Analysis of the key achievements and challenges in the implementation of the national MDGs agenda.

Transcription

1 Analysis of the key achievements and challenges in the implementation of the national MDGs agenda. This brief * aims to provide a snapshot of the recent progress in achievement of the national MDG targets and reflect on key driving trends behind it. The brief also seeks to offer an easy-to-understand visual guide to gauge progress made after 2009 as well as towards final targets, but also to assess the likelihood of set targets being achieved. Ultimately, it may well serve as a call for action by all relevant stakeholders to ensure the targets are met by 2015, i.e. the conditions of the most poor and vulnerable people are improved. Overview Implementation of the national Millennium Development Goals agenda has been a stern development challenge for Moldova. Since the signature of the Millennium Declaration back in 2000, the country has made significant progress in certain dimensions of human well-being, economy, governance and management of ecosystems, while in others more sustained effort is needed to achieve the national targets by The progress may become harder to attain under the current conditions of economic uncertainty and financial austerity. Despite the fact that Moldova has weathered rather well the consequences of the global economic crisis, the progress on the achievement of the national targets remained uneven. The main areas of concern are the MDG 2 and MDG 6 whose targets Moldova is likely to miss. Furthermore, there are looming downside risks stemming from limited sustainability and inclusiveness of economic growth. As the latter slows down, the Government, with support of development partners, should take steps to ensure that new growth opportunities are identified and its benefits are distributed in a more inclusive and equitable manner. All in all, measuring progress along the national MDGs, designing and implementing feasible and sustainable acceleration solutions requires consolidated efforts by all relevant stakeholders, ranging from central and local authorities, civil society organizations, development partners, private sector and each citizen. MDG 1. Reduce extreme poverty and hunger After rising spectacularly in , poverty in Moldova began to decline in In 2006, a new methodology was adopted for estimating poverty indicators, a fact which determined changes in targets related to poverty and hunger reduction. Since 2008, key poverty indicators reveal decreasing poverty levels. The absolute poverty rate in 2010 reached 21.9%, a decrease of 4.4 p.p. compared to 2009, putting the country firmly on the path to attain the target by As in the previous years the children were more affected by poverty than adult population. Against the background of falling poverty, every fourth child (24.2%) still lives in absolute poverty, and 1.9% - in extreme poverty. The overall extreme poverty rate followed same pattern and targets set for 2010 and planned for 2015 have been already met. Moreover, the progress in 2010 was mostly driven by declines in rural poverty as opposed to the previous years, when rising incomes in big cities aided poverty reduction. Indeed, in 2010 poverty reduction was mostly pronounced in rural areas (by 6 percentage points down to 30.3%) and small towns (by 5.5 p.p. to 14.2%). Despite this progress poverty remains in many ways rural phenomenon as 80% of country s poor reside in rural areas. Furthermore, poor households tend to have lower levels of educational attainment and bigger number of children. This fact has an important implication for future poverty-reduction efforts both in short- and long-term. In the short-term, remittances and better targeted social protection policies help eradicate poverty. In the longer run, better access to and higher quality of education will have to play a more prominent role. The key risks to the positive progress remain sustainability and inclusiveness of economic growth in forthcoming years, and mainly: (a) rural-urban divide; (b) uncertainties surrounding global and regional economic growth outlook which will affect the growth prospects of Moldovan economy and availability of * We are extremely grateful to our UNICEF, WHO and UNFPA colleagues for providing valuable suggestions that helped us improve this brief. The source of used data is the National Bureau of Statistics if not otherwise stated. MLSPF, Annual Social Report, pag

