SITUATION ANALYSIS OF CHILDREN AND
WOMEN IN KOSOVO
UNICEF Kosovo
February 2004
UNICEF Kosovo Office
SITUATION ANALYSIS OF CHILDREN AND
WOMEN IN KOSOVO
Table of Contents:
Situation Analysis of Children and Women in Kosovo
Table of Contents
List of Tables....................................................................................................................... i
Acronyms i
Map of Kosovo ................................................................................................................... ii
Executive Summary ........................................................................................................... 1
1.
Introduction ........................................................................................................... 4
1.1
Population Changes .............................................................................................. 9
1.1.1
Post-Conflict Demographic Data ........................................................................ 9
1.1.2
Ethnic Breakdown ............................................................................................ 10
1.1.3
Age and Sex Distribution ................................................................................. 11
1.1.4
Rural/Urban Migration Patterns ........................................................................ 12
1.2
Political-Administrative Context in Kosovo .......................................................... 13
1.2.1
Transitional Government (PISG) and Administrative (UNMIK) Institutions ....... 13
1.2.2
Implications for Social Development ................................................................ 15
1.2.3
Municipal Government ..................................................................................... 15
1.2.4
The Role of Civil Society .................................................................................. 16
1.3
Economic Overview ............................................................................................ 17
1.3.1
Structure of the Economy ................................................................................ 18
1.3.2
Employment ..................................................................................................... 18
1.3.3
Structure of Unemployment ............................................................................. 19
1.3.4
Youth Unemployment ...................................................................................... 20
1.4
Public Expenditures and Policies ........................................................................ 20
1.4.1
The Health System .......................................................................................... 21
1.4.2
The Education System ..................................................................................... 22
1.4.3
Social Welfare ................................................................................................. 24
1.4.4
Youth ............................................................................................................... 24
1.4.5
Administration of Justice .................................................................................. 25
1.5
1.5.1
UNICEF's Medium-Term Strategic Plan and the
Millennium Development Goals ........................................................................... 26
Why are the Millennium Development Goals relevant to Kosovo? ................... 26
2.
Early Childhood Development ............................................................................. 27
2.1
Antenatal Care .................................................................................................... 28
2.1.1
Quality of Care ................................................................................................. 29
2.1.2
Maternal Nutrition and Health .......................................................................... 30
2.1.3
The Situation of Minorities ............................................................................... 30
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Situation Analysis of Children and Women in Kosovo
2.1.4
2.2
Table of Contents
Maternal Mortality ............................................................................................ 30
Infant Mortality .................................................................................................... 31
2.2.1
Perinatal and Neonatal Mortality ...................................................................... 32
2.2.2
Breast Feeding ................................................................................................ 32
2.2.3
Nutrition ........................................................................................................... 33
2. 3 Immunisation ........................................................................................................... 34
2.3.1
EPI Reporting and Surveillance System .......................................................... 35
2.3.2
Social Mobilisation and Communication ........................................................... 36
2.3.3
Epidemiology of Vaccine Preventable Diseases in Kosovo .............................. 36
2.3.4
Common Childhood Illnesses .......................................................................... 37
2.3.5
Safe Drinking Water ......................................................................................... 37
2.3.6
Under-Five Mortality Rate ................................................................................ 38
2.4
2.4.1
2.5
Care and Development ....................................................................................... 38
Care within the Home ...................................................................................... 38
Early Childhood Development Programmes ........................................................ 39
2.5.1
Kindergarten .................................................................................................... 39
2.5.2
Community-Based Education Centres ............................................................. 40
2.5.3
Pre-Primary Classes ........................................................................................ 40
2.5.4
Increasing Coverage ........................................................................................ 40
2.5.5
Girls and Minorities .......................................................................................... 41
2.5.6
Training ........................................................................................................... 41
2.5.7
Preschool Curriculum....................................................................................... 41
2.5.8
Parental Awareness ......................................................................................... 42
2.6
Policy Agenda for Early Childhood Development ................................................ 42
3.
Children and the Education System .................................................................... 44
3.1
Enrolment: Who’s in School? .............................................................................. 45
3.1.1
Primary and Lower Secondary School ............................................................. 46
3.1.2
Upper Secondary School ................................................................................. 47
3.1.3
Retention Rates ............................................................................................... 48
3.1.4
Relevance........................................................................................................ 49
3.2
Ensuring a Quality Education .............................................................................. 50
3.2.1
Learning Environment ...................................................................................... 50
3.2.2
Learning Content ............................................................................................. 52
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Situation Analysis of Children and Women in Kosovo
3.2.3
Table of Contents
Learning Process ............................................................................................. 53
3.3
Girls' Education .................................................................................................. 54
3.4
Policy Agenda ..................................................................................................... 55
4.
Young People ..................................................................................................... 56
4.1
Young People's Health ........................................................................................ 56
4.1.1
Tobacco consumption … time to kick the habit? .............................................. 57
4.1.2
Alcohol and Drugs ........................................................................................... 57
4.2
4.2.1
4.3
Sexual and Reproductive Health ......................................................................... 58
Low Contraceptive Use .................................................................................... 59
HIV/AIDS ............................................................................................................ 60
4.3.1
Knowledge and Behaviour ............................................................................... 60
4.3.2
More Needs to be Done ................................................................................... 61
4.4
Youth and Participation ....................................................................................... 61
4.4.1
“Democracy” in the Family ............................................................................... 62
4.4.2
Youth and Society............................................................................................ 62
4.4.3
The Role of Youth Organisations ..................................................................... 63
4.4.4
The Need for Space …. ................................................................................... 63
4.4.5
Relationship with Governmental Institutions..................................................... 64
4.4.6
The Source of Decision-Making Power. ............................................................ 65
4.4.7
Media and Youth.............................................................................................. 65
4.5
Policy Agenda for Youth ...................................................................................... 66
5.
Protection from Violence, Abuse, Exploitation and Discrimination ....................... 67
5.1
The Concept of Child Rights ............................................................................... 67
5.2
Policies and Legislation ....................................................................................... 73
5.3
Child Labour........................................................................................................ 74
5.3.1
Nature and Extent ............................................................................................ 74
5.3.2
Ethnic Differences............................................................................................ 75
5.3.3
Access to Education ........................................................................................ 76
5.4
Commercial Sex Work and Trafficking ................................................................ 77
5.4.1
Extent .............................................................................................................. 77
5.4.2
Awareness ....................................................................................................... 78
5.5
5.5.1
5.6
Domestic Abuse .................................................................................................. 78
Extent .............................................................................................................. 79
Children without Parental Care............................................................................ 79
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Situation Analysis of Children and Women in Kosovo
5.7
Juvenile Justice ................................................................................................... 81
5.7.1
5.8
Table of Contents
Children Deprived of Liberty............................................................................. 82
Children with Disabilities ........................................................................................ 83
5.8.1
Extent .............................................................................................................. 83
5.8.2 Access to Education .......................................................................................... 83
5.8.3
Special Schools ............................................................................................... 84
5.8.4
Teacher Training.............................................................................................. 84
5.9
Minorities ............................................................................................................ 84
5.9.1
Ethnic Composition .......................................................................................... 85
5.9.2
Access to Services .......................................................................................... 85
6.0
Gender Discrimination ......................................................................................... 86
6.1
Policy Agenda ....................................................................................................... 87
List of Indicators ............................................................................................................... 90
Conceptual framework ..................................................................................................... 90
Bibliography ................................................................................................................... 104
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Situation Analysis of Children and Women in Kosovo
List of Tables
List of Tables
Table 1 Census Data 1948 – 2003 ........................................................................................ 9
Table 2 Estimated Current Population................................................................................... 9
Table 3 Breakdown by Ethnic Group ................................................................................... 10
Table 4 Population Growth Indicators ................................................................................. 10
Table 5 Urban/Rural Population Ratio ................................................................................. 12
Table 6 Structure of Output by Sector ................................................................................. 18
Table 7 Employment by Sector ........................................................................................... 19
Table 8 Employment Rates ................................................................................................. 19
Table 9 Youth Unemployment Indicators for Selected Countries ......................................... 20
Table 10 Government of Kosovo Budget Allocations (million €) .......................................... 21
Table 11 Health Expenditures by Category (million €) ......................................................... 22
Table 12 Education Resources at Municipal Level (million €) .............................................. 23
Table 13 The New Education System in Kosovo ................................................................. 23
Table 14 Perinatal Indicators in Kosovo (PEPC 2002) ........................................................ 31
Table 15 Causes of Neonatal Deaths.................................................................................. 32
Table 16 KOSOVO EPI SCHEDULE ................................................................................... 34
Table 17 Primary and Lower Secondary School Coverage ................................................. 46
Table 18 Primary and Lower Secondary School Enrolment ................................................ 46
Table 19 Upper Secondary School Enrolment..................................................................... 47
Table 20 Education Enrolment (per cent) ............................................................................ 48
Table 21 Children without Parental Care ............................................................................. 80
Acronyms
February 2004
i
Situation Analysis of Children and Women in Kosovo
AAK
ANC
ARI
BFHI
BMI
CBC
CEDAW
CRC
CRS
CSO
CSW
DHS
ECD
EMIS
EPI
EU
FAO
FHH
FRY
GDI
GDP
GOK
HDI
HBV
HIV
IDP
IOM
IMF
IMR
IPH
IRC
KAP
KCB
KEC
KFOR
KLA
KPS
KYN
LDK
LFS
LMS
Alliance for the Future of Kosovo
Antenatal Care
Acute Respiratory Infection
Baby Friendly Hospital Initiative
Body Mass Index
Community Based Centres
Convention on the Elimination of All
Forms of Discrimination Against
Women
Convention on the Rights of the
Child
Catholic Relief Services
Civil Society Organisation (s)
Centres for Social Work
Demographic Health Survey
Early Childhood Development
Education Information Management
System
Extended Programme of
Immunisation
European Union
Food and Agriculture Organization
Female Headed Household
Former Republic of Yugoslavia
Gender Development Index
Gross Domestic Product
Government of Kosovo
Human Development Index
Hepatitis B Virus
Human Immunodeficiency Virus
Internally Displaced Person
International Organization for
Migration
International Monetary Fund
Infant Mortality Rate
Institute of Public Health
International Rescue Committee
Knowledge Attitudes and Practice
Kosovo Consolidated Budget
Kosovo Education Center
Kosovo Forces
Kosovo Liberation Army
Kosovo Police Service
Kosovo Youth Network
Democratic League of Kosovo
Labour Force Survey
Labour Market Survey
LSMS
MDG
MEST
MMR
MNSS
MTS
MTSP
NATO
NGOs
OB/GYN
OCHA
OECD
OHCHR
OSCE
PDK
PEM
PEPC
PISG
PSI
RAE
SITAN
SGPP
SME
SOK
SRSG
STI
TB
TTRB
UNDP
UNFPA
UNHCR
UNICEF
UNIFEM
WHO
Map of Kosovo
February 2004
List of Tables
ii
Living Standards Measurement
Survey
Millennium Development Goal(s)
Ministry of Education, Science and
Technology
Maternal Mortality Rates
Micronutrient Status Survey
Mother Teresa Society
Medium-Term Strategic Plan
(UNICEF)
North Atlantic Treaty Organization
Non-Governmental Organisation
Obstetrics and Gynaecological
Office for the Coordination of
Humanitarian Affairs
Organization of Economic
Cooperation and Development
Office of the High Commissioner for
Human Rights
Organization for Security and
Cooperation in Europe
Democratic Party of Kosovo
Protein-Energy Malnutrition
Promoting Effective Perinatal Care
Provisional Institutions of SelfGovernment
Population Services International
Roma, Ashkalia and Egyptian
Situation Analysis
School Grant Pilot Project
Small and Medium Enterprise
Statistics Office of Kosovo
Special Representative of the
Secretary-General
Sexually Transmitted Infection
Tuberculosis
Teacher Training Review Board
United Nations Development
Programme
United Nations Population Fund
United Nations High Commissioner
for Refugees
United Nations Children’s Fund
United Nations Development Fund
for Women
World Health Organization
Situation Analysis of Children and Women in Kosovo
Map of Kosovo
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Situation Analysis of Children and Women in Kosovo
Executive Summary
Executive Summary
One of the legacies of the conflict, and the years of neglect that preceded it, has been a
dearth of reliable data and analysis on the status of children and women in Kosovo. This
report, commissioned by UNICEF, attempts to fill this gap by drawing on a large body of
research (existing and new) that looks at a number of key issues impacting on the basic
rights of children and women in Kosovo. The Situation Analysis represents an opportunity to
take stock of the considerable achievements of the last four years and to set out an agenda
and vision for the post-conflict era in Kosovo and the new generation of young people. This
vision is rooted in the principles of the UN Convention on the Rights of the Child (CRC) and
the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)
which form the basis for UNICEF’s mandate.
Following the UN General Assembly Special Session on Children held in May 2002, UNICEF
prepared a five year Medium-Term Strategic Plan (MTSP) and identified five corporate
priority areas that would contribute to making the world a better place for children. These five
priorities are closely related to the Millennium Development Goals (MDGs) agreed upon at
the Millennium Summit in 2000:

Girls' education

Integrated early childhood development

Immunisation "plus"

Fighting HIV/AIDS

Protecting children from violence, abuse, exploitation and discrimination
These five priorities guide UNICEF programming in Kosovo.
This report focuses on children, young people and, to a lesser extent, on women in the
context of the importance of women's health, well-being and development if they are to
adequately care for and nurture their children. It also addresses the role of women within
civil society. It examines a number of conditions that lead to shortfalls in the realisation of
human rights at different stages of childhood and youth. The report is divided into five main
chapters. The introductory chapter provides an overview of key demographic, political,
economic and social developments in Kosovo in the post-conflict period. Drawing on existing
data, this chapter attempts to provide a context for the subsequent analysis on the current
status of respect for the rights of children and women.
Chapter two examines early childhood survival, development and a healthy start to life including the essential aspect of maternal health before, during and after pregnancy. There
are critical data shortages that have precluded the accurate determination of infant and
maternal mortality in Kosovo which need to be addressed. However, it is clear that both
maternal and infant mortality rates are high compared with other countries in the region.
