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        Economic and Social Council
8 August 2005

Original: English

United Nations Children’s Fund
Executive Board
Second regular session 2005
28-30 September 2005
Item 5 of the provisional agenda*


Summary of midterm reviews and major evaluations of country programmes

Middle East and North Africa region

The present document was prepared in response to Executive Board decision 1995/8 (E/ICEF/1995/9/Rev.1), which requested the secretariat to submit to the Board a summary of the outcome of midterm reviews (MTRs) and major country programme evaluations, specifying, inter alia, the results achieved, lessons learned and the need for any adjustments in the country programme. The Board is to comment on the reports and provide guidance to the secretariat, if necessary. The MTRs and evaluations described in this report were conducted during 2004.

* E/ICEF/2005/10.


1. Nine countries of the region conducted midterm reviews (MTR) in 2004: Algeria, Egypt, Lebanon, Morocco, the Occupied Palestinian Territory, Sudan, the Syrian Arab Republic, Tunisia and Yemen. United Nations partner agencies as well as donor representatives and non-governmental organizations (NGOs) took part in all the reviews. For the first time, two countries, Morocco and Tunisia, conducted joint United Nations inter-agency MTRs.

Country midterm reviews



18. Introduction. The MTR was carried out by the Government and UNICEF in close cooperation with local NGO partners. The Ministries of Public Health, Education, Social Affairs and Justice were represented at the General Directorate level. A number of thematic studies were prepared in mother and child care, education and child labour.

19. The situation of children and women. IMR and U5MR, at 27 and 35 per 1,000 live births, respectively, are among the lowest in the region, but considerable disparities exist. Immunization rates for infants have been sustained at over 90 per cent. No indigenous cases of polio have been reported since 1993; one imported case of polio, however, was confirmed in 2003.

20. Primary education is almost universal, with near equal enrolment rates for girls and boys. A growing problem, child labour engages some 10 per cent of children aged 14-18. Although prevalence is low, HIV/AIDS is a potentially serious health threat.

21. Progress and key results. UNICEF supported national immunization by procuring vaccines, cold-chain and immunization equipment and essential drugs. Important alliances were formed with the World Bank and WHO to strengthen Primary Health Care (PHC) centres, train staff and develop quality standards as part of PHC reform. As part of parent education efforts, 13 episodes of a television programme, “My Child”, were developed. ECD education materials were provided to 46 day-care centres and kindergartens. UNICEF, working with ILO, contributed to research on child labour and to the development of the national plan of action to combat its worse forms. A draft national youth policy is being developed. A partnership with Government Ministries and NGOs was developed to pilot vocational training programmes for young people in 12 districts. UNICEF has supported the national AIDS programme within the joint United Nations Plan of Action for HIV/AIDS Prevention. Preparation of Lebanon’s third report to the Committee on the Rights of the Child involved the participation of a panel of children and the mobilization of the media to promote child rights.

22. Resources used. Out of a budgeted total for the country programme of $8 million ($3 million in regular resources and $5 million in other resources), around $3 million was spent in the first three years ($1.8 million in regular resources and $1.2 million in other resources). During 2002-2004, programme budget implementation was 92 per cent for regular resources and 52 per cent for other resources. Office restructuring in 2004, which caused prolonged vacancy of several posts, was a major factor in low expenditure.

23. Constraints and opportunities affecting progress. Weaknesses in statistical and information systems hamper the improvement of monitoring and the effectiveness of programmes. The lack of institutional capacity, especially in child protection issues, remains a major concern. The next United Nations Development Assistance Framework (UNDAF) will be a good opportunity to improve the effectiveness of United Nations agencies. UNICEF is playing an active and often catalytic role in the theme groups on Millennium Development Goals monitoring, youth empowerment and HIV/AIDS prevention.

24. Recommendations and adjustments made. The MTR included several key recommendations: re-define project objectives to make them result-oriented, to avoid an overlap of activities and to better reflect the niche of UNICEF; in the absence of a child protection programme, incorporate child neglect, violence, abuse and exploitation into the existing youth empowerment and protection programme; more actively mobilize young people as agents of social change; include all young Lebanese, not just working and out-of-school youth, in the youth empowerment and protection programme; and improve performance in other resources fund-raising.


The Occupied Palestinian Territory

33. Introduction. As the country programme cycle lasts two years (2004–2005), the MTR at the end of 2004 was combined with the annual review. The review involved partner Ministries, United Nations agencies, donors, national and international NGOs and children. Five working groups were formed for the preparation of the review.

34. The situation of children and women. The majority of Palestinian women and children continue to suffer the consequences of the conflict and of the restrictions of access. There are rising trends in IMR and MMR, decreasing access to education and increasing signs of psychosocial distress. Mortality rates in Gaza have increased by 30-35 per cent in the last four years. Stunting rates have increased from 7 per cent in 1996 to almost 10 per cent in 2004, reflecting the growing levels of poverty and malnutrition. Research indicates that 51 per cent of students admitted to using physical violence against schoolmates, and 44 per cent of teachers and 56 per cent of parents applied physical punishment.

35. Progress and key results. Nine emergency psychosocial support teams were established across the West Bank. Counsellors in 300 schools and 12,000 caregivers were trained to observe and detect violence and distress among children and provide them with support. The National Mine Action Committee was reactivated, and UNICEF is working closely with this committee to review strategy and training. The child-friendly cities project included four more municipalities and has taken steps towards nationwide expansion. The seven-year plan for Palestinian children within the framework of A World Fit for Children was finalized and endorsed. A national position paper on child protection was drawn up as a first step towards a national policy.