2 resources to devote to social protection policies. Indeed, the poverty reduction in rural areas was mainly driven by recovering remittances (majority of migrants are of rural background), but also from growing incomes from agriculture activity (rising food prices) and social assistance. Nonetheless, the strong reliance on remittances raises question marks about sustainability of poverty reduction trend in rural areas. Furthermore, the dim economic outlook in the euro-zone (where significant share of Moldovan labor migrants work) casts shadow over the scale on which remittances will prop up incomes in rural areas even in the close future. Ultimately, the high vulnerability of Moldovan agriculture towards climate risks / weather conditions may eventually undercut or even reverse the positive trends underpinned by rising farmers incomes as it may well happen in the aftermath of this year s drought. MDG 2. Achieve universal access to general compulsory education Moldova is still to overcome many obstacles on its way to the Millennium Development Goal in the area of education. A major difficulty is the inefficient financing of the education system and the quality of the provided services. Despite substantial public investment in education as share of GDP (over 9% of GDP in 2011) compared to other countries (including EU with average 5.5% of GDP education expenditure), the quality and continuum-wise accessibility of provided services to most vulnerable children failed to improve. It continues to be highly unlikely that the country will reach the targeted level of gross enrollment into compulsory education since the enrollment rate has steadily decreased since The causes of the fall in the enrolment rates are related to the continuing levels of high poverty, especially in families with many children and with members of lower education levels. The latter aspect is critical since it propagates path dependency as poverty levels are directly correlated with educational attainment. Thus, parents with lower educational attainment tend to be generally poorer and therefore are less able to invest in education of their children. In urban areas, the rate of enrolment in both pre-school and compulsory education is higher than in rural communities. There are no gender discrepancies in schooling rates, although boys are slightly disadvantaged in secondary education. Maintaining literacy rate for the year-old population seems very likely, but in the long-term, there are still risks that arise from the drop in enrolment into compulsory education. Contrary to falling enrolment in compulsory education, the gross enrollment rate in pre-school education is continuously increasing (from 44.1 percent in 2000 to 79.6 percent in 2011). However, data show that children in rural areas and children from families with a lower economic status have a much lower enrolment rate in pre-school education. MDG 3. Promote gender equality and empower women Despite enshrining equal rights in national legislation, many challenges remain in ensuring gender equality. The greatest disparities relate to horizontal and vertical gender segregation: Moldovan women are mostly employed in low-paying jobs and occupy lower positions in the job hierarchy where they are employed. The representation of women in decision-making positions is very patchy in Moldova, with 19.8% of MP seats held by women in At the local level, women are underrepresented as they manage only 166 mayoralties, out of the total number of 898 entities. Compared to previous local elections, the share of women in LPAs increased from 15.37% (2003) to 18.15% (2007) and 18.49% (2011). In the central government, despite gender parity in the distribution of salaries and even of high-ranked positions, the higher up in the hierarchical structure of decision makers one looks, the fewer women one finds compared to men. Discrepancies between the salaries of women and men decreased in , however, this trend has slightly reversed since then. Thus, the average female salary represented only 74.4 percent of the average male salary in The gap persists because women, most often, either work in lower-paid sectors education, healthcare or services - or occupy lower-paid positions. Although the Government of Moldova has made efforts to improve the country s performance in gender equality and empowering women, it is still hard to foresee sustainable path. Thus, even though all women benefit from the same employment rights as men, they are still considered a relatively vulnerable group on the labor market. To some extent the new law on equality which will enter into force on January 1, 2013, can positively contribute