Some progress has been made in decentralising the healthcare system to make it more
responsive to the needs of the communities. The emphasis, however, remains focused on
treatment rather than prevention. As a result, although most pregnant women have access
to antenatal services, it is not easy to obtain advice, counselling and guidance on how to
ensure a healthy pregnancy. The majority of women attend antenatal services infrequently
and mainly for ultrasound examinations. Most mothers (more than 95 per cent) give birth in
a health facility but maternal mortality is high (rate unknown – estimates vary from 509 to 12
per 100,000 live births). There is a need to raise awareness among women as to the quality
of health service they should both expect and demand.
Infant mortality is high at an estimated 35 per 1000 live births mainly due to poor delivery
practices and quality of newborn care. Perinatal mortality is 29 per 1000 live births. Recent
improvements in practices in health facilities have led to five maternity clinics/hospitals in
February 2004
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Situation Analysis of Children and Women in Kosovo
Executive Summary
Kosovo being certified as "baby-friendly". Among new mothers, 95 per cent initiate
breastfeeding while still in the maternity clinic but only 12 per cent go on to breastfeed
exclusively for the first six months of life. Under-five mortality is not recorded by the current
health information system but, for young children, overall immunisation coverage is quite
good at around 90 per cent. However, between the BCG dose given while newborns are still
in the health facility (99.5 per cent coverage) and the MMR vaccine given when the child is
12 to 18 months old (67 per cent coverage), a considerable reduction occurs. This indicates
the need to increase parental awareness of the importance of immunisation. There is also a
need to identify the small number of children not being vaccinated at all – almost certainly
from the Roma, Ashkalia, Egyptian (RAE) communities, as it is these mothers who are least
likely to give birth in a health facility and thus miss the opportunity even for BCG
immunization.
Pollution is high in Kosovo (industrial pollution, traffic and ubiquitous cigarette smoke) as is
the incidence of acute respiratory infections among children. Water quality and waste
management is poor, and there is a high incidence of diarrhoeal disease. Many women
smoke during pregnancy and there is a high incidence of low birth weight babies. There is a
need for greater awareness of health, nutrition and environmental issues among parents,
children and the general public.
In the area of early childhood development, including socialisation, much more could be
achieved. Most young children are cared for within the home and only a fraction of three to
six year olds attend any form of kindergarten or pre-school programme. As a result, they are
missing the opportunity to mix with other children and to understand other cultures and
practices among their peers from other communities. For the child this can make the
transition from home to primary school quite traumatic and can be detrimental to learning
achievement. Participation in good quality early childhood programmes before primary
school make children much more at ease with each other, more tolerant of differences
between them, and more eager and ready to learn.
The education level of mothers has been shown to be important for early childhood
development. In Kosovo, 14 per cent of rural women are illiterate (compared with four per
cent of men). Some studies show as much as 26 per cent of young women aged 16 to 19 to
be relatively illiterate with 9.5 per cent totally illiterate. This has direct implications for
parenting knowledge and skills
Chapter three analyses the interaction between children and the education system in
Kosovo. Globally, UNICEF has committed itself to ensuring that all girls complete a quality
primary education. In Kosovo, enrolment rates are high but there is a need to address
disparities - both ethnic- and gender-based. Primary enrolment is 97.5 per cent for Kosovo
Albanians, 99 per cent for Kosovo Serbs but only 77 per cent among the non-Serb minority
communities (Roma, Ashkali, Egyptian, Turkish, Bosniak, Gorani, etc) and for them drop out
is also high. Girls from Roma and Ashkalia communities often do not enrol at all, although
statistics are lacking. In terms of retention, there is a pressing problem especially among
girls. At the start of Grade 5 (age 11), around 10 per cent of girls leave the school system
and between 8th and 9th Grade (age 14/15) this rises to 30 per cent. (In Kosovo, there has
recently been an increase from eight to nine years of compulsory education). Almost half of
all girls from the Kosovo-Albanian community and 60 per cent of girls from the non-Serb
minority communities drop out before upper secondary (Grades 10-12). There are
indications that illiteracy rates are increasing for girls among the non-Serb minority
communities, as it has been more difficult for these children to access school since the
conflict and the resulting tensions - and preference is given to boys. In the Kosovo Serb
community there is traditionally a greater importance given to education – including for girls
– and both enrolment and retention rates are higher.
February 2004
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Situation Analysis of Children and Women in Kosovo
Executive Summary
Children with special needs tend to be kept at home and not benefit from any sort of
education. Of those few with special needs who do go to school, approximately 70 per cent
are boys.
Other issues affecting children within the education system include the existence of a
separate parallel system for children from the Kosovo Serb community, run from Belgrade by
the Serbian government. Also, after the war, many international agencies reconstructed
destroyed or damaged schools – rebuilding them on their original sites. In 1999, however,
there was a huge population shift from rural to urban areas in search of security and jobs.
Now many rural schools are underused while urban schools are grossly overcrowded and
forced to run up to four shifts a day - to the detriment of the children who in consequence
receive greatly reduced hours of teaching. The quality of the learning environment also
remains a problem. Teaching methods traditionally are fairly rigid with little interactive
teaching or learning. Materials are outdated and teacher's salaries are extremely low. A
comprehensive education reform programme is underway addressing curriculum
development, teacher training and other key issues. The challenges however remain
considerable.
Chapter four examines the specific situation of teenagers and young people in Kosovo.
According to population estimates, 50 per cent of Kosovars are under 25, 40 per cent of
whom are under 18. This age group grew up during a period of tremendous instability and
change. They are the generation mostly educated under the parallel system in the 90s and –
then as well as now – with little expectation of future jobs and opportunities. Whereas young
Kosovars previously lived in relative isolation within the culture and traditions of their own
communities, young people today have access to satellite TV and the internet – both of
which have fundamentally transformed attitudes and behaviours, particularly among urban
youth. These changes are manifested in a number of different ways relating to how young
people view their rights and responsibilities within society. Although this is the generation
that will provide the future parents, decision makers and leaders of Kosovo, they feel
marginalised and excluded from broader discussions about the future of Kosovo and
neglected by a system that is failing to address their needs and expectations. With a 57 per
cent overall unemployment rate in Kosovo and an even higher rate of 71.2 per cent for 16 to
24 year olds, there is an urgent need for better and different education and skills training for
young Kosovars. Despite this, the majority continue to feel positive about the future and
ready to put their energy and talents into making Kosovo a better place.
There are many concerns, not least the fact that knowledge and awareness about sexual
and reproductive health in general, and HIV/AIDS in particular, remain worryingly low. Less
than 50 per cent of 14 to 19 year olds surveyed knew that HIV could be transmitted through
shared needles and less than 41 per cent of sexually active young people use condoms on a
regular basis. Young people are frustrated by the inability to discuss these issues within the
family or to have them addressed at school. The health system does not lend itself to
providing "youth-friendly" services where young people can feel comfortable going for advice
or information and the education system does not yet provide a grounding in life skills. The
problems of unwanted pregnancies, high rates of abortion, abandonment of newborn babies
and the increased risk from sexually transmitted infections and HIV will not go away until and
unless fundamental changes in policies and practices are introduced. On a positive note,
surveys of young people show that almost all information on such matters comes to them
through the media, especially television, and this is becoming a powerful tool, enabling
young people to voice opinions and share views.
Chapter five deals with the promotion and protection of children's rights. Overall in Kosovo,
there is a need for greater awareness about the rights and responsibilities of children and
youth and of those who are there to care for and protect them. There are a number of
serious child protection issues that need to be addressed. For example, the growing
incidence of child labour. While most children are not engaged in hazardous forms of work,
and most manage to attend school as well, the sheer number of working children, some as
February 2004
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Situation Analysis of Children and Women in Kosovo
Executive Summary
young as ten, needs to be monitored, regulated and understood. There is also evidence of a
fairly dramatic increase in the reported cases of children being trafficked into and through
Kosovo as it becomes a major transit route and destination for victims of trafficking across
Eastern Europe. Other concerns such as children with special needs, children in conflict with
the law, children affected by domestic violence, neglect and abuse, all need to be much
more comprehensively understood and addressed.
Much has changed in Kosovo since 1999 and much has changed for the better. It is clear
that the future of Kosovo is inextricably linked to the fate of its youth with over 50 per cent of
the population under 25. This is the generation that will have to chart a new path that will
lead to Kosovo becoming an integral part of Europe and the global community.
1. Introduction
Kosovo came to international prominence in 1998-1999 when it appeared to be on the verge
of becoming the latest casualty of rising nationalist tensions in the Balkans region.1 After the
failure of the Rambouillet talks held in February 1999, the international community (under the
auspices of NATO) intervened militarily to prevent the ethnic cleansing and destruction that
had been witnessed in Bosnia- Herzegovina and Croatia earlier in the decade.2 In the
summer of 1999, Kosovo came under the administration of the United Nations (UNMIK)3 in
1
Part of [the former] Federal Republic of Yugoslavia, Kosovo is bordered by Albania, Macedonia, Serbia and
Montenegro and has a landmass of 10,887 square meters, which is roughly one-third the size of Belgium.
2
The talks attempted to broker an agreement between the government of Slobodan Milosevic and leaders of
the Kosovo Albanian community on the future of the province and would have given Kosovo substantial
autonomy within a federal Yugoslavia. Despite the willingness of the Kosovo Albanians to sign the
agreement, it was rejected by the Milosevic regime and thereby precipitating the crisis.
3
United Nations Mission in Kosovo.
February 2004
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Situation Analysis of Children and Women in Kosovo
Introduction
partnership with the European Union (EU) and the Organization for Security and
Cooperation in Europe (OSCE). Since 1999, more than US $1.7 billion in international
assistance has been provided to Kosovo in support of humanitarian relief and development
work, just over $900 million of which has been channelled through UN Agencies.4
One of the legacies of the conflict, and the years of neglect that preceded it, has been a
dearth of data and analysis on the status of children and women in Kosovo. This report,
commissioned by UNICEF, attempts to fill this gap by drawing on a large body of research
(existing and new) that looks at a number of key issues impacting on the basic rights of
children and women. The Situation Analysis represents an opportunity to take stock of the
considerable achievements of the last four years and to set out an agenda and vision for the
post-conflict era in Kosovo and the new generation. This vision is rooted in the principles of
the UN Convention on the Rights of the Child (CRC) and the Convention on the Elimination
of All Forms of Discrimination against Women (CEDAW) which form the basis of UNICEF’s
mandate.
The CRC establishes children's rights as enduring ethical principles and as international
standards of behaviour towards children. The CEDAW provides for the equal rights of
women and girls and requires their full participation in the political, social and economic
development of their communities. This Situation Analysis has been developed using a
human rights-based conceptual framework that reflects the three guiding principles of the
CRC and CEDAW – accountability, universality and the indivisibility and interdependency of
rights - as well as the four foundation principles of the CRC – non-discrimination, the best
interests of the child, the right to life, survival and development and respect for the views of
the child.5
The report focuses on children themselves and examines a number of conditions that lead to
shortfalls in the realisation of human rights at different stages of childhood and youth. It is
divided into five main chapters. The introductory chapter provides an overview of key
demographic, political and economic developments in Kosovo in the post-conflict period.
Drawing on existing data, this chapter attempts to provide a context for the subsequent
analysis of the current status of respect for the rights of children and women. Subsequent
chapters of the report are organised around the life-cycle of children – early childhood
development, involvement with the education system, and adolescence and youth – and
assess the inter-related problems encountered at each stage of childhood. The report also
analyses specific child rights and child protection issues.
The following section outlines the "problem tree" analysis around four main themes or key
issues and provides a conceptual overview for the report. Each table begins with a brief
over-arching problem statement before proceeding to identify its manifestations in the
context of Kosovo. The analysis then looks at the immediate and underlying causes. The
analysis identifies specific causes that relate to key aspects of children’s rights, as well as a
number of causes (such as the status of women and youth) that cut across a number of
areas and which need to be addressed. In particular, the analysis provides evidence that
more attention needs to be given to the related activities of advocacy and social mobilization
if respect for children’s rights is to become a reality in Kosovo.
4
This figure covers development assistance only. When factoring the cost of the KFOR mission and
expenditures by humanitarian agencies, an estimated US$10 billion has been spent on Kosovo. It should be
noted, however, that much of this has not been spent in Kosovo itself.
5
Using a human rights-based conceptual approach has a number of important implications for the preparation
of the SITAN. It will require a shift in focus from meeting the basic needs of children through service
provision to working to strengthen and build institutions. It will involve increasing the awareness and
understanding of the situation and rights of children among both policy makers and civil society actors.
Finally, it will require acting as advocates for children to be [become] stakeholders in their own lives and
futures.
February 2004
6
Situation Analysis of Children and Women in Kosovo
Introduction
A Chronology of Recent Historical Events in Kosovo
1945 – 1991
Kosovo exists as a province within the Socialist Federal Republic of
Yugoslavia. The 1974 Constitution grants substantial autonomy to
Kosovo.
March 1989
Kosovo’s autonomous status is revoked by emergency legislation.
December 1989
The Democratic League of Kosovo (LDK) is formed under the
leadership of Ibrahim Rugova. The LDK emphasise non-violent
political resistance.
1990
Laws passed by the Serbian Parliament leads to the removal of most
Albanians from the public sector, civil service and managerial
positions. Doctors and educators are dismissed and Albanians begin
to rely on the parallel system to meet their basic needs.
1992
The Socialist Federal Republic of Yugoslavia is dissolved and the
new Federal Republic of Yugoslavia (FRY) is formally recognised by
the European Union. The FRY is made up of Serbia and Montenegro,
and Kosovo is considered a province of Serbia under Belgrade’s
control.
1997
The Kosovo Liberation Army intensifies its armed action against
Serbian rule.
February 1998
The first reported massacre occurs in the Drenica region. Clashes
between the KLA and the Yugoslav Army increase in frequency and
February 2004
7
Situation Analysis of Children and Women in Kosovo
Introduction
intensity.
March 1999
The NATO bombing campaign begins following the failure of
Rambouillet Peace talks. A massive refugee crisis develops as over
800,000 people flee the conflict.
