Executive Summary

This Situation Analysis is produced in accordance with UNICEF procedures, which mandate such an assessment prior to the preparation of a new country programme. Its conceptual framework draws on the principles of human rights, and in particular the Convention on the Rights of the Child. It adopts the causal analysis approach that examines the immediate, underlying and basic causes for specific outcomes.

The report begins by describing the political and socio-economic context of Iraq, a country which, after a decade of conflict in the 1980s and early 1990s, has been under comprehensive United Nations sanctions for 11 years, and the various arrangements put in place since 1996 to mitigate the impact of sanctions on the population. Overall, these efforts appear to have arrested the deterioration of the situation, but not to have greatly improved conditions for the majority of the population, which is now close to 25 milllion.

In terms of children's rights to life and survival the report notes that infant mortality today is 107 per 1,000 live births, over double what it was at the end of the 1980s (47), and that under-five mortality is 131 deaths per 1,000 live births, two-and-a-half times what it was a decade ago (56). It also notes that 15.9% of children suffer from being moderately to severely underweight or from general malnutrition; 22.1% suffer from moderate to severe stunting or chronic malnutrition; and 5.9% suffer from moderate-severe [sic]

The immediate causes for this situation include disease and malnutrition, with preventable illnesses such as diarrhoea and respiratory infections accounting for 70% of the mortality. In 1998, 22.8% of children - more than on in five - suffered from malnutrition. Nearly a quarter of babies were low birth weight, indicating malnutrition in mothers. Micro-nutrient deficiencies also affect the population.

The underlying causes include the paucity of resources to rehabilitate service sectors, including health, water and sanitation, and electricity, as well as in education. Iraq's electricity "deficit" is estimated to be over 2,300 megawatts, and power cuts affect the majority of the population, with knock-on effects on the provision of clean water and treatment of sewage. Between 1990 and 2000, the daily per capita share of potable water went from 330 litres to 150 litres in Baghdad, 270 to 110 in other urban areas, and 180 to 65 in rural areas. Some 500,000 tons of raw sewage are dumped into fresh water bodies each day. At the household level, causes include poverty, with many Iraqis living on as little as $3 to $6 a month, as well as behaviours such as early marriage, insufficient birth spacing, and the low rate of exclusive breast-feeding.

Basic causes include systems-related as well as crises and sanctions-related causes. As regards systems, links between different sectors are week; human resources are insufficient; very low user fees do not encourage conservations of scarce resources; government policies equate universal and uniform coverage with equity; and there is insufficient data for anallysis and planning. The cumulative effects of two major wars and more than a decade of economic sanctions have resulted, among other things, in the non-availability of sufficient financial resources to provide and support effective services; ad hoc, intermittent, and insufficient supplies; restrictions on purchase of local goods, and an increase in the numer of female headed households.

Interventions have addressed the immediate and underlying causes, but not the basic causes. Interventions include screening of children to detect malnutrition and address it throught therapeutic feeding; Vitamin A and other supplements; iodisation of salt; an intensive immunisation campaign; and some rehabilitation fo services and utilities.

In terms of children's education, the Multiple Indicator Cluster Survey (MICS) undertaken in the year 2000 revealed that as many as 23.7% of children are not attending primary school, with nearly twice as many girls staying out of school as boys - 31.2% of girls and 17.5% of boys. Other worrying trends include the sharp decline in adult female literacy.

Immediate causes include the decline in coverage and quality, with two and sometimes three shifts in schools due to the shortage of buildings and teachders; few books and supplies ;and little revision of the curriculum in recent years. Underlying causes include the fact that some 8,613 school buildings are still in a deteriorated state, and 5,132 additional buildings are needed, and that sanitation and other services are lacking. Underlying causes at the household elevel include poverty; family attitudes to education in general given that highly educated graduates are earning a living driving taxis; attitudes to girls' education; and early marriage.

Systems-related basic causes include a need for more emphasis on quality; weak linkages between sectors; insufficient community involvement; weak management information systems and the need for reform of key policies that inhibit effective targeting of assistance for the most vulneraqble. Crises and sanctions-related basic causes include insufficient resources to rehabilitate and rebuild facilities and to mjeet new growth; the stagnant economy affects household incomes and drives teachers out of the system; and there is a difficulty in securing supplies and spare parts. Again, interventions have focused on immediate and underlying cauxses. These include partial or full rehabilitation of 1,000 schools, and some in-service teacher training.

As regards the right of vulnerable children to protection, perhaps the most striking aspect is the lack of sufficient information. There is clearly an increase in the number of children working on the street, as well as in the number of orphans needing state assistance, together with an inability of existing institutions to meet the need of these children or of children with disabilities. The situation has improved a little during 2001, although more resources are necessary together with more social awareness of the issues.