3 to achieving equal remuneration for same type and/or volume of work. Accelerated progress is therefore required in this respect to ensure that planned targets are met by MDG 4. Reduce child mortality Moldova achieved important progress in reducing infant and child mortality and targets for the under-five mortality and infant mortality rates have been already achieved. The infant mortality rate has been falling steadily since the mid-1990s reaching 11.8 per 1000 live births in 2010, which is close to average for countries of the CIS (11.7 per 1000 live births in 2010), but still more than double the European Union average of 4.2 per 1000 live births in Vaccination of under-two year old children is rather problematic and requires increased attention of the local authorities. Besides this the general child immunization levels have been consistently high in the Republic of Moldova for all vaccine preventable diseases, and in 2010, 97.1 percent of children was immunized against measles. Perinatal diseases, congenital malformations and respiratory diseases remain the prevalent factors driving infant and child mortality. Children from poor families and from families with many children are less likely to have access to health care and face a higher risk of mortality. MDG 5. Improve maternal health Some modest positive progress achieved by 2009 when the mortality rate decreased to 17.2 per 100,000 births was suddenly lost in 2010 (44.5 per 100,000 births). The fluctuations in figures for the maternal mortality rate are determined by precarious health conditions, quality of offered care and methodological aspects of estimations. Although the absolute number of maternal deaths is small, the non-linear evolution of the maternal mortality rate raises some concerns. The maternal mortality structure by cause of death in 2010 was the next: direct obstetric causes in 41.7% (8 cases) hemorrhages, late gestoses (including preeclampsia and eclampsia), septic states, embolism with amniotic fluid; and indirect obstetric causes in 52.9% (9 cases) pandemic flue, neoplasm and tumors, hepatic cirrhoses, and, rarely, cases of anaesthesia-related complications. Social determinants (particularly poverty and migration) play a determinant role in half of the cases of maternal mortality. Accomplishing the 2015 target largely depends on ensuring constant financing, the human resources for health, quality assurance, i.e. development and implementation of the standards of care and protocols, inter-sectorial collaboration, especially with the social protection, in order to strengthen the measures for early identification of at-risk cases. Regarding the second target of maintaining the high number of births assisted by qualified medical staff, Republic of Moldova has made good progress. In 2009 the proportion of births attended by skilled health personnel was 99.8 percent that was maintained in The national target for 2015 will most probably be met, under the condition that sufficient financial allocations to healthcare services for mothers and their children are ensured. MDG 6. Combat HIV/AIDS, tuberculosis and other diseases The HIV incidence trends in general population and adults aged have been up and down over the last five years in Moldova. A particularly alarming situation in this context can be found in Transnistria, the break-away region in eastern Moldova, where incidence is extremely high (up to cases per 100,000 general population and cases per 100,000 young population vs per 100,000 in the rest of Moldova in 2010). The evolution of HIV epidemiological situation requires immediate actions to cut back on the HIV incidence in Moldova in general, and in Transnistria in particular. Given the above, in Moldova the national targets under the HIV segment will most probably be missed by The situation is similarly difficult with regards to tuberculosis (TB), with particularly worrisome trends again in Transnistria. TB morbidity stayed high throughout 2011, as reflected in marginal changes to some indicators, as compared to the previous years. The global incidence of tuberculosis reached per 100,000 people in 2011, almost on par with 2010 (114.3 per people, or 4673 cases). There were 3,833 new cases reported in 2011 or 93.8 per 100,000 people, going up by 2.3% as compared to 2010, while going down by 7.9% as compared with There were 839 relapse cases reported in 2011, or 20.5 per 100,000 people - 4.8% fewer than in Multidrug-resistant (MDR) TB accounted for about a quarter of all new cases, and for about two-thirds of retreatment cases in 2010 (NTP data). TB mortality stayed high, with 16.1 per 100,000 people in 2011, slightly lower than that reported over the previous two years. It is worrying that out of the total number of deaths up

4 to 26.6% were recorded in people with up to one year of treatment, showing late detection of tuberculosis. The treatment success rate was extremely low, at 54% for new cases and 34% for retreatment cases in Given the above, it is unlikely that Moldova will meet its TB-related targets by Overall, reverting the spread of these two infections in the short run is very unlikely, as it requires sustainable efforts in the mediumto-long run to halt the spread of disease. MDG 7. Ensure environmental sustainability Addressing the environmental challenges and risks is imperative for Moldova. From the perspective of the target of increasing areas covered by forests, progress has been slow. From 2000 to 2008, period for which are available, the proportion of land covered by forests increased only from 10.5 to 10.9 percent. Given the slow expansion of forest coverage, the little forestation work done in and the cuts in public expenditures that were made due to the economic crisis, we can predict that final targets will not be accomplished. The situation is better when it comes to the target of increasing the share of the state-protected areas for maintaining biological diversity, for which both the interim and final targets have been achieved already in 2007 (when the indicator reached 4.76 percent). The progress in expanding access to water and sanitation infrastructure has been quite slow. In 2009, the proportion of the population with sustainable access to improved water sources was 55 percent (with the 2010 target set at 59 percent). Despite this increase in the population s access to safe water sources maintained in recent years, it is difficult to believe that final target for 2010 could be achieved. Another important problem for the population of Moldova is the construction, development and renovation of centralized waste water collection systems and waste water treatment stations. As a result of the actions carried in this period, the proportion of the population with sustainable access to sewerage was just 54.6 percent in The slow progress recorded in recent years towards the achievement of this target shows that the desired level for 2015 (65 percent) will probably not be achieved. Moreover, the aggregated data hides high levels of inequality with respect to access to sewage. Thus, of those with no access to sewage rural population makes up 90%. This striking feature highlights the multi-faceted nature of poverty affecting rural population: monetary, access to services, etc. The access of the population to sanitation services is being extended even more slowly. The proportion of the population that had access to improved sanitation in 2008 has not changed significantly (45.9 percent). No data are available for 2009, but the slow dynamics of this indicator suggests that the final target (71.8 percent) could be most probably left unaccomplished. Overall ensuring environmental sustainability is difficult, particularly in view of scarce financial resources available. Important issues remain to be addressed with reference to waste management, including the need for harmonizing legislation with EU standards, development of waste collection and recycling mechanisms in rural area, rigorous control of the imported dangerous substances, among others. MDG 8. Develop a global partnership for development The overall trends remain positive under certain national targets; one important overarching concern is the uptick in youth unemployment in the aftermath of the global economic crisis. Since 2008, youth employment has never recovered, with unemployment rate of 17.8% in 2010 and 14.9% in 2011, compared to 11.2% in The country continues to run a high negative trade balance with the rest of the world, with % in 2010 and 40.9% in 2011 and rising. There is increased risk of widening of deficit given the effects of the current consumption-led growth model, a model which is unsustainable in medium and long term. The share of investments in the transportation sector as percentage of overall public investment increased to 16.4% in 2010, compared to only 7.2% in the previous year. Same positive trend is observed in air and naval transportation, with a share of 58.7% in 2011, compared to the 27.5% in the previous year. The fixed telephony penetration continued to slowly increase and reached 33.6% in The number of internet users subscribed to broad band services increased impressively and reached thousand users in Q4 2011, compared to 186,9 thousand in Q4 of Public and publicly guaranteed debt, to include general government debt and that of the monetary authorities, steadily increased in the WHO country profile