June 1999
The Yugoslav Army withdraws from Kosovo. UN Security Council
Resolution 1244 is passed bringing Kosovo under UN Administration
but guarantees FRY sovereignty.
October 2000
Municipal Elections are held in Kosovo.
May 2001
The promulgation of the Constitutional Framework for Provisional
Self-Government in Kosovo.
November 2001
Elections to the National Assembly of Kosovo are held with the LDK
emerging as the largest party, followed by the PDK.
March 2002
The Provisional Institutions of Self-Government (PISG) are sworn in
by the Special Representative of the Secretary-General (SRSG).
Certain key governmental functions are transferred to PISG control.
October 2002
Second round of Municipal Elections are held.
February 2004
8
Situation Analysis of Children and Women in Kosovo
1.1
Population Changes
Population Changes
Kosovo is characterized by a lack of accurate demographic data that is a consequence of its
turbulent recent history and the significant population changes that accompanied it. The last
commonly accepted census in Kosovo took place in 1981, when the total population was
estimated to be 1,584,000.6 This represents a near doubling of the population since the end
of World War II. The most notable feature is the growth in the Albanian population relative to
other communities in the intervening decades between the late 1940s and early 1980s (see
Table 3).
Table 1 Census Data 1948 – 2003
Year
Total Population
1948
729,000
1953
808,000
1961
964,000
1971
1,244,000
1981
1,584,000
1991
1,956,000
2003
2,000,000
Source: UNFPA-IOM-SOK 2000
2003 figures are population estimates from the Statistics Office of Kosovo (SOK)
1.1.1
Post-Conflict Demographic Data
Despite coming under UN Administration, no comprehensive census has yet been
conducted and the absence of reliable population data remains one of the most fundamental
constraints to effective social planning in Kosovo. Various attempts have been made to
shed light on the current demographic situation using data drawn from a variety of sources.
The information presented in Table 2 draws from the Demographic Health and SocioEconomic Survey (DHS) conducted by the United Nations Population Fund (UNFPA) in
conjunction with the International Organization for Migration (IOM) and the Statistics Office
of Kosovo (SOK) (2000) and the Living Standards Measurement Survey (World Bank
2000a), which are considered to be the most reliable sources of quantitative data available. 7
The population density of 200 persons per square kilometre is one of the highest in Europe.
Table 2 Estimated Current Population
World Bank
UNFPA-IOM-SOK
6
Following the re-imposition of direct rule from Belgrade in 1989, a census was held in 1991. The results are
considered unreliable due to the low levels of participation from the majority Kosovo-Albanian community.
However, it should be noted that the results of the 1991 census showed a similar pattern of high population
growth for Albanians relative to other ethnic groups in Kosovo.
7
The DHS is due to be updated in 2003 and will provide some basic trend data in the post-conflict period
(albeit with a base year of 2000).
February 2004
9
Situation Analysis of Children and Women in Kosovo
2000
2001
Population Changes
Low variant
1,746,932
1,586,000
High variant
1,923,413
1,886,000
Low variant
1,778,377
1,614,548
High variant
1,958,034
1,919,948
Source(s): World Bank 2000 and UNFPA-IOM-SOK 2000
1.1.2
Ethnic Breakdown
The demographic picture was further
Population by Ethnic Group
complicated by the conflict that saw a
massive movement of population both
90%
during and after the hostilities. The
80%
conflict itself displaced upwards of
70%
800,000 Kosovo Albanians (mainly to
60%
the FYR Macedonia and Albania) plus
50%
40%
another 500,000 people who were
30%
internally displaced within Kosovo.
20%
Following the NATO intervention and
10%
0%
the end of hostilities in June 1999,
1948
1953
1961
1971
1981
1991
2003
around 242,000 non-Albanians left
Kosovo. Of these, around 200,000
Albanian Serbian Other
Serbs and Montenegrins and 35,000
people from minority groups (mainly
Roma) are registered in Serbia as displaced from Kosovo.8 Others are currently living in
Montenegro.
Table 3 Breakdown by Ethnic Group
Albanian
Serbian
Other
1948
68 per cent
24 per cent
8 per cent
1953
65 per cent
23 per cent
11 per cent
1961
67 per cent
24 per cent
9 per cent
1971
74 per cent
18 per cent
8 per cent
1981
77 per cent
13 per cent
10 per cent
1991
82 per cent
10 per cent
8 per cent
2003
88 per cent
7 per cent
5 per cent
To date, a little more than three per cent have returned to Kosovo despite a concerted effort
on the part of the international community to create the necessary "conditions for return".
Those minority families that have returned continue to remain confined to enclaves with
limited freedom of movement and access to services. It is estimated that the current nonAlbanian population of Kosovo is less than 200,000, made up of Serbian (7 per cent),
Bosniak (3 per cent), Roma (1.8 per cent), Turkish (0.8 per cent), and other minority groups
(0.4 per cent).
Table 4 Population Growth Indicators
Population
8
Population
Population
Crude Birth
Rate
UNHCR
February 2004
10
Crude Death
Rate9
Total
Fertility
Infant
Mortality
Situation Analysis of Children and Women in Kosovo
(millions)
Density
under 15
per sq km
per cent
Population Changes
per 1000
per 1000
(2)
per 1000
Kosovo
1.932
175
33
19
4
2.7
(18) 35 *
Albania
3.1
110
32
17
5
2.1
12
Croatia
4.3
75
20
10
12
1.4
8
Slovenia
2.0
100
16
9
9
1.3
5
Greece
11.0
80
15
10
10
1.3
6
Italy
58.1
190
14
9
9
1.3
5
8.9
20
18
10
11
1.6
3
Sweden
Source:
Kosovo and its Population, Statistics Office of Kosovo, September 2003 (revised version)
* The official SOK figure is 18/1000 but the commonly cited figure using data from the DHS 2000 is 35/1000.
1.1.3
Age and Sex Distribution
The problems with estimating accurate
population figures are magnified when
it comes to looking at the structure of
the population (age breakdown, sex
ratios, and urban-rural patterns). What
is clear, however, is that Kosovo has
one of the youngest populations in
Europe. Most estimates suggest that
young people (defined as below the
age of 25) make up over 50 per cent of
the population.10
Age Distribution by Quintile
Source: DHS 2000
12
10
8
6
4
2
0
The population pyramid is still
0-4
10 to 14
20-24
30-34
40-44
50-54
60-64
70-74
80-84
triangular, despite the squaring at the
base due to population movements.
Another particularity of the population is the shortage of males aged 20 to 50, mainly caused
by the emigration of males for economic reasons and deaths during the recent conflict
(estimates of fatalities range from 2,000 to 10,000), leading to significantly more females
than males in that age group. Although there are signs that Kosovo’s fertility patterns are
changing, households (except in the Kosovo Serbian community) continue to be large with
an average of 5.6 members per family (compared to France for example which has an
average size of 2.4 members per family). Moreover, a significant number (21 per cent) of
households are made up of two or more families. One-parent families make up around 10
per cent of all families with the vast majority (85 per cent) being headed by women. Just over
half (55 per cent) of female-headed households are the result of economic migration and
presumably most of the remainder due to the death of the husband. The high sex ratio for
small children, with significantly more boys than girls, should also be noted. Household
surveys show a slightly higher per cent of men (about 50.5 per cent) than women (about
49.5 per cent) in the total population of Kosovo.
9
The very low crude death rate suggests that death registration records in Kosovo are poor. It should also be
noted that Kosovo has the highest fertility rate in Europe.
10
The DHS did not present data based on ethnic groups and the tables presented above cover the entire
surveyed population in Kosovo. However, a number of important distinctions are worth noting. Overall the KAlbanian population is known to be younger than the K-Serb population. This is due to the fact that existing
K-Serb population is comprised primarily of those people who were either to old or lacked the resources to
move when the conflict ended. Family size in the K-Serb community is also known to be lower than for the KAlbanian population.
February 2004
11
Situation Analysis of Children and Women in Kosovo
Population Changes
Figure 1 : Age Pyramid
Source: Statistics Office of Kosovo
1.1.4
Rural/Urban Migration Patterns
Kosovo is still considered to be a predominantly rural society with between 55-60 per cent of
the population dependent on agricultural holdings for their livelihood. In the immediate
aftermath of the conflict there was, however, a marked increase in urban migration. The
collapse of the agricultural economy and destruction of housing were the most commonly
cited reasons among Albanians who moved. Another important factor was the availability of
employment opportunities with international organisations in the urban centres. Most
conservative estimates indicate that the population of Prishtina alone has doubled since the
end of the conflict. All indications are that those who have migrated to urban areas remain
there to this day. There has also been significant internal migration of Kosovo Serbs from
southern parts of Kosovo to Mitrovicë/Mitrovica and other municipalities that have Serb
majority populations.
The flow of population to urban areas has had negative impacts on both urban and rural
areas. In the case of the former, it has increased demand on already stretched resources. In
some cases, schools have to run up to four shifts a day, which has resulted in greatly
reduced contact hours per child. This reduction in the quantity of education is exacerbated
by a curtailment of extra-curricular activities within schools. One noticeable consequence of
this trend has been an increase in the number of children on the street involved in petty
trading or begging, which is a common sight in towns and cities. In contrast, in rural areas,
the decline in population has seen schools close due to an insufficient number of students,
resulting in reduced access for those who remain. It has also been reported that there is an
increased shortage of qualified teachers, many of whom have also migrated (these issues
will be discussed in more detail later in this report).
Table 5 Urban/Rural Population Ratio
1981
1991
2002
Rural
67.5
65
55
Urban
32.5
35
45
Source: RIINVEST Household Survey 2002
February 2004
12
Situation Analysis of Children and Women in Kosovo
Political-Administrative Context in
Kosovo
This demographic overview provides a snapshot of the Kosovo that has emerged from the
conflict. In the absence of accurate data it is, however, impossible to gauge how well Kosovo
is doing in terms of meeting the needs of its people. It is impossible to know what
percentages of children are enrolled in school. We know how many enrol and can track their
progress, but we do not know how many children should be in school. It enables us to
observe that sex ratios in the 0-9 age group favour boys, but it does not shed light on why
this is so. The World Health Organization (WHO) and Institute of Public Health (IPH) have
collected data on immunisation which indicates that between 25-50 per cent of children are
not immunised fully. We do not yet know who is being missed or why. While adequate
information is a basic pre-requisite, there is also a need to complement that with solid
qualitative analysis that will shed light on the root causes of the biggest problems facing
children and women in Kosovo.
1.2
Political-Administrative Context in Kosovo
The political status of Kosovo has long been a source of dispute and controversy. As part of
the former Federal Yugoslavia, Kosovo enjoyed a large measure of self-government and
autonomy. This enabled the development of local institutions and political leadership and
saw the emergence of a strong Kosovo Albanian identity. In 1989, however, these trends
were abruptly halted with the re-imposition of direct rule from Belgrade. Kosovo Albanians
were forced out of the administration and police force, schools were either closed or forced
to use Serbian as the only medium of instruction and access to medical services was limited.
In response to these changes the Kosovo Albanian community developed what came to be
known as the "parallel system" funded through an informal tax system. This parallel system
was responsible for providing basic health and educational services to the Albanian
community and, as the 2002 Kosovo UNDP Human Development Report acknowledges,
ensured that the impact of direct rule on basic social indicators was not catastrophic.
However, it also fundamentally undermined the capacity for self-government and effectively
disenfranchised the majority population. This institutional vacuum was mirrored within civil
society and remains a problem today.11 Under UNMIK auspices, Kosovo is attempting to
rebuild its basic democratic institutions at both the central and local levels, gradually
developing capacity within Ministries and local Municipalities, re-establishing the rule of law,
justice and respect for human rights, and to create a functioning and stable economy.
In June 1999, Security Council Resolution 1244 authorised the United Nations to administer
the province and to oversee the creation of a functioning administration. However, and most
significantly, unlike a similar UN mandate for East Timor, Resolution 1244 explicitly left open
the question of the final status of Kosovo. This failure is rooted in political differences that go
well beyond Kosovo but its impact on the current situation within Kosovo cannot be
underestimated. It is without doubt the single most
PISG Priority Areas
important issue in Kosovo, and has had a
profound impact not only on the political process
1. Consolidation
of
democratic
but also the prospects for economic and social
structures in Kosovo.
development.
2. Increasing the transparency and
efficiency of the administration.
1.2.1 Transitional Government and
Administrative Institutions
The mandate of UNMIK has been to oversee the
restoration of peace and stability in Kosovo and a
transition to local administration.
Municipal
3. Improving the educational standards
for all inhabitants of Kosovo.
4. Improving the quality of the health of
all inhabitants of Kosovo.
5. Promoting economic development
11
Since Kosovo came under UNMIK administration this situation has
to an extent
been reversed economic
in relation to
and
international
the K-Serb community. Today health, education and social welfare
responsibilities for (K-Serb majority)
cooperation.
areas remain under the administrative and financial control of Belgrade (although teachers and healthcare
professionals also receive a salary from the Kosovo Budget). 6. Increasing employment.
February 2004
13
7. Establishing pension insurance and
social assistance for vulnerable
groups.
8. Integrating all ethnic communities
into Kosovar society.
Situation Analysis of Children and Women in Kosovo
Political-Administrative Context in
Kosovo
elections in October 2000, followed by elections to the Kosovo Assembly in November 2001
and the formation of the Provisional Institutions of Self-Government (PISG) of Kosovo on 4th
March 2002, represented important milestones in fulfilling this mandate. The elections
resulted in a power-sharing agreement between the three main political parties in Kosovo:
the Democratic League of Kosovo (LDK), the Democratic Party of Kosovo (PDK) and the
Alliance for the Future of Kosovo (AAK). According to the agreement, Ibrahim Rugova of the
LDK and Bajram Rexhepi of the PDK hold the posts of President and Prime Minister
respectively, while members from the AAK hold two ministerial posts. Furthermore,
representatives from minority communities head two ministries (Health – Turkish, and
Agriculture - Serbian) under the terms of the transition agreement. Only one of the ten
positions is held by a woman (Health).
A second round of municipal elections was held in October 2002.12 There are 30
Municipalities in Kosovo and they all now have elected assemblies and an administration in
place.
