complementary support networks for families have also been created. At the same time, there is a need for increased testing and support for groups most at risk of infection, including most-at-risk adolescents.
With regards to water, sanitation and hygiene conditions, gaps in hygiene knowledge at the household level and access to facilities among some parts of the population require attention. According to official statistics, access to piped water and centralised sewage systems vary across the country. Such circumstances can lead to a high prevalence of sanitation- and hygiene-related diseases. To tackle this issue, in 2012 the Ministry of Health adopted the National Hygiene Promotion and Deworming Strategy based on evidence produced in three pilot regions, wh ere new hygiene promotion and deworming interventions led to a 40 per cent decrease in helminthic prevalence 
Uzbekistan has inherited from the Soviet times protection policies that are geared mostly towards institutionalisation. According to National sources there were at least 34,817 children living in various types of residential institution in 2010-11, such as infant homes, ‘Mekhribonlik’ children’s homes, boarding schools for children with special needs and from low-income families, family-type children’s homes and SOS villages.
The government has recently started developing the State Programme on Child Care Reform for the period from 2013 to 2015. This multi-sectoral process will facilitate an integrated approach to reviewing legislative and normative frameworks, and ensuring enhanced coordination among the State actors that hold responsibilities in child care. While the Reform Programme is on the way, a range of actions have already been undertaken as part of the child care agenda. Social work has been recognised as a profession, and recently the first official positions for social workers have been created in infant and children homes. However further steps are required to ensure a more systematic approach to guaranteeing the sustainability of social work practices in the country. The development of gate-keeping and community-based prevention services are also critical actions to ensure smooth and sustainable child care reform in the country.
According to official statistics, of the 93,918 persons who committed crimes in 2010, 2,659 were under 18 years of age.  Publicly-available data regarding children in contact with but not necessarily in conflict with the law, as well as the availability of specific services directed to protect their interests, is lim ited. In 2010 the Parliament passed a Law on the Prevention of Child Neglect and Juvenile Delinquency,  which contains plans for preventing child neglect and children coming into conflict with the law.
Besides the allocation of human and financial resources the implementation of the law requires the further development of secondary legislation, and the expansion of the role of social work agencies in carrying out prevention measures.
 The Ministry of Public Education, Education Sector Plan Draft Version, 5 October 2012, UNICEF
 The Ministry of Public Education data, released by State Statistics Committee
 The Law RUz -251 of 7 June 2010.
 Figures provided by Republican Specialized Scientific Practical Medical Center of Endocrinology
 GOSCOMSTAT 2010
 Administrative data by the Ministry of Health
 Data from the Republican State Centre for Sanitary and Epidemiological Surveillance, 2012
 The State Committee on Statistics, Social Development and Living Standards in Uzbekistan, 2011
 Law 263 of 29 September 2010