5 aftermath of the global crisis; in 2011 it reached 1.52 bil. USD, an increase of 12.8% compared to the previous year. The gross external debt as share of GDP represented 82.3% of GDP in 2010 and 77.9% in The public and publicly guaranteed external debt to GDP ratio constituted 23.2% in 2010 and 21.7% in 2011 **. Overall, the growth constraints analysis for the Moldovan economy conducted in 2010 by the Government revealed that key constraints are the human capital, low quality of road infrastructure, and the limited access to loans. These constraints persist and their removal remains high in the national policy agenda. ** NBM.

6 Annex Assessed target Value of the indicator Value of the indicator (2010 and/or Attainability (2009) 2011) by 2015 Goal 1: Reduce extreme poverty and hunger Target 1. Reduce the proportion of people whose consumption is under $4.3 a day/person (in PPP terms) from 34.5 percent in 2006 to 29 percent in 2010 and 23 percent in Most likely Target 2. Reduce the proportion of people under the absolute poverty line from 30.2 percent in 2006 to 25 percent in 2010 and 20 percent in (2010) Most likely Target 3. Reduce the proportion of people under the extreme poverty line from 4.5 percent in 2006 to 4 percent in 2010 and 3.5 percent in (2010) Most likely Goal 2. Ensure access to general compulsory education Target 1. Ensure opportunities for all children to attend general secondary education. Increase the gross enrolment rate for general secondary education from 94.1 percent in 2002 up to 95 percent in 2010 and 98 percent in (2010), 90.1 (2011) Unlikely Target 2. Maintain the literacy rate for the year-old population at 99.5 percent (2010) and 99.6 (2011) Most likely Target 3. Increase the enrolment rate for pre-school programs for (group 3-6 years old) (group 3-6 years old) 77.1 (2010), 79.6 Unlikely 3-6 year-old children from 41.3 percent in 2002 to 75 percent in 75.5 (2011) 2010 and 78 percent in 2015, and for 6-7 year-old children from 66.5 percent in 2002 to 95 percent in 2010 and 98 percent in 2015, as well as reduce by less than 5 percent the discrepancies (group 6-7 years old) 93.8 (group 6-7 years old) 93.1 (2010), 93.0 (2011) between rural and urban areas and between disadvantaged and middle-income groups. Goal 3. Promote gender equality and empower women Target 1. Increase women s representation in decision-making MPs MPs 19.8 (2012) Uncertain positions. Increase representation of women at the decision making level (from 26.5 percent in local councils in 2007 to 40 Mayors (2007) Mayors (2011) percent in 2015, from 13.2 percent in district councils in 2007 to 25 percent in 2015, from 18 percent women mayors in 2007 to 25 percent in 2015 and from 22 percent women MPs in 2005 to 30 percent in 2015) Target 2. Reduce gender inequality in employment: reduce disparity between women s and men s salaries by at least 10 percent by 2015 (the average monthly salary of women represented 68.1 percent of the average salary of men in 2006) (2010), 74.4 (2011) Likely Goal 4. Reduce child mortality For methodological aspects the metadata provided by NBS can be consulted at