The elections to the Assembly and the formation of the new Government have created the
basis for the beginning of a process of transfer of powers from UNMIK administration to local
control. With the exception of finance and economy, law and order, trade and foreign policy
the control of most governmental functions is now under local administration.13 Ministers
continue to be supported by a team of international advisors working under the auspices of
UNMIK. The chart below outlines in more detail how Kosovo is governed today.
12
However, voter turnout was significantly lower than in past elections, which highlights the fragility of the
political system in Kosovo.
13
The Assembly is responsible for the nomination of judges and prosecutors, but these are still appointed at
the discretion of the SRSG.
February 2004
14
Situation Analysis of Children and Women in Kosovo
Political-Administrative Context in
Kosovo
Figure 2 Administrative Organogram Source: UNMIK
1.2.2
Implications for Social Development
The transfer of power to the PISG has significant implications for the future of children’s
rights in Kosovo. It is the Kosovo government that will assume the responsibility for ensuring
that Kosovo works towards meeting the goals set out in the Millennium Declaration. Although
Kosovo is not party to the CRC or CEDAW, it has an opportunity to demonstrate its
willingness to meet international standards and to be guided in its social policy making by
the Millennium Development Goals (MDGs).
Using available data from 1999, the latest Global Human Development Report, estimated
that Kosovo had a Human Development Index (HDI) of between 0.67 and 0.73, placing it
among countries considered to have a medium level of development. However, a closer
analysis reveals considerable disparities in key indicators. Kosovo ranks significantly behind
other countries in South-Eastern Europe in terms of gender equality, with a Gender
Development Index (GDI) of 0.687. There is still a strong son preference and the male to
female birth ratio is 109:100, which might indicate sex-selection practices. In areas such as
girls’ education, gender equality and infant and maternal mortality rates, Kosovo continues to
trail most of its neighbours. This provides an indication of sectors that deserve the priority
attention of both the PISG and its partners. While the prognosis for the future is good, much
still remains to be done.
There is also a need to establish inter-ministerial bodies to ensure that issues related to
women's and children’s rights, that are beyond the purview of individual Ministries, are not
marginalised. The PISG has taken the first steps in this direction by creating the InterMinisterial Children's Committee under the Office of the Prime Minister. The committee is
made up of representatives from the Ministries of Labour and Social Welfare, Health,
Education, Youth, Department of Justice and the Institute for Social Policy, with UNICEF
serving as a technical advisor. While the Committee has yet to make its full impact felt, the
decision to house it in the Office of the Prime Minister is an indication that the PISG is
committed to ensuring that it meets the needs of children. The challenge will be to turn this
commitment into concrete actions and policies on the ground that will see the Prime
Minister’s Office act as the leading advocate of children’s rights in Kosovo.
While social spending continues to make up over 30 per cent of all government
expenditures, it is important to ensure that spending is targeted to support the development
of future capacity (and not only to meet recurrent expenditures). At the same time, advice
and guidance is needed to facilitate the transformation of policies into concrete plans of
action and subsequent implementation.
1.2.3
Municipal Government
The efforts to promote decentralised governance have seen considerable authority being
devolved to the 30 municipalities and this has important consequences for meeting the
needs of children in Kosovo. The role of municipalities in the provision of education and
primary health care services was a central platform of the decentralization thrust of UNMIK
Regulation 2000/45. However, although Regulation 2000/45 offered a framework for local
responsibilities, subsequent decisions and slow transfer of power from UNMIK to the PISG
have resulted in unclear lines of accountability. This has created significant obstacles to
effective implementation at the municipal level. As a recent study conducted by UNDP notes,
the efforts at decentralisation have been hampered by “[T]he complexity of Kosovo's existing
governance structures [and] … left the general public, at best, bewildered and, at worst,
disenchanted. Further refinement of local government or decentralization policies must bring
clarity where there is little.” This extract illustrates the complications involved when
February 2004
15
Situation Analysis of Children and Women in Kosovo
Political-Administrative Context in
Kosovo
promoting greater accountability within the public domain.14 The report also notes that there
is considerable variation in public opinion about the performance of municipal authorities.
This suggests a need to explore the specific differences between municipalities and how
these differences impact upon the rights of citizens. It should also be noted that there was
very little difference in opinion between different age groups. In most municipalities, the
opinions of young people tended to mirror those of their parents (and ethnic group).
1.2.4
The Role of Civil Society
While decentralisation has moved forward, it is clear that much needs to be done to make
municipal authorities more accountable to their communities. This is a legacy of the past
where all decision-making power rested with highly centralised government structures and
municipalities acted solely as implementing agencies. The devolution of management
responsibilities in health and education represent a unique opportunity for communities to
take a much more prominent role in ensuring that the rights of children are respected.
Bridges need to be built between policymakers and citizens. Community members, including
women and youth, need to become actively involved in local decision-making and mobilised
to articulate the needs of their community. A strong civil society is required to hold political
leaders accountable and require government to be transparent and accessible.
The end of the conflict saw a tremendous increase in the number of NGOs active in Kosovo.
Despite their numbers, however, most local NGOs have not yet reached their full potential in
terms of supporting the development of a strong civil society and mobilising the communities
in which they work. In post-conflict countries in other parts of the world, NGOs have played a
vital role as an interlocutor between communities and the State. Where government
resources are over-extended, NGOs can help to fill the gap. NGOs are also an important
source of new ideas and initiatives that can influence the formation of national policies in a
number of different areas. For the long-term development prospects of Kosovo, it is vital to
continue to focus on ways to strengthen NGOs and to build links between the NGO sector
and other stakeholders in society.
Transparency, accountability and respect for the human rights of all citizens are the building
blocks of a democratic state. Kosovo has made remarkable progress towards developing the
institutions necessary to safeguard the rights of its people. The challenge will be to continue
to build on these achievements and to demonstrate a commitment to tackling the many
challenges that remain. The future of Kosovo is inextricably tied to the prospects for young
people, and policy makers need to focus on addressing the basic needs and aspirations of
this group.
Culture and Traditions
Kosovo is a society in the midst of transition. On the one hand, it reflects many of the
values and practices of centuries of Balkan and Ottoman influence combined with the
legacy of 50 years of socialist rule. At the same time, it is a society that aspires to
modern European values and standards. From the perspective of this report, a few
important points are worth noting. Until recently, Kosovo was a predominantly
agricultural country with large extended families and strong patriarchal traditions. It is
still usual, for example, for a woman to move into the extended family of her husband
14
The UNDP report "The Kosovo Mosaic" goes on to note that: “The current debate about decentralization has
assumed strong ethnic dimensions, and must obviously be understood against the backdrop of the political
realities of post-conflict Kosovo. ……, to the extent that local government is intended to allow more tailored
responses to locally perceived needs, the "ethnicity" dimension is an inevitable component of the dialogue,
and not necessarily inappropriate. Decentralization and particularly devolution are partly about distributing
responsibility and authority more equitably, and countering the divisive forces of exclusion or inequity, real or
perceived. …... An unbiased discussion of how decentralization can contribute to greater efficiency and
effectiveness in the delivery of essential services deserves greater prominence in this politically charged
environment.”
February 2004
16
Situation Analysis of Children and Women in Kosovo
Political-Administrative Context in
Kosovo
upon marriage and for children to be considered wards of the father’s family. This has
meant that women, children and young people often have far fewer rights within the
family. Within some Kosovo communities, marriage at an early age (around 14) is still
common. There is also an expectation that couples should have a child within the first
year of marriage. Both these traditions impact on the ability of women to continue
their education and to enter the job market. There is an overall reluctance within the
family, schools and the wider community to discuss issues related to sexual
behaviour with young people - an issue discussed in more detail later in this report.
1.3
Economic Overview
Historically, Kosovo has been one of
the poorer regions of the former
Yugoslavia and was predominantly an
agricultural economy with over 60 per
cent of the population depending on the
land for their livelihood. During the
1970s and 80s, a concerted effort was
made to boost industrial production, in
particular through the development of
mining. Nonetheless, per capita income
was on average 66.8 percent that of
the rest of Yugoslavia's other regions
and less than half that of Slovenia.
Estim ated GDP per Capita ($)
S our c e : Wor l d B a nk 2 0 0 2 a nd U N M I K
Kosovo has experienced tremendous
economic disruption over the last decade. Following the re-imposition of direct rule from
Belgrade, the World Bank (2001) estimates that the GDP contracted by 50 per cent and per
capita income fell from US$1,060 in 1988 to a low of US$320 per annum in 1995. Following
the end of the conflict, the economy of Kosovo was in a state of collapse. Over 25 per cent
of the housing stock was totally destroyed and agricultural livestock and equipment was
decimated (with estimated losses of between US$700 m and US$800 m).
In the four years since the end of the conflict, considerable progress has been made towards
economic stabilisation, supported by a massive flow of donor assistance. Basic
infrastructure, such as roads and bridges, has been rebuilt. Hospitals and schools have been
rehabilitated and re-equipped and there continues to be significant investment in the housing
sector. The inflow of donor funding has also helped to stimulate economic growth and
employment and per capita income is approaching pre-1989 levels.15 The PISG has also
made progress in reducing its dependence on donor funding for recurrent expenditures. The
2003 Budget was almost fully financed by domestic revenues from customs duties, excise
and VAT taxes, and significant progress has been made towards developing a tax base for
future public expenditures. There has been a successful transition to the Euro and
macroeconomic indicators have been stabilised though at very low levels of activity. For the
large part, industrial production continues to be dominated by inefficient state-run enterprises
(though steps are now underway to begin a process of gradual privatisation). Despite the
impressive gains made in the last three to four years, however, the World Bank estimates
that around 50 per cent of the population continues to live in shallow poverty with 12 percent
15
However, it should be noted that the economy is still very dependent on foreign transfers. Conservative
estimates suggest that well over 50 per cent of GDP comes from outside Kosovo in the form of expenditures
by KFOR, UNMIK and foreign aid transfers. In addition, over €500m a year is sent home in remittances from
Kosovars living in Europe.
February 2004
17
Situation Analysis of Children and Women in Kosovo
Economic Overview
said to be living in extreme poverty (defined as having insufficient income to meet basic food
consumption needs).
1.3.1
Structure of the Economy
With external aid projected to decline rapidly over the coming years, imports are forecast to
decrease from 145 per cent of GDP in 2002 to around 45 per cent of GDP by 2005 (WB
2002). This decline will test the sustainability of Kosovo’s economic recovery. Imports of
goods and services are also predicted to decrease reflecting the declining presence of
internationals.16 It should be noted that the vast majority of imports (54 per cent) are for
direct consumption. Imports of intermediate producer goods accounted for only €55m or less
than six per cent of total imports. In contrast, Kosovo imported €61m of tobacco products
during 2002. To date, the volume of exports of goods (primarily textiles and shoes, metals,
and electrical equipment) has been limited, rising from €19m in 2000 to €27m in 2002.17
This is expected to increase as structural reforms lead to increased economic activity and
productivity in Kosovo. There is, however, an urgent need to continue to focus on identifying
industries and opportunities that could help sustain economic growth that are not tied to the
continuation of donor assistance or the presence of the international community. Failure to
do so will have serious long-term consequences for job creation and economic growth
prospects.
Table 6 Structure of Output by Sector
Sector
1971
1988
1996
2001
Industry
33.3
47.4
33.8
-
Agriculture
28.2
20.4
28.8
-
Other
38.5
32.2
37.4
-
Source: RIINVEST 1998
1.3.2
Employment
Although macro-economic stability has been achieved, the impact on long-term job creation
in Kosovo has been limited. As with all other sectors, there continues to be very uneven data
with regard to employment. As Table 7 illustrates, there has been a steady growth in
employment in the private sector and informal economy. However, the vast majority of firms
are small-scale shops and restaurants or other establishments that have developed in
response to the declining economic opportunities for Albanians after the political changes in
the late 1980s, and now cater to the large international community. While the firms represent
a source of income and employment, they do not amount to sustained patterns of investment
in production.
16
Following the end of the conflict, upwards of 50,000 internationals came to Kosovo as part of the UNMIK and
KFOR presence, significantly boosting consumer demand. With the UNMIK presence decreasing there is a
strong likelihood that Kosovo will face severe deflationary pressures over the next few years.
17
The KCB however, estimates that actual total exports are at least ten times larger than official exports
suggest and include internal exports (sales of goods and services to foreigners in Kosovo) and unregistered
exports, especially re-exports of cigarettes estimated at €50-80 million.
February 2004
18
Situation Analysis of Children and Women in Kosovo
Economic Overview
Table 7 Employment by Sector
2000
2001
2002
SME
54,153
61,023
61,555
Private Enterprise
88,062
116,237
124,023
NA
NA
64,000
Public Sector
56,971
62,409
65,187
International Organisations
18,015
17,771
17,522
NA
NA
97,460
219,201
259,441
429,747
“Informal” Economy18
Agriculture
Total
Source: RIINVEST, Labour Market Survey 2002
Similarly, the agriculture sector is made up of numerous small-scale family-owned land
holdings with the majority of production being for personal consumption. While some
attempts are being made to move towards agricultural production for the domestic market
the lack of processing facilities limit its potential. This suggests an urgent need for Kosovo to
focus on developing new industries that require a skilled labour force. Kosovo enjoys a small
labour cost advantage over most of its neighbours but is limited in its ability to exploit this
advantage because of the on-going uncertainty about final status. This acts as a disincentive
for investment, especially by foreign firms.19
1.3.3
Structure of Unemployment
Information from RIINVEST and the Statistics Office of Kosovo paints a sombre picture. It
shows an unemployment rate in Kosovo of 57 per cent with the unemployment rate among
women approaching 70 per cent. A similar picture is painted when looking at the distribution
of the unemployed by age. Among both males and females, over 70 per cent of those not
employed are below the age of 34. The female unemployment rate is 56 per cent higher than
the male unemployment rate, despite the fact that only 40.6 per cent of working age females
are active in the labour market.