36. Routine immunization was maintained with the support of UNICEF in both the facilities of the Ministry of Health and the United Nations Relief and Works Agency for Palestinian Refugees in the Near East (UNRWA), and a nationwide measles immunization campaign and polio mop-up campaign were conducted. Immunization training was provided to 121 trainers and 440 service providers. To expand the IMCI initiative, 45 trainers and 260 health care providers were trained, and 15 district training units were equipped.

37. Revised remedial education materials were printed and distributed; 18 lessons were developed and three workshops were held to train 100 teachers. A plan to conduct the national assessment of teacher-training needs was drafted. A two-day refresher training on life skills-based education was held for 80 trainers, who in turn trained 750 teachers and 450 school principals in 19 schools in Gaza.

38. A youth-focused decentralized participatory process was launched, which will lead to the development of a National Youth Policy covering the 15-24 age group. A pilot HIV/AIDS awareness-raising project for adolescents was launched in nine schools and six youth clubs.

39. A monitoring project was initiated for violence in school, domestic abuse and child labour, and UNICEF took the lead in introducing the concept of a protective environment for children. A baseline survey on the psychosocial status of Palestinian children was carried out by the Palestine Central Bureau of Statistics.

40. Resources used. The bulk of the programme funds comes from other resources and emergency funding. In 2004, the programme spent $426,700 in regular resources (against the planned $558,000); $3.27 million in other resources (against the planned $4.11 million); and $3.98 million in emergency funds (against the planned $13.9 million and actual emergency funding of $5.06 million). The low expenditure for other resources and emergency funds reflects the fact that the funding was received late in the year and disbursement was carried to 2005.

41. Constraints and opportunities affecting progress. The programme benefited from increased funding opportunities. UNICEF partners and civil society organizations show great enthusiasm and cooperation in moving ahead with children’s and women’s issues, though the number of these organizations is small. Ongoing violence and movement restrictions pose major constraints. There is a need for better common understanding of child protection issues; despite some progress, social sensitivity regarding certain “taboos” is still high.

42. Adjustments made. The MTR made several recommendations: make a transition from emergency programming towards development; continue to make educational quality a priority; continue to strengthen ECD, including the community IMCI and pre-school education; strengthen school health; focus more on children living under difficult circumstances; invest more in making society child-focused; and increase collaboration and coordination with UNFPA, the United Nations Educational, Scientific and Cultural Organization (UNESCO) and other United Nations agencies. To increase programme performance, in Gaza, specific operations such as procurement of supplies should be conducted locally rather than from Jerusalem.


Syrian Arab Republic

57. Introduction. Five thematic groups were established for education, health, communication, Healthy villages and child protection. The reports of the groups were presented in meetings at the State Planning Commission. The findings and recommendations formed the basis of the draft report presented at the MTR meeting, which included participants from the Ministries of Education, Health, Information, Social Affairs, and Interior, the Women’s General Union, Damascus University, United Nations agencies and national experts and researchers.

58. The situation of children and women. The country’s performance in child health and education is among the best in the region. However, iron deficiency and resulting anaemia is still a problem affecting 40 per cent of women of child-bearing age, 45 per cent of infants and 27 per cent of children under 5. The country has gender and geographical disparities, with five north and north-eastern governorates having especially low access to health services, and several showing a school dropout rate of 38 per cent, compared with a national average of 10 per cent.

59. Progress and key results. IMCI was adopted and implemented in four districts in four governorates. On-the-job training in capacity-building was conducted in more than 50 per cent of districts for doctors, nurses and health workers. A district health system was adopted to ensure decentralization. National Days of Immunization and mop-up operations were conducted twice to sustain the polio-free status. Mid-level managers in the expanded programme on immunization (EPI) in all governorates were trained, as were private doctors. More than 50,000 youths participated in summer camps at which HIV/AIDS awareness campaigns were held, and two AIDS information centres were established in the cities of Damascus and Hama. More than 40 villages in five governorates joined the Healthy Villages Programme. Iodine deficiency disorders have been eliminated, and a pilot flour-fortification project is being implemented. The school curricula are being modified to become gender sensitive. Some 5,500 girl dropouts returned to school as a result of the condensed curriculum project. Global education has been implemented in 382 schools, and health education in 60 per cent of schools. ECD concepts and strategies have been introduced in partnership with UNESCO and the Aga Khan Development Network. Around 6,000 caregivers have been educated in better parenting. The inclusive education initiative was implemented in four schools and one kindergarten. Training was given to 80 trainers in dealing with orphaned children. The second report to the Committee on the Rights of the Child was submitted. A six-episode television programme on child protection was aired.

60. Resources used. The programme spent $2.6 million in regular resources, $160,000 in other resources and $454,000 in emergency funds for the Palestinian Programme in the first three years. The Syrian Arab Republic attracts very little donor interest, partly because of its achievements in key indicators related to children.

61. Constraints and opportunities affecting progress. The rapid turnover of trained staff, due to low salaries, prevented the expansion of IMCI into the seven targeted governorates. Social, cultural and financial obstacles thwarted achievement of the annual target of returning girl dropouts to school. The lack of qualified teachers and educational resources delayed the expansion of the inclusive education initiative. The Healthy Villages Programme continued to suffer from weak management and an unclear vision. The health education programme benefited from the Ministry of Education’s commitment to expand and fund it. The child-friendly school concept will aid in addressing child protection issues in schools.

62. Adjustments made. Several adjustments were made to emphasize certain components of the programme and/or to reorganize the structure to make it more effective.



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