In terms of women's human rights, there is a sharp increase in maternal mortality, which means that women are not getting emergency obstetric care when they suffer complications durinjg pregnancy and childbirth. There is also a lower rate of girls' attendance in primary school, and a dramatic rise in female illiteracy. The discrepancy between females and males in this area can be attributed to poverty compounded by lingering negative attitudes to girls' education. Economic need is driving low and middle income women into the work force, but opportunities are constrained by the overall economic situation.

The main conclusion from the analysis is that unless basic causes are addressed, the best that can be hoped for from programme intervention is a mitigation of the situation. To date, programme interventions have not addressed basic causes. Given this situation, the report concludes that, while programme interventions are important, rights-based advocacy should be top of the ist of priorities so as to ensure that basic causes are addressed. Rights-based advocacy could promote the understanding necessary to secure a change in the present conditions and policies, and, in particular, to secure the resources necessary to rehabilitate key service sectors in a sustained and sustainable manner, to support a shift from humanitarian efforts to comprehensive long-term development planning and to review policies that inhibit the effectiveness of programe interventions - such as the inclusion of breastmilk substitutes in the universal food ration. The report's recommendations for rights-based advocacy, research and programme interventions include:

Advocacy and Research

  1. Advocacy should highlight the importance of securing the requisite resources to rehabilitate each of the water and sanitation, electricity, health, and education sectors both for present users and to meet population growth. Further research is necessary on the plans and resources for each sector, the inter-relations amongst these sectors, the obstacles to rehabilitation, the gaps in skills and capacities and the impact this has on the rights of children. Capacity for data collection and analysis should be supported in the relevant institutions to produce this research.
  2. Another key issue for advocacy is the need to shift from a humanitarian approach, which by definition consists of discrete and standalone activities, to a comprehensive medium- to long-term development approach.
  3. A furhter issue for advocacy is that Iraq should be able to use its financial resources to purchase locally supplied goods and services in order to ignite the economy and give families more opportunities to earn a living wage.
  4. Advocacy to promote policy reform is needd in several areas including the composition fo the food basket/ration (i.e. withdrawal of infant formula and inclusion of more food for pregnant and lactating women) and the promotion of targeted assistance to the most vulnerable groups (i.e. female headed households, out of school children) and communities.
  5. The existence of vulnerable groups of children and women, and the need for resources to promote the human rights of these groups and their special needs, is an important point to highlight.
  6. Advocacy for behavioural change is necessary on issues like girls' education and the use of scarce resources such as water and electricity.

Programme Interventions

  1. More focus is required on reduction of neo-natal mortality (improving feeding and anaemia prevention among pregnant and lactating women, prevention of low birth weight, withdrawal of infant formula from food ration, promotion of breastfeeding)
  2. Programme interventions that support stronger links between the education, health and nutrition, and water and sanitation sectors would enable optimum use of scarce resources.
  3. A better understanding of how the systems function in each o fthe sectors and where the national and local bottlenecks and capacity gaps are would greatly assist future development in general, and effective and timely co-ordination and decision making on cross-sectoral issues in particular.
  4. A more comprehensive plan for health information campaigns would make better use of scarce resources, factoring in a range of health, nutrition, environmental, and behavioural issues, including family planning, birth spacing, early marriage, exclusive breast-feeding, as well as disease control, water quality, personal hygiene, and disposal of sanitation.
  5. The quality of education emerges as a major issue, in particular the revision of the curriculum and investment in teacher and management salaries, capacities and skills.
  6. Girls' education and related household factors need to be addressed through targeted support, as well as public awareness campaigns.
  7. Further investment is necessary in management information systems, and data is needed in several areas, for example, what are children no longer enrolled in schools doing with their time?
  8. More popular awareness of and community involvement in resource use, along with modest user fees would assist in conserving and rehabilitationg the water and sanitation and electricity sectors and in potection of the environment.
  9. More comprehensive planning would assist the rehabilitation of the water and sanitation sector.
  10. Collaboration between the Ministry of Labour and Social Affairs and the Ministry of Health could help to address the issue of avoidable disability during delivery.
  11. For orphans and street/working children, it would be useful to put mechanisms in place to detect families and children at risk, who could then be given special support.
  12. Introducing emergency obstetric care as part of regular services in clinics and at hospitals will save pregnant women's lives.
  13. Support is necessary to expand the business and employment opportunities available to women, particularlay female heads of household.
  14. Special support for women's education and eradication of illiteracy is needed.

© UNICEF 2002
Electronic version prepared by CASI