Table 8 Employment Rates
RIINVEST LMS
Total
F
M
SOK LFS
Total
F
M
Employment: working age population
29.5
14.8
45.1
20.0
8.2
31.8
Unemployment: working age population
28.4
25.8
31.2
26.7
19.2
34.2
Activity rate
58.0
40.6
76.3
46.7
27.4
66
Employment rate
51.0
36.4
59.2
42.9
30.1
48.3
Unemployment rate
49.0
63.6
40.8
57.1
69.9
51.7
Source: RIINVEST Labour Market Survey 2002 and SOK Labour Force Survey 2001
18
The survey data shows employment in this sector to be 64,000 higher than that claimed by the official
statistics. This suggests that these people make up what is known as informal employment. Employment in
these categories accounts for as much as 15 per cent of total employment and 34 per cent of employment in
the private sector.
19
Low wages and low productivity appear to characterise the labour market in Kosovo.
February 2004
19
Situation Analysis of Children and Women in Kosovo
1.3.4
Economic Overview
Youth Unemployment
Youth unemployment is an issue of concern in all Eastern European transition countries.
Unemployment rates for those up to 24 years old in the Balkans are routinely twice or even
three times higher than those of the total working-age population. In Kosovo, this problem
seems to be even worse given the very young population. As the table below shows, the
unemployment rate for those aged 16 to 24 is nearly twice as high as the overall
unemployment rate. The ratio of youth unemployment to the overall unemployment rate is
1.46. Compared to other age groups, youth unemployment is more than double that for
those aged 40-54 and 55-64 years old.
Table 9 Youth Unemployment Indicators for Selected Countries
National
Youth
Unemployment
Unemployment
Rate
Rate
Youth
unemployment:
Adult
unemployment
Youth
Unemployment as
per cent of total
Kosovo
49.0
71.6
1.4
40.2
Bulgaria
14.1
32.6
2.5
23.5
Croatia
13.5
29.8
NA
38.6
Romania
6.8
19.5
3.8
38.5
Czech Rep.
8.7
17.0
2.4
29.4
Hungary
7.0
12.4
2.1
27.6
12.5
30.0
2.9
26.4
7.4
18.2
3.1
31.1
Poland
Slovenia
Source: Key Indicators of the Labour Market 2001-2002, ILO (2002) from RIINVEST Labour Market Survey 2002
Given that overall unemployment
stands at 57 per cent it is perhaps not
Unem ploym ent Rates by Age Group
surprising that over 71 per cent of
those leaving school and tertiary
80%
education (16-24) are unemployed.
However,
the
fact
that
the
60%
unemployment rate for the next age
40%
cohort (25-39) is approaching 50 per
20%
cent suggests that there are serious
problems with regard to how the job
0%
16-24
25-39
40-54
55-64
market is structured in Kosovo. The
rigidity of the labour market, coupled
with a continued gap between the skills sought by employers and those that are being taught
in the higher education system and training schemes, requires immediate attention to
address the problem of long-term youth unemployment.
1.4
Public Expenditures and Policies
In the case of Kosovo, after years of under-investment in
health, education and social welfare, both UNMIK and
February 2004
20
Article 4 of the CRC states
“With regards to economic,
social and cultural rights, States
Parties shall undertake such
measures to the maximum
extent of their available
resources.”
Situation Analysis of Children and Women in Kosovo
Public Expenditures and
Policies
now the PISG have made a significant commitment to redressing this balance. Over 30 per
cent of the Kosovo Consolidated Budget (KCB) is devoted to health and education alone
and, when social welfare is included, this figure rises to 50 per cent of government
expenditures - although most of it is spent on recurrent costs, especially salaries.
It is important to note the existence of parallel social service structures that cater to the
Kosovo Serb population and remain under the control of Belgrade. Social service providers
in Kosovo Serb communities receive two salaries – one from the PISG and another plus
hardship allowance from the Serbian Government in Belgrade.
Table 10 Government of Kosovo Budget Allocations (million €)
Sector
2002
percent
2003
percent
2004
percent
2005
percent
Education
77.741
19.31
80.465
15.56
81.660
15.77
85.273
15.32
Health
57.657
14.34
59.639
11.53
56.974
11.00
59.895
10.76
Social Protection
66.797
16.61
82.600
15.98
109.015
21.06
108.857
19.56
Public Order and
Security
48.647
12.10
63.044
12.19
65.440
12.64
64.381
11.57
Economic Affairs
30.601
7.61
48.363
9.35
51.733
9.996
72.704
13.06
Other
120.631
30.00
182.748
35.35
152.702
29.50
165.381
29.71
Total
402.074
100 per
cent
516.859
100 per
cent
517.524
100 per
cent
556.491
100 per
cent
Source: Government of Kosovo Consolidated Budget 2003
1.4.1
The Health System
As with most other former socialist countries, the health system in Kosovo was heavily
geared towards the provision of tertiary care and treatment rather than prevention. All health
facilities were state-owned and the service was funded publicly through a social security
system. The result was a centralised, bureaucratic and for the most part ineffective health
system with large and inefficient facilities, low bed occupancy rates and extended stays in
hospital for patients.
Between 1989 and 1999, there was a functional parallel primary healthcare system run by
the Mother Teresa Society (MTS) through a network of 96 clinics that catered to the Kosovo
Albanian population. Many doctors worked
Paying for Health Care
as volunteers within the parallel health
structure, and the MTS was especially
Based on the UNDP Human Development
active in providing free health care to
Report Kosovo 2002 and on the findings of the
children. Since the end of the conflict,
UNICEF Micro-Nutrient Status Survey, 95 per
however, the MTS system has largely
cent of Kosovars have free access to health care
collapsed with only about 10 percent of the services. However, according to recent surveys
previous facilities, mainly in the cities, by both the World Bank and WHO, the most
common barrier to health-care access is the cost
continuing to operate.
Many Kosovo
Albanian doctors have moved to the of the service. In the fiscal year 2000,
government health expenditure was about €20
hospitals, claiming rights to previous
per capita; however, the population also had to
employment or to specialist training
spend the same amount or more in out-of-pocket
positions denied to them during the past 10 expenses, primarily on pharmaceuticals. A WHO
years. This transfer of skills has had an
survey showed that an average household
adverse effect on the operation of primary
spends about €35 for drugs, €9 for transport, €3
health care, especially in the rural areas.
for dental care and €2 for inpatient care per
As a result, the provision of adequate
year. About 28 percent of those surveyed
reported having had a medical problem at some
standards of health care for the poor and
time for which they did not seek treatment
for rural communities is now in decline.
There is currently an attempt to once again
decentralise the health care system, with
February 2004
because they could not afford health-care. The
same survey has shown that the most expensive
item of expenditure for patients are
pharmaceuticals required for treatment, as well
as general expenses and "gifts" for medical
21personnel.
Situation Analysis of Children and Women in Kosovo
Public Expenditures and
Policies
responsibility for primary health care devolving to the municipalities. Some of the activities
within primary health care services include health education, nutrition, safe water and basic
sanitation, maternal and child health, immunisation, basic medical treatment, communitybased mental health, basic oral health and drug supply. However, weak administrative
capacity and the lack of incentives for improving efficiency and accountability at the local
level are slowing the decentralisation process.
Despite receiving over 11 percent of government expenditures, there continue to be serious
imbalances with regard to how funds are allocated within the healthcare system. By far the
largest expenditures, €13.250m (30 per cent) is on the purchases of pharmaceuticals,
followed by expenditures on salaries. This is in contrast to the 11 per cent spent on capital
outlays (infrastructure). Of the total, 26 per cent is provided as designated grants to the
municipalities for primary health care expenses. This supports the 2003 intergovernmental
grant policy to increase the amount of the grant for general municipal services, allowing the
Municipalities to determine how to allocate the increased funding.
Table 11 Health Expenditures by Category (million €)
Department
Employees
Wages &
salaries
Goods &
Services
Subsidies &
Transfer
Capital
Outlays
TOTAL
6,443
10.631
8.400
0.000
1.012
20.043
Other Health Services
599
1.125
16.439
1.000
1.269
19.834
Department of Administration
177
0.484
1.368
0.000
2.672
4.523
12.240
26.207
Program Activity
Hospital Health Services
TOTAL
7,219
percentage of Total Budget
NA
27.6 per cent 59.0 per cent
1.000
4.953
44.400
2.3 per cent
11.2 per cent
100.0 per
cent
Source: Government of Kosovo Consolidated Budget 2003
1.4.2
The Education System
The assertion of centralised control over the content of education in 1990 in Kosovo led the
majority Kosovo Albanians to withdraw from the formal school system and develop a
“parallel” education system financed by remittances from abroad and by informal tax
revenues collected and managed at the municipal level. Despite the efforts – particularly
among teachers – to maintain a functioning education system under extremely difficult
conditions, the quality of education inevitably suffered. Enrolment rates, at over 90 per cent
in primary school prior to 1989, are thought to have declined substantially during the 1990s,
particularly among girls. Although primary enrolment rates are now high, the legacy of the
90s means that a significant cohort of teenage girls today are illiterate. The government has
signalled its commitment to education by passing several laws and regulations (detailed
below) that set new standards for education in Kosovo. However, MEST faces a continuing
challenge to implement and administer regulations and instructions at both central and
regional levels. There also appears to be a lack of awareness among educators regarding
the new policies.
20
Document/Law
Area of Regulation/ Relevance
The Constitutional Framework for Kosovo
Highlights the right to education for all
regardless of gender, ethnic or religious
background, or disabilities. 20
The Law on Primary and Secondary
education21 and the Law on Higher
education22
Provide the legal framework for the
education system in Kosovo
Promulgated by the SRSG on 15 May 2001
February 2004
22
Situation Analysis of Children and Women in Kosovo
Administrative Instructions and Policy
Drafts developed by MEST with (in some
cases) advice from TTRB23
Public Expenditures and
Policies
Regulating concrete issues in specific
areas of the education system, e.g. the
school calendar for the next year. Policy
drafts, e.g. on Standards of Professional
Practice, Teacher Accreditation or a Code
of Ethics for teachers
Education spending continues to receive a high proportion of total government expenditures
(19 per cent and 16 per cent of the KCB in 2002 and 2003 respectively). The majority
(€63.9m) of educational expenditures comprises grants to municipalities to finance preprimary, primary and secondary education expenses. This is part of an on-going
commitment to decentralising the management of basic services to municipalities. The
balance (€18.6m) covers Central Ministry expenditures for higher education, curriculum
development, special needs education, teacher training and educational administration (and
is not reflected in the table below). One point to note is the very high proportion of education
spending on wages and salaries as opposed to capital investments.
Table 12 Education Resources at Municipal Level (million €)
2001
2002
2003
-
42.9
61.9
Central Budget Spending on Primary and
Secondary Education
52.2
26.7
2.0
Total
52.2
69.6
63.9
Municipal Education Grant
Source: Government of Kosovo Consolidated Budget 2003
In 2000, the age of enrolment in primary school was lowered from seven to six and
compulsory schooling was increased from eight to nine years in line with European
standards. Children now receive five years of primary schooling between the ages of six
and 11 followed by four years of compulsory secondary education to the age of 15. An
optional three years of higher secondary education follow. The addition of Grade 9 to the
lower secondary education cycle began in the 2002 school year and aims to serve as an
orientation year towards possible further education. A new 9th Grade curriculum has been
completed and the establishment of this extra compulsory grade is a decisive step towards
achieving European education standards. However, budgetary constraints, especially for
extra classrooms and publishing of text books, continue to make its implementation difficult.
Table 13 The New Education System in Kosovo
21
Passed by the Kosovar Assembly on 27 July 2002
22
Promulgated by the SRSG in early 2003 after a dispute concerning the status of the (Serb) institutes for
higher education in North Mitrovica.
23
The Teacher Training Review Board is an advisory body to MEST that was established in 2001 with support
from KEDP. It is chaired by MEST and includes representatives of various stakeholder groups, i.e. parents,
teachers and school directors.
February 2004
23
Situation Analysis of Children and Women in Kosovo
New Structure, 2002
Public Expenditures and
Policies
Grade
Age
Scheme till 2001
Kindergarten
3-5
Pre-primary
5-6
I
6-7
II
7-8
I
III
8-9
II
IV
9-10
III
V
10-11
IV
VI
11-12
V
Lower Secondary School
VII
12-13
VI
(compulsory)
VIII
13-14
VII
IX
14-15
VIII
X
15-16
1
Secondary
XI
16-17
2
Education
XII
17-18
3
1
18-19
Preschool Education
Primary Education
(compulsory)
Primary
Education
Upper Secondary School
University B.A
1.4.3
University
Higher
Social Welfare
The Ministry of Labour and Social Welfare was established under UNMIK Regulation
2001/19. Annex VII of the Regulation defines the duties of the Ministry to include: developing
labour and social welfare policies and implementing the legislation in these areas, promoting
policies and practices for the protection of families and children, directing and supervising
social welfare institutions in co-operation with the municipalities, the social welfare offices
and other institutions and providing financial assistance.24
In respect of social welfare, the Ministry’s powers are devolved to the Department of Social
Welfare, which co-ordinates with the Municipalities and the different forms of previously
established associations for social protection including the Centres for Social Work (CSW) at
an operational level. The CSWs are the principal social welfare bodies operating at
municipal level. The municipal local governments are not involved in social services in
practice. There are 32 CSWs, one in each of the 30 municipalities, and two in
Mitrovicë/Mitrovica.
The law governing social protection institutions in Kosovo and their functions was originally
enacted following the promulgation of the 1971/1974 Constitution, during the period of the
decentralisation of “self-managing” socialist structures. The law provides for the existence of
CSWs as the primary form of associations for social protection. The main tasks and
procedures governing the work and responsibilities of CSWs are outlined in the Law on
Social Protection, the Law on Marriage and Family Relations, the Law on Non-contested
Procedures and the municipal statutes of the CSWs (OSCE 2003:11). Under the present
legal framework in Kosovo, the attributes of the CSWs have not significantly changed, as the
relevant domestic laws governing social protection remain virtually the same. The Ministry is
currently revising legislation in this area.
1.4.4
Youth
The PISG established the Ministry of Culture, Youth, Sports and Non-Resident Affairs to
coordinate all activities relating to young people in Kosovo. Policies and procedures are
24
OSCE 2003:11-12
February 2004
24
Situation Analysis of Children and Women in Kosovo
Public Expenditures and
Policies
handled by the Department of Youth and there are municipal youth officers responsible for
interacting with youth groups in the community.
