2015年-世界发展银行全球_Former_Yugoslav_Republic_of_Macedonia_Early_Childhood_Development___SABER_Country_Report_2015_27页_740kb

Summary of the Former Yugoslav Republic of Macedonia's Early Childhood Development (ECD) Situation

Core Content

The Former Yugoslav Republic of Macedonia (FYROM) is a country with 2.1 million people, located in the Balkan Peninsula. It is classified as an upper middle-income country with a gross national income per capita of $4870 in 2013. The country has a relatively high human development index (84th out of 187 countries in 2013), but faces significant challenges in ensuring equitable access to early childhood development (ECD) services.

The SABER-ECD (Systems Approach for Better Education Results - Early Childhood Development) report highlights three core policy goals for improving ECD outcomes: Establishing an Enabling Environment, Implementing Widely, and Monitoring and Assuring Quality. Macedonia is currently classified as Emerging in the first goal and Established in the latter two.

Main Policy Goals and Key Findings

1. Establishing an Enabling Environment

• Preprimary Education: Not mandatory, with an enrollment rate of 21.8% (2005–2012). Rates are even lower among Roma children (4%) and the poorest quintile (4%).
• Legal Framework: Exists but is not comprehensive. Laws on health, social protection, and child protection are in place, but lack integration and robust mechanisms.
• Financing: Inadequate tracking of ECD spending, necessitating new mechanisms to fund increased enrollment and service quality.
• Intersectoral Coordination: Limited, with unclear roles and responsibilities among ministries. The Ministry of Education (MoE) does not oversee preprimary education, which is the responsibility of the Ministry of Labor and Social Policy (MoLSP).
• Healthcare: Free basic health services are available for pregnant women and young children, but coverage and quality of services, particularly in nutrition and breastfeeding, are insufficient.

2. Implementing Widely

• Coverage Gaps: Preprimary enrollment is low, especially in rural areas and Roma settlements, where only 2.6% of four-year-olds attend preschool.
• Equity Issues: Disparities in access to preprimary education exist, with wealthier children more likely to attend than poorer ones.
• Health Interventions: Immunization coverage is high (96% for DPT3), but exclusive breastfeeding rates are low (23% for 2008–2012), with Roma settlements showing slightly higher rates (32.1%).
• Child Protection: Services are in place, including birth registration, legal protections for pregnant women, and mechanisms to address domestic violence and child abuse. However, there is no specialized child court and limited integration of services.

3. Monitoring and Assuring Quality

• Data Collection: Macedonia collects administrative and survey data, but lacks a comprehensive system for tracking ECD outcomes.
• Standards: Professional and service delivery standards exist, but they could be strengthened to align with international best practices.
• Compliance: There is high compliance with existing standards, but no systematic enforcement or quality assurance mechanisms in place.

Key Recommendations

• Develop and disseminate Macedonian and Albanian language materials on the benefits of breastfeeding.
• Train healthcare workers to support and educate mothers on breastfeeding.
• Engage the media, NGOs, and community leaders in promoting breastfeeding.
• Improve intersectoral coordination between the Ministry of Health (MoH) and the Ministry of Labor and Social Policy (MoLSP) to ensure integrated services for children.
• Establish clear delineation of responsibilities for different age groups (e.g., 0–2 years under health and social protection, 3–5 years under education).
• Expand nutrition programs, particularly focusing on iron fortification and anemia prevention.
• Strengthen preprimary education financing and tracking mechanisms to increase enrollment and improve service quality.
• Ensure that preprimary education curricula are aligned with primary school standards to better prepare children for formal schooling.

Regional Comparison

Example of Effective ECD Coordination: Chile

Chile's Chile Crece Contigo program is an example of an effective intersectoral ECD initiative. It involves a multidisciplinary approach and multisectoral coordination at all levels of government, including a Presidential Council for planning and budgeting, and institutional bodies at regional, provincial, and local levels for supervision and support. This model could be useful for Macedonia to improve its ECD coordination.

Conclusion

Macedonia has made progress in establishing ECD services, particularly in health and child protection, but significant gaps remain in preprimary education access, intersectoral coordination, and financial tracking. Strengthening these areas is essential for improving child development outcomes and long-term economic and social equity.