7 Target 1. Reduce infant mortality from 18.5 (per 1,000 live births) in 2006 to 16.3 in 2010 and 13.3 in (2010), 10.9 (2011) Likely Target 2. Reduce the under-5 mortality rate from 20.7 (per 1,000 live births) in 2006 down to 18.6 in 2010 and 15.3 in Target 3. Maintain the proportion of children under 2 years with vaccination against measles at no lower than 96 percent in 2010 and (2010), 13.4 (2011) Likely (2010) and 91.3 (2011) Unlikely Goal 5. Improve maternal health Target 1. Reduce the maternal mortality rate from 16 (per 1,000 live births) in 2006 to 15.5 in 2010 and 13.3 in (2010) and 15.3 (2011) Unlikely Target 2. Maintain the number of births assisted by qualified medical staff during 2010 and 2015 at 99 percent (2010, 2011) Likely Goal 6. Combat HIV/AIDS, tuberculosis and other diseases Target 1. Stabilize the spread of HIV/AIDS infection by Reduce HIV/AIDS incidence from 10 cases per 100,000 population in 2006 to 9.6 cases by 2010 and 8 cases by (2010), 17.6 (2011) Unlikely Target 2. Reduce HIV/AIDS incidence in the year age group from 13.3 cases per 100,000 population in 2006 to 11.2 cases by 2010 and 11 cases by (2010), 18.4 (2011) Highly unlikely Target 3. Halt and begin to reverse the spread of tuberculosis by Reduce the rate of mortality associated with tuberculosis from 15.9 (per 100,000 population) in 2002 down to 15.0 in 2010 and 10.0 in (2011) Unlikely Goal 7. Ensure a sustainable environment Target 1. Integrate principles of sustainable development into country policies and programs and reduce degradation of natural resources. Increase forested area from 10.3 percent in 2002 to 12.1 percent in 2010 and 13.2 percent in Target 2. Increase the share of protected areas to preserve biological diversity from 1.96 percent in 2002 to 4.65 percent in 2010 and 4.65 percent in n/a n/a 4.76 n/a n/a Target 3. Increase the share of people with permanent access to safe water sources from 38.5 percent in 2002 up to 59 percent in 2010 and 65 percent in n/a n/a Target 4. Increase the share of people with permanent access to sewage systems from 31.3 percent in 2002 to 50.3 percent in 2010 and 65 percent in (2010) and 54.6 (2011) Likely Target 5. Enlarge the population with access to sanitation systems from 41.7 percent in 2002 to 51.3 percent in 2010 and 71.8 percent in N/A n/a n/a Goal 8. Create a global partnership for development Target 1. Further develop a transparent, predictable and non- Trade balance (% of GDP) Trade balance (% of GDP) (2010), - Likely

8 discriminatory trade and financial system based on rules through promoting exports and attracting investments. Target 2. Deal with issues associated with Moldova's landlocked status by upgrading transportation and customs infrastructure (2011) Share of investment in Share of investment in transportation transportation sector, (% sector, (% of public investment) 16.4 of public investment) (2010) and 10.7 (2011); Share of 7.2; investment in air and naval transportation (% of investment in Share of investment in transportation) 58.7 (2010) and 15.4 air and naval (2011) transportation (% of investment in transportation) 27.5 Unlikely Target 3. Monitor external debt issue External public debt (% of GDP) 15.9; Gross external debt (% of GDP) External public debt (% of GDP) 23.2 (2010), 21.7 (2011); Gross external debt (% of GDP) 82.3 (2010), 77.9 (2011) Likely Target 4. Develop and implement youth strategies. Reduce unemployment among youths to 15 percent in 2010 and 10 percent in (2010), 14.9 (2011) Unlikely Target 5. Ensure access to basic medication n/a n/a n/a Target 6. Build an information society. Double the number of fixed and mobile telephone subscribers from 2006 to 2015 and increase the number of personal computers and Internet subscribers at a minimum annual rate of 15 percent Fixed telephony penetration per 100 population 32.6 (2010), 33.6 (2011) Likely