In the 2003 budget, €0.240 million was allocated for subsidies and transfers to support youth
programmes in the municipalities. The Department of Youth promotes the involvement of
youth in all aspects of civil society and the democratic process, and gives special emphasis
to the participation of young people from minority communities and rural areas. There is also
a strong focus on youth health and general health education as a response to increased
levels of drug abuse and risk of HIV infection among young people. The Department
continues to require external additional funding to support youth centres in municipalities,
most of which were established with international support in the aftermath of the conflict and
are now struggling to survive. The centres provide an important network for youth
mobilisation, serve as training centres for non-formal education, and in some cases promote
inter-ethnic activities among youth.
The Department of Youth has also committed itself to the establishment of a series of
important legal and policy initiatives that will have a direct impact on youth in Kosovo. This
includes actively promoting youth networks to increase learning within the sector and
increase co-operation and contacts with youth organisations, social agencies and
governmental institutions in order to exchange information and support youth development.
The initiatives also aim to strengthen the capacity of municipalities to address youth issues,
and to ensure greater co-operation between youth organisations and municipal youth
directorates. The Department has also identified youth unemployment as a major priority and
has committed itself to developing a strategy to provide training and non-formal educational
opportunities to young people in Kosovo, and to work with local businesses and employers
to encourage job-training schemes.
1.4.5
Administration of Justice
Justice issues, including Juvenile Justice, are the responsibility of the Department of Justice.
As a reserved power of the SRSG, the Department of Justice is administered by UNMIK
rather than the PISG. For children and young people, there are two relevant Divisions within
the Department of Justice – the Judicial Development Division which contains a Unit for
Victim Assistance and Advocacy, and the Penal Management Division for those sentenced
to deprivation of liberty.
The Victim Assistance and Advocacy Unit, while clearly responsible for assisting all victims
of crime, should in particular be a key advisory body for courts when dealing with minors and
women who are victims of abuse, neglect, trafficking or other crimes. It is not entirely clear
how the Unit functions or how effective it is.
For young offenders who are sentenced in a criminal court, there are two options – (1)
detention and (2) non-custodial measures. Detention may be in the Lipjan/Lipljan centre
which provides education and rehabilitation opportunities, or in the high security prison in
Dubrava. For juveniles who are convicted of serious crimes there is no alternative but
Dubrava, where there is little emphasis on rehabilitation, education or skills training and
where young offenders get little attention compared with the vast majority who are adult
offenders.
With regard to non-custodial sentences, in 2002 Terres des Hommes, supported by UNICEF
and in partnership with the Department of Social Welfare and Department of Justice,
introduced a pilot programme of Community Service Orders as an alternative to detention for
juvenile offenders. This programme was extended Kosovo-wide in 2003. However, the lack
of capacity of social workers and of the newly introduced probation officers limits the
effective implementation of such a scheme and raises questions regarding its sustainability.
February 2004
25
Situation Analysis of Children and Women in Kosovo
1.5
UNICEF's Medium-Term Strategic Plan and the Millennium Development Goals
Following the United Nations General
Assembly Special Session on Children in
May 2002, UNICEF adopted a MediumTerm Strategic Plan (MTSP) for the period
2002 - 2005. This framework is the
contribution of UNICEF and its partners to
building "A World Fit for Children" and to
achieving the Millennium Development
Goals (MDGs) agreed upon at the
Millennium Summit in 2000.
At this
Summit,
world
leaders
committed
themselves to fighting poverty, disease,
illiteracy, hunger, gender inequality,
maternal and infant mortality and
environmental degradation. The five
Medium-Term Strategic priorities (see
box) provide the framework for all
UNICEF programmes.
1.5.1
MTSP and MDG
UNICEF’s Medium-Term Strategic Priorities
 To ensure that every girl completes a quality
primary school education.
 To promote integrated early childhood
development, ensuring every child the best
possible start in life.
 To safeguard every child against disease and
disability, emphasising immunisation "plus."
 To work to stop the spread of HIV/AIDS and to
ensure that children and young people already
affected by the disease are cared for.
 To work to protect every child so that all
children can grow up free from violence,
exploitation, abuse, and discrimination.
Why are the Millennium Development Goals relevant to Kosovo?
Kosovo representatives did not attend the
The Millennium Development Goals
Millennium Summit in 2000 because of
Kosovo's undetermined status and thus
1. Eradicate extreme poverty and hunger
have
not
signed
the
Millennium
2. Achieving universal primary education
Declaration. Nonetheless, the Millennium
3. Promoting gender equality and empower
Development Goals are very relevant to
women
the situation in Kosovo. Poverty is
widespread. Education was historically
4. Reducing child mortality
well established, but the events of the last
5. Improve maternal health
decade have reduced both access and
6. Combat HIV/AIDS, malaria and other
quality. Many women and girls are
diseases
illiterate, especially in rural areas. Maternal
and infant health is a deep concern.
7. Ensuring environmental sustainability
Women are not equal to men whether in
8. Developing a global partnership for
the home, the community or within
development, with targets for aid, trade and
Government. HIV/AIDS, while not yet
debt relief
widespread, requires vigilance and action
to prevent it from spreading, and other
endemic diseases, such as tuberculosis,
must be overcome. Industrial and domestic pollution pose a serious challenge to the
environment in Kosovo.
The MDGs can provide guidance to Government in its policy making and allocation of
resources. The MDGs can also be a tool for negotiating further international aid. Policy
planning in Kosovo is guided by many sets of priorities and standards defined by both the
international community and Kosovars themselves. The PISG has its own set of eight
priorities (see box on page 14). The European Commission has a comprehensive set of
criteria within its Stabilization and Association Process, aiming to draw South Eastern
Europe countries closer to the EU. UNMIK has established benchmarks for the PISG and,
more recently, Standards for Kosovo.
February 2004
26
Situation Analysis of Children and Women in Kosovo
MTSP and MDG
The MDGs do not represent a "stand-alone" development strategy. The targets and
indicators can and should be integrated into existing social and economic strategic planning
exercises. They are focused on long-term human development, but their targets and
indicators constitute good governance and performance measurement tools.
2. Early Childhood Development
February 2004
27
Situation Analysis of Children and Women in Kosovo
A central focus of UNICEF's Medium-Term
Strategic Plan is the need to improve early
childhood development. This derives not only
from UNICEF’s mandate to protect the rights
of children and women but also as a central
component of the MDGs. There is a wellestablished
body
of
evidence
that
demonstrates that choices made and actions
taken by parents and society in the earliest
years of childhood have a powerful and lasting
influence on the progress of individual
children. Quality care and protection in these
years are essential to address and avoid
death, disease, stunted growth, trauma,
malnutrition and developmental delays, while
ensuring healthy growth, self-esteem and the
ability to learn. These, in turn, are central to
school
readiness,
further
learning,
effectiveness of school-based programmes,
and the future ability of children to contribute
as parents, economic actors and citizens.
Investing in young children will bring long-term
social change and sustained realisation of
children’s rights.
Early Childhood
Development
Article 24 of the CRC states that
1. States Parties recognize the right of the
child to the enjoyment of the highest
attainable standard of health and to facilities
for the treatment of illness and rehabilitation
of health. States Parties shall strive to
ensure that no child is deprived of his or her
right of access to such health care services.
a) To diminish infant and child mortality;
b) To ensure the provision of necessary
medical assistance and health care to all
children
with
emphasis
on
the
development of primary health care;
c) To combat disease and malnutrition,
including within the framework of
primary health care, through, inter alia,
the application of readily available
technology and through the provision of
adequate nutritious food;s
d) To ensure appropriate pre-natal and
post-natal health care for mothers;
e) To ensure that all segments of society,
in particular parents and children, are
informed, have access to education and
are supported in the use of basic
knowledge of child health and nutrition,
the advantages of breastfeeding,
hygiene and environmental sanitation
and the prevention of accidents;
This chapter examines some of the major
aspects of early childhood in Kosovo for which
available data exists. Section 2 examines the
health of mothers – a key prerequisite for
ensuring a good start to children’s lives.
Section 3 looks at indicators and direct
determinants of early childhood survival,
growth
and
development,
including
immunisation coverage. Section 4 considers
early childhood care within the home and the
community.
The
concluding
section
summarises some of the key policy priorities
for ensuring a healthy start to life.
f)
To develop preventive health care,
guidance for parents and family planning
education and services.
2. States Parties shall take all effective and
appropriate measures with a view to
abolishing traditional practices prejudicial to
the health of children.
3. States Parties undertake to promote and
encourage international co-operation with a
view to achieving progressively the full
realization of the right recognized in the
present article. In this regard, particular
account shall be taken of the needs of
developing countries.
Frequency of ANC Visits MNSS 2001
2.1
Antenatal Care
One of the most important determinants
in both maternal and infant mortality is
the quality of antenatal care (ANC). In
>3
3
2
February 2004
281
0%
10%
20%
30%
40%
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
Kosovo, most pregnant mothers have access to antenatal care.25 However, access does not
always equate to utilisation and there continues to be varied information regarding the extent
to which women use ANC services. The UNICEF Micro Nutrient Status Survey (MNSS),
conducted in Kosovo in 2002, showed that one third of women attended an ANC clinic only
once during pregnancy. Only 25 per cent of women made more than three visits, which is
the global recommended standard for care. In contrast, a more recent ANC KAP survey
conducted in 2003 showed a significant improvement in the number of women who had
three or more ANC visits.
2.1.1
Quality of Care
There are significant concerns with
regard to the quality of ANC care being
Frequency of Visits ANC KAP Survey 2003
provided in Kosovo. The KAP survey
found that virtually all women visited
>4
OB/GYN specialists during pregnancy.
However, almost three quarters of
4
those interviewed did not receive basic
3
advice about normal pregnancy,
nutrition, possible complications during
2
pregnancy, labour, and on the
1
importance of breastfeeding. As a
result, only 15 per cent of all
0
respondents were able to identify at
0%
10%
20%
30%
40%
50%
60%
least three danger signs during
pregnancy that would require them to
seek care immediately from a trained health worker. Another phenomenon is the over-use of
ultrasound technology in lieu of appropriate antenatal care. On average, pregnant women
have up to four ultrasound examinations prior to birth.26 However, the incidence of other
tests, such as monitoring foetal heart rates or blood pressure, was significantly lower.
Furthermore, given the poorly developed primary health care services available in Kosovo,
there are no systematic antenatal procedures or monitoring systems in place at the
community level. It is rare for pregnant women to be examined or monitored by family
doctors, midwives or community nurses. Part of the problem stems from the lack of
adequate training of primary healthcare workers - a legacy of the highly centralised health
system that Kosovo inherited from the former Yugoslavia. Only specialists monitor
pregnancies and for many women, especially those living in rural areas, this reduces the
likelihood of finding appropriate care, particularly when there are complications during
pregnancy. There is also increasing evidence that women are now turning to private clinics
for their antenatal care, with up to 60 per cent of women going to private doctors on a feefor-service basis compared to 30 per cent who use public facilities and 10 per cent who use
both. However, there is evidence to suggest that the quality of care being provided in private
clinics is lower than that in the public sector, particularly with regard to advice and
counselling regarding maternal nutrition and the importance of breastfeeding.
Quality of Care Private vs. Public
45%
40%
25
The "Micronutrient Status Survey" findings show that35%
95 per cent of women have access to antenatal care
services. This is a significant improvement from the 2000
UNFPA survey that showed that only 65 per cent
30%
of women had access to ANC services.
25%
26
There is a growing suspicion that this is related to sex
selection practices although no conclusive evidence
15%
exists other than the fact that sex ratios at births are 103
boys per 100 girls.
10%
20%
5%
0%
Nor mal P r egnanc y
February 2004
29
Compl i cat i on dur i ng
M at er nal Nut r i t i on
P r egnancy
P r i v at e s ect or
P ubl i c sec t or
B r east Feedi ng
ANC Care, Access & Quality
10%
Uterine Height
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
13%
Foetal heart rate
16%
Maternal weight
46%
BP
60%
Urine test
2.1.2
Maternal Nutrition and Health
65%
Gyn. examination
Hb test
68%
Another major determinant of the
health of newborn children is the level
of nutrition of the mother. With 50
percent of the population living in
shallow poverty and 12 percent in
extreme poverty, there is a strong
likelihood that many women are not receiving adequate nutrition during pregnancy. The
MNSS indicates that Low Body Mass Index (BMI) was observed in only 3.5 per cent of
pregnant mothers. However, mild and moderate anaemia was observed in 14 percent of
women in the general population. This suggests that further research is needed to monitor
the specific conditions affecting pregnant women.27 Similarly, despite the fact that 84 per
cent of households consume iodized salt, half of women studied had low concentrations of
iodine in their urine. The 2003 KAP survey found that almost 20 per cent of women living in
urban areas smoked during their pregnancy, which can be directly linked to low birth weight.
All these factors suggest that maternal nutrition levels need to be monitored more carefully,
and that the importance of ensuring a proper diet during pregnancy needs to be stressed
during ANC visits, as well as the importance of not smoking or drinking alcohol while
pregnant. Awareness of these key health and nutrition issues needs to be raised among the
general public, with emphasis on the young people who will become Kosovo's next
generation of parents.
86%
Blood group
98%
Ultrasound
ANC visits
99%
0%
2.1.3
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
The Situation of Minorities
Antenatal care for women from minority communities is poor, both in terms of quality and
access. Nurses in many primary health care facilities in Serbian enclaves are not monitoring
pregnancy, even in situations where they have been trained to do so. Due to on-going
constraints to freedom of movement, many women and children lack access to health care
facilities and, in consequence, there have been cases of maternal death due to lack of
transport and timely access to medical assistance. Currently, there are only two functional
maternal and child health care facilities in Kosovo Serbian areas that are freely accessible to
the community. One is located in the northern part of Mitrovicë/Mitrovica and the other in
Graçanica, not far from Prishtinë/Priština.
There is limited information regarding the degree to which women from the Roma, Ashkalia,
and Egyptian (RAE) communities utilise ANC services. Given the low levels of educational
attainment for women and the generally poor economic situation of the RAE community, it is
likely that usage is sporadic at best. This is an area of concern given that RAE women tend
to marry younger and have more children than women from other communities.
Furthermore, many RAE families live in dwellings with non-existent or very basic sanitation
facilities and lack running water, all of which significantly increase the risk of disease and
infections. Further research is required to determine the extent and quality of ANC for
women from minority communities and its impact on both infant and maternal mortality. 28
2.1.4
Maternal Mortality
The lack of comprehensive vital registration
records and the mixed use of medical facilities for
childbirth have resulted in a lack of reliable data
27
28
The degree to which a nation’s children
and women enjoy good health is
manifested in the extent to which they
fall ill or die, particularly from preventable
Approximately five per cent of women used iron-foliate tabletscauses.
during pregnancy.
Mortality rates are generally
considered
bePlementina
a good indicator
of how
The DRC study quotes a survey from Doctors of the World working intothe
IDP camp
which
a countryhealth
is looking
after itsamong
children
indicated very low levels of awareness and knowledge aboutwell
reproductive
and practices
RAE
and women.
women (DOW 2002). Given that women from the Roma community
tend to have lower levels of education
and to marry at a younger age than the general population, this would suggest that specific programmes to
reach this group with life skills classes need to be developed.
February 2004
30
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
regarding maternal mortality rates (MMR) in Kosovo. It is usually stated that in Kosovo 95
per cent of women give birth in a health facility. However, a recent study on child
abandonment claimed that up to 17 per cent of all births take place without trained
healthcare personnel present. The presence of skilled health personnel at birth is one of the
main indicators for safe maternal health. Further research is needed to identify those
mothers who continue to give birth at home and to ensure that all women have access to
medical facilities as needed.
Despite the relatively high incidence of hospital births, under-reporting and poor recordkeeping continues to be a serious problem when measuring maternal mortality rates. For
example, women suffering complications during birth are moved to the emergency ward for
treatment and subsequent deaths are not included in maternal mortality figures. Similarly,
there is no follow up after a woman has been discharged from hospital, which makes it
difficult to accurately record post-partum mortality. The 2000 DHS report estimated MMR to
be 509 per 100,000.29 A health facility based study for 2000 and 2001 indicated that the
MMR in Kosovo was 23 and 12 per 100,000 respectively. The most recent facility-based
study, conducted by the OB/GYN Association in 2002, cites the figure of 21 per 100,000.
The tremendous variance in figures makes it impossible to properly gauge the extent of the
problem in Kosovo, but indicates an urgent need to address the gap in data to permit
effective measures to be taken to reduce preventable maternal mortality and for Kosovo to
meet the goals set out in the MDGs.30
2.2
Infant Mortality
The Infant Mortality Rate (IMR) records the number of deaths per 1,000 live births before the
age of one. The IMR is considered relatively sensitive to changes in socio-economic
developments, in health provision, nutrition practices, and improvements in maternal
education or hygiene, as these directly affect the health of a baby in its first year. Though
accurate data remains a problem it is estimated that the current IMR rate in Kosovo is 35 per
1,000.
Table 14 Perinatal Indicators in Kosovo (PEPC 2002)
Year
2000
2001
2002
Total number of deliveries
39,196
39,725
35,399
Total number of live births
38,907
39,506
35,271
572
579
527
Total number of stillbirths
Total number of neonatal deaths
577
574
444
Neonatal mortality rate
14.83
14.52
12.58
Stillbirth rate per 1000
14.8
14.4
14.7
Perinatal mortality rate per 1000
29.1
28.7
27.1
7.5
9.1
10.3
1.08
1.09
1.06
Caesarean section rate
Sex ratio
29
Using the same data, however, the Kosovo NHDR 2002 derived a figure of 126 (which is probably closer to
the real situation).
30
The 2003 ANC KAP survey also showed the high use of abortion as a birth control device with over 22
percent of all women having had a prior abortion. The UNFPA estimates that there are four abortions for
every live birth in Kosovo.
February 2004
31
Situation Analysis of Children and Women in Kosovo
2.2.1
Early Childhood
Development
Perinatal and Neonatal Mortality
A perinatal death is one that occurs
during late pregnancy (after 22 weeks
gestation), at birth or during the first
week of life. A recent study based on
health facility-based data from 19
maternity wards in Kosovo indicates
that perinatal mortality rates have
declined slightly over the last three
years from 29.1 per 1,000 live births in
2000, to 28.7 in 2001, and 27.1 in 2002.
In the context of unreliable IMR data,
the perinatal mortality rate serves as a
useful proxy indicator as the vast
majority of deaths in the first year of life
take place during this perinatal period.
Perinatal Mortality, Still Births and
Early Neonatal Mortality Rates 2000-02
35
30
25
20
15
10
5
0
2000
2001
Stillbirth rate
2002
Perinatal mortality rate
Early neonatal mortality rate
Neonatal deaths are those occurring within the first 28 days of life. There has been a slight
decrease in neonatal deaths over the last three years (2000-2002) for which data is
available. In 2000, it was 14.8 per 1,000 live births, 14.5 in 2001 and 12.6 in 2002. The two
most common causes of neonatal deaths in Kosovo were low birth weight including
premature birth, and perinatal asphyxia. From Table 16, it is clear that there is significant
potential to further lower the neonatal death rates through a number of measures. A
significant number of women in Kosovo smoke during pregnancy. This, coupled with poor
maternal nutrition, directly impacts the birth weight of children and would suggest a need to
continue to educate mothers on appropriate practices during pregnancy. These messages
need to be reinforced during visits to health facilities and ANC check-ups. The high
percentage of children who are dying during or immediately after child birth suggests greater
attention needs to be paid to the continued training of medical personnel to enable them to
deal with and assist mothers having difficult births. Lastly, greater emphasis needs to be
placed on ensuring that babies are not exposed to infections and disease.
Table 15 Causes of Neonatal Deaths31
Low birth weight
38 %
Congenital anomalies
16 %
Birth asphyxia and injuries
28 %
Infections
15 %
Others
2.2.2
3%
Breast Feeding
The lack of adequate knowledge
among parents with regard to
pregnancy
and
healthy
child
development is demonstrated by the
early incidence of complementary
feeding of young babies. While the
WHO recommends that a child should
be exclusively breastfed during the first
31
Breastfeeding Patterns 0 - 6 months
17%
50.8%
Annual Activity Report 2000. OB/GYN Clinic, Prishtinë/Priština, February 2001
20.1%
12.1%
February 2004
32
Exclusive
Pr ed o minant
B F +Ener g y f o o d
No BF
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
six months of life, in Kosovo many mothers introduce complementary feeding as early as the
second month. Low rates of exclusive breastfeeding are often associated with growth
retardation and anaemia in young children.
The 2002 Micronutrient Status Survey (MNSS) showed that the vast majority (90 per cent) of
children under two years of age had been breastfed, at least partially, with no significant
differences between ethnic communities. However, only a little over 12 per cent of mothers
breastfeed exclusively during the first six months. What is noticeable is the high rate of
breastfeeding among women from rural Kosovo Serb communities compared with those
from all other communities, with breastfeeding prevalence rates of 51 per cent up to the age
of four months and 46 per cent to six months, compared with 23 per cent and 17 per cent
respectively among mothers in the Albanian speaking population.
As part of UNICEF’s Baby Friendly Hospital Initiative, health workers in maternity wards
have been trained to stress the importance of breastfeeding for the healthy development of
the child. As a result, 98 per cent of women at medical facilities and maternity wards initiate
breastfeeding within an hour of birth. However, most women leave clinics within 12 to 24
hours of giving birth, making it difficult to reinforce the importance of continuing to
breastfeed. There is clear evidence that women are reverting back to more traditional
feeding patterns once they return home.32
2.2.4
Nutrition
The
effects
of
protein-energy
malnutrition (PEM) and micronutrient
deficiencies on children’s survival,
growth and development are well
known. It weakens children's resistance
to attack by infectious diseases, and
the course and outcome of these
diseases are more severe and more
often fatal in malnourished children.
Malnutrition is also linked to impaired
intellectual development and can
reduce a child's learning ability in
school.
Prevalence of Anaemia in Under-5s
Severe
M oderate
M ild
According to the MNSS, vitamin A
deficiency was observed in one third of the children under five surveyed (36 per cent) with
rural areas (40 per cent) showing a higher prevalence rate than urban areas (32 per cent).
Children under two were also more likely to show signs of vitamin A deficiency (43 per cent)
compared to older children (34 per cent). However, cases of severe vitamin A deficiency
were found in less than one per cent of the children examined. Nonetheless, even mild
levels of vitamin A deficiency impair the immune system, reducing children’s resistance to
diarrhoea and infections such as measles, and can increase infant mortality by as much as
25 per cent. This suggests that steps need to be taken to ensure that children have access
to vitamin A supplements.
Iodine deficiency can lead to impaired
mental and physical development,
congenital abnormalities and cretinism.
Due to an insufficient supply of iodized
salt in Kosovo (including supplies of
Hungary
Croatia
FRY
Macedonia
Kosovo
Armenia
Serbia and
33
Montenegro
February 2004
Turkey
In 2002, 12 sessions of a Breastfeeding Counselling Course were held at five maternity wards and five
primary health facilities. In total 393 health workers were trained. This figure includes 150 health workers in
K-Serbian areas. In addition, 120 women of childbearing age, including 38 Roma/Ashkalia women
(considered to be a particularly vulnerable group) were trained in lactation management.
Tajikistan
32
Prevalence Stunting in Children under 5 in
Selected European Countries
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
salt that are inaccurately labelled), half of all school aged children that were tested had low
levels of iodine and up to 14 per cent of children had severe cases of iodine deficiency. This
suggests a need to raise awareness among parents about the need to ensure that their
children have access to iodized salt.
In relation to other Balkan countries, Kosovo has the lowest prevalence of anaemia among
children under five. Mild and moderate anaemia were observed in 16 per cent of children
under five while severe cases of anaemia were virtually absent. However, there are minor
differences between rural and urban areas.
While food security is not a concern in Kosovo, the fact that stunting (defined as low height
for age) has been observed in approximately 10 per cent of children is worrying. This rate is
considerably higher than other Balkan countries, although still lower than rates found in
Central Asia and Turkey. The prevalence of low weight-for-age (four per cent) and low
weight-for-age (five per cent) among children in Kosovo is below the levels where it would be
considered a serious public health problem.
2. 3 Immunisation
During the 1990s, immunisation
coverage declined in Kosovo as a
result of persistent under-investment in
the health sector, the lack of effective
social mobilisation activities, ethnic
tension and conflict, and the operation
of a parallel health system. Partly as a
result, morbidity and mortality from
diseases such as measles and polio
increased, especially among the
Kosovo Albanian population.
Table 16 KOSOVO EPI SCHEDULE
PRIMARY VACCINATION
REVACCINATION
Age
Vaccine
Application*
At birth
BCG
I.d.
2 months
DTP
I.m.
3 months
DTP
I.m.
4 months
DTP
2 months
Age
Vaccine
12-18 months
Application*
DTP
I.m.
Polio
Per os
DT
I.m.
I.m.
Polio
Per os
Polio
Per os
MMR
S.c.
3 months
Polio
Per os
dT
I.m.
4 months
Polio
Per os
Polio
Per os
12-18 months
MMR
S.c.
TT
I.m.
At birth
Hepatitis B
I.m.
2 months
Hepatitis B
I.m.
6-7 year
12-13 year
18 year
Immunization Policy for Kosova
NIPH of Kosova 2003
February 2004
34
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
Other factors that contributed to low
immunisation
coverage
included
Im m unization Rates by Sex
vaccine shortages, the lack of cold
chain
equipment,
destruction
of
infrastructure
and
the
internal
displacement
of
families,
which
prevented the proper identification of
the
population
targeted
for
immunisation.33 Due in large measure
to significant investment by UNICEF
and the WHO, there has been a
noticeable
improvement
in
immunisation coverage in Kosovo since
Females
M ales
the end of the conflict. The coverage
level for BCG vaccinations is estimated
to be 99.5 per cent (based on card and history). The coverage rates for DPT1/OPV1,
DPT2/OPV2 and DPT3/OPV3 (97 per cent, 95 per cent and 87 per cent respectively) were
also satisfactory. The one exception is the continued low levels of MMR (measles, mumps,
rubella) coverage (67 per cent). However, a recently completed measles/rubella
immunisation campaign (October 2003) has seen the coverage rate improve to above 95 per
cent. This campaign presents the first phase of the indigenous measles elimination and
congenital rubella syndrome control programme for Kosovo, which is being developed as
part of the regional strategy.
From the data above it can be seen that there continue to be very high drop out rates
(estimated at 32 per cent) between BCG immunisation (which is given at birth) and MMR
vaccination, which takes place between 12 and 18 months (constituting the last stage of the
immunisation process). BCG is administered while the infant is still in the maternity but, for
MMR, parents have to be aware of the importance of the vaccination and take their child to a
health centre. The "LOT Survey" carried out by WHO and IPH at the end of 2002 also
revealed long intervals between the three doses of DPT and OPV that are supposed to be
administered within the first four months of life. The long intervals can be attributed to a
number of factors including a lack of awareness among parents about the need to complete
a full immunisation course, as well the misinterpretation of contraindications, missed
opportunities and poor quality of services.
The lack of accurate demographic data and poor flow of information between the different
levels of the system has also hindered immunisation planning. There is an absence of
information regarding the immunisation coverage of non-Serbian minorities, in particular for
Roma and Ashkalia children. However there have been some positive steps with regard to
greater co-ordination between Kosovo Serb enclaves (which use the immunisation schedule
followed by Belgrade) and the National Institute for Public Health. The two systems are now
– as of 2003 - using the identical EPI programme and schedule.
2.3.1
EPI Reporting and Surveillance System
One of the major constraints regarding both EPI coverage and eliminating vaccine
preventable diseases has been the centralised reporting and surveillance system used in
Kosovo. Small health facilities report to the municipal Main Family Health Centre (which is
responsible for coordinating primary health care delivery as part of the move towards
decentralised health care provision). Facilities subsequently report to the EPI Unit of the
National Institute of Public Health. Steps have been taken towards shifting the balance of
responsibility of EPI coverage reporting to regional Institutes of Public Health working in cooperation with primary healthcare centres. However, three years after the introduction of the
33
UNICEF, 2000c.
February 2004
35
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
family medicine concept there has only been limited integration of immunisation planning
and delivery into the primary health care system.
As part of the Department of Epidemiology, the EPI Unit has been able to track vaccine
preventable diseases. The computerisation and installation of EPI software in municipalities
has enabled the municipal immunisation centres and the NIPH to monitor both EPI coverage
and impact much more effectively. Both polio and acute flaccid paralysis (AFP) surveillance
systems, which were established in 1996, have been reactivated and strengthened while the
recent measles control programme has laid the ground for the establishment of a measles
surveillance system. Overall, there needs to be continuous strengthening of reporting and
surveillance systems, especially for adverse effects following immunisation and for
exanthematic (measles like) diseases.
2.3.2
Social Mobilisation and Communication
The most significant shift in EPI policy in Kosovo has to do with a much greater emphasis on
social mobilisation efforts. Prior to the change, immunisation was conducted through
"invitation" where parents were sent written notification to bring a child in to be immunised
with penalties for non-compliance. What was absent from the policy was an attempt to
mobilise communities and the 2002 EPI Lot Quality Assessment concluded that the low level
of social mobilisation was one of the contributing factors for immunisation failure. The
notification system has now been abandoned in favour of a policy that aims to raise
awareness among parents concerning the importance of regular immunisation and to work
within the community to create a demand for immunisation services. This will build on the
efforts to decentralise immunisation services further to primary healthcare providers and the
immunisation-on-demand policies now being followed.
2.3.3
Epidemiology of Vaccine Preventable Diseases in Kosovo
Despite the problems with the primary health
care system in Kosovo, there has been
noticeable progress in the elimination of certain
vaccine preventable diseases. The last
recorded polio case in Kosovo was in 1996, no
cases of diphtheria have been reported since
1981, and no cases of neonatal tetanus
reported since 1998.
Poliomyelitis in Kosovo was registered in
epidemic and sporadic forms. For the
period 1980 – 1996, there were 64 cases
of paralytic polio and three deaths
registered. The last cases of polio in
Kosovo were registered in 1996, during the
polio outbreak that affected northern parts
of Albania and western parts of Kosovo
with 26 confirmed cases of Polio. There are
no cases of polio registered since then.
Successful polio campaigns conducted
since 1996 have resulted in polio
eradication and Kosovo was certified Polio
Free in June 2002.
Kosovo is however, considered to be an
endemic area for tuberculosis (TB). Based on
recent available data, the rates of TB are also in
decline. Between 1990 and 2000, there were
9,309 cases of TB reported with 86 deaths. In
2001, there were 1,614 new cases reported
(Case rate: 75.4 per 100,000) while in 2002
there were 1,443 new TB cases (Case rate: 67.4 per 100,000).
In the ten years prior to the conflict, there were a total of 3,919 cases of whooping cough
recorded, with 50 deaths. This figure has since fallen to 63 cases after peaking at 375 in
2000.
Measles occurs in endemic-epidemic form in Kosovo. For the period 1989 – 1998, there
were 16,756 cases of measles with 43 deaths registered. Following the last measles
epidemic in 1997, when 3,931 cases were reported, there has been a noticeable decline in
the measles rate in Kosovo. Recent epidemiological data shows sporadic outbreaks. There
were nine cases in 2000 and 12 cases of verified measles in 2001.34 There were 2,812
34
As noted earlier, Kosovo adopted the Program for Elimination of Indigenous Measles in 2003
February 2004
36
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
cases of rubella reported in Kosovo from 1989 to 1998. For the period 1999 – 2002, there
were 585 cases of rubella reported. During the period 1989 – 1998, there were 11,891
cases of mumps with no deaths reported. In 1999, Kosovo registered mumps epidemics with
620 cases which continued into 2000 with 8,786 cases. In 2001, there were 1,403 cases
registered. According to the NIPH Kosovo these outbreaks mainly affected children that
were not vaccinated against mumps between 1994 and 1999. There is no reliable data on
the epidemiological situation with Hepatitis B. Limited information from NIPH and the
Institute for Blood Transfusion of Kosovo estimates that between two to seven per cent of
the population has serological evidence for the Hepatitis B Virus (HBV) infection. This ranks
Kosovo among the countries with intermediate endemic HBV.
In response to the regional measles elimination programme, the NIPH of Kosovo, supported
by WHO and UNICEF, successfully carried out a measles/rubella immunisation campaign
and a Vitamin A supplementation campaign in October 2003. Half a million children from 12
months to 15 years of age were targeted, reaching 99 per cent coverage. This campaign
represents the first phase towards the elimination of indigenous measles and the control of
congenital rubella syndrome in Kosovo.
2.3.4
Common Childhood Illnesses
In Kosovo, the most common reasons
for childhood morbidity and outpatient
consultation
still
remain
Acute
Respiratory Illness (ARI) – i.e. sore
throat, fever, and ear infections - and
diarrhoeal
diseases.
The
high
incidences of ARI can be traced to the
very high levels of environmental
pollution found in Kosovo. Children
living in Mitrovicë/Mitrovica (which
houses a large mining complex) and
Obiliq/Obilić (where there is an
unfiltered coal burning power plant) are
routinely exposed to high levels of
polluted air and water. Children in
urban areas suffer from traffic related pollution and all children are exposed to high levels of
secondhand cigarette smoke.
While there appears to be no concrete quantitative data about the incidence of childhood
illnesses among minority children, general poverty, poor living conditions, as well as low
levels of awareness about hygiene, have resulted in high levels of illnesses among RAE
children. In the RAE IDP camps in particular, overcrowding has resulted in poor levels of
hygiene. However, in areas where the RAE community are better integrated into the general
population, such as in Gjilan/Gnjilane region, the problem of poor sanitation is much less
apparent.
2.3.5
Safe Drinking Water
One of the main causes of child morbidity is the lack of access to safe drinking water. A
recent study carried out by the NIPH found that only 64 per cent of the population has
access to bacteriologically and chemically clean water. On average less than 50 per cent of
households are connected to public sewage works and in rural communities this figure falls
to around seven per cent. Most families continue to rely on septic tanks as the main means
of excreta disposal.35 Given that the vast majority of the rural population uses well water,
there is serious risk of ground water contamination from poor septic disposal and improper
35
In addition, most sewage pipes in urban areas are badly in need of repair.
February 2004
37
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
construction of wells. A NIPH-UNICEF study conducted in 40 rural schools36 found that only
seven schools had safe drinking water according to accepted drinking water quality
standards. From the samples collected, only 17.5 per cent were drinkable and 82.5 per cent
were contaminated. Of these, 75 per cent were shown to have bacteriological contamination
while 52.5 per cent of total samples showed chemical contamination. Given the high levels
of unsafe water, it is highly surprising that only 18 per cent of children who visited a doctor
did so for diahorreal disease treatment. In Mitrovicë/Mitrovica, the water supply has very
high levels of mercury.
2.3.6
Under Five Mortality Rate
The Under-Five Mortality Rate (U5MR) reflects the number of children who die before the
age of five for every 1,000 live births. Many factors impact upon the mortality rates of
children, including the prevalence of common preventable diseases, access to health care,
the economic status of the family, the mother’s education and age, whether the child is a
first-born, and the interval between births. Again, the data in Kosovo concerning the U5MR
is highly unreliable due to the absence of census information and a failure to register births
in some communities. However, best estimates suggest that in 1999 the U5MR was
between 35 and 40.5 per 1000.37
2.4
Care and Development
Child development is the process by which the child learns to handle more complex levels of
movement, thought, emotion and interaction with other people and the surrounding
environment. Early childhood development programmes are those designed to promote the
conditions of care, socialisation and education in the home or community that enhance a
child’s overall development. For these reasons, early childhood development has been
included as one of UNICEF’s medium-term strategic priorities. The next section looks briefly
at care of young children within the household and then goes on to discuss care provided
through community institutions such as kindergartens and preschools.
2.4.1
Care within the Home
As has been mentioned earlier in this report, most people live in extended family households
with several generations living under the same roof. As a result, much of the early
socialisation of young children takes place within the family. While there has been no
comprehensive study of child-rearing practices in Kosovo, discussions with young mothers
suggest that traditional practices continue to play a strong role in how children are raised.
Grandparents or elder siblings often share childcare duties with limited direct interaction
between a child and its parents (and in particular fathers). There is also a lack of basic
awareness about the need to stimulate a child’s physical and cognitive development from an
early age. This problem is exacerbated by the fact that many young mothers, especially in
rural and more conservative communities, have only a basic education, having themselves
been withdrawn from school at an early age. Traditional values which place a premium on
age also preclude a more child-focused approach to early socialisation and instead promote
a culture of "elders know best".
This is also the age at which attention can be focused on promoting greater tolerance and
understanding of differences, whether related to ethnicity, disability or culture. Young
children have no prejudices or preconceptions and if they mix with others at an early age it is
proven to help them resist stereotyping later in life. Children cared for within the home may
lack the opportunity to learn about and become aware of other cultures and traditions. Given
36
Drinking Water Supplies and Quality Survey in 40 Rural Schools, UNICEF and NIPH (2002)
37
UNDP MDG Report quoting RIINVEST.
February 2004
38
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
Kosovo’s commitment to becoming a genuinely inclusive society, it is important to expose
children to environments that will promote their ability to communicate with and respect other
communities.
2.5
Early Childhood Development Programmes
Unlike many other countries in the region, Kosovo does not have a strong tradition of early
childhood development programmes or preschool education. This is in part due to the fact
that many families live in large households where childcare is provided within the family unit.
The one exception has been within the Kosovo Serbian community where there have always
been high levels of participation in preschool programmes. In the absence of reliable
population figures, it is not possible to definitively capture the number of children between
the ages of nine months and six years that do not attend any form of childcare centre,
kindergarten or preschool. Data from the DHS estimates that approximately 12 per cent of
the population, or around 240,000 children, are under the age of six years of age. This would
suggest that less than 10 per cent of children attend some form of early childhood centre or
preschool programme. In contrast, in Albania 37 per cent of the preschool population is
enrolled in some form of education and in Macedonia the figure is approximately 20 per cent.
Prior to 1999, formal preschool or early childhood programmes took place in kindergartens
and were open to all children between the ages of nine months and six years old where both
parents were working. Kindergartens served both as a day care service for younger children
and also provided early childhood education to children between the ages of three and six.
Since the end of the conflict, the availability of early childhood programmes has expanded to
include the formation of pre-primary school classes, which are attached to existing primary
schools, catering for children aged between five and six. With assistance from UNICEF, a
number of community-based early childhood centres have also been established for three to
six year olds. Kindergartens (both public and private) are fee-based, with costs ranging from
€35- €100 per month - a barrier for low-income families and those with more than one young
child. Fees for community-based childhood centres are, on average, lower at €5 per month.
Pre-primary classes come under the ambit of free education in Kosovo.
2.5.1
Kindergarten
There are currently 43 kindergartens in
Kosovo and most are located in urban
areas, limiting the access of rural
children. Six municipalities (20 per cent)
have no kindergartens at all.38
Although called kindergartens, they are
in fact a combination of day care and
early childhood education programmes
catering to children from nine months to
six years. (In other countries, day care
or crèche is usually for children up to
three, and kindergarten for children
from three to preschool age five or six
years old). It is estimated that there are
approximately 1,930 children aged 9
38
Enrolment by Establishment 2002/3
3%
3%
18%
76%
pre-primary
kindergarten
Pvt. Preschool
CBC
The six municipalities are Shtimë/Štimlje, Dragash/Dragaš, Malishevë/Mališevo, Deçan/Dečani,
Štrpce/Shtërpcë and Novobërdë/Novo Brdo. In addition, Novobërdë/Novo Brdo has no pre-primary
classrooms either.
February 2004
39
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
months to 3 years old attending kindergartens or 10 per cent of the eligible age group. In
addition, there are 4,424 children aged between three and six years in kindergartens, or 21
per cent of the eligible age group. Due to high levels of demand, the size of most
kindergartens is inadequate. The practice of including children from nine months to six years
in the same centre also raises serious questions about the quality of care and education
being received, given that the developmental needs of those under the age of three are very
different from those between three and six years.
2.5.2
Community-Based Education Centres
In an attempt to address the lack of early childhood facilities in rural areas, UNICEF working
in collaboration with MEST, EveryChild and a network of local women's NGOs, has
supported the development of community-based childhood education centres. A total of 24
such centres were opened between 2000 and 2003, with an additional 22 due to open in
2004. The centres are linked to those used for women's literacy classes. The average
number of contact hours is limited, with children attending classes for three days a week for
two hours per day - the model is, however, sustainable and can gradually be expanded if the
communities are sufficiently committed to the programme. The centres established so far are
in Albanian, Ashkalia and Bosniak communities. To date, the community-based early
childhood centres have proved extremely popular but still accommodate only a very small
percentage (2.5 per cent) of children between the ages of three and six, or about 600
children in total.
2.5.3
Pre-Primary Classes
The most common forms of preschool education are pre-primary classes for children in the
year before they enter primary school (aged five to six) and they operate within the
framework of existing primary schools. There are currently 485 pre-primary classes in
Kosovo, including five Serbian, four Bosnian and two Turkish language schools as well as
Albanian. There are currently 14,090 children in pre-primary classes, approximately 70 per
cent of all those enrolled in any form of preschool education programme.
This suggests that more emphasis should be placed on the early childhood development
needs of the younger children aged three to five, with the establishment of more
kindergartens, early childhood centres and preschools for children before they reach preprimary age – more focus on play, socialisation and stimulation before they embark on the
serious challenge of education.
2.5.4
Increasing Coverage
It appears that the renovation of
Sex Ratios in Preschool Education
primary school classrooms (or other
buildings in the community) and
equipping them with child-centred
materials has been the most successful
model in terms of increasing access to
preschool education. Not only is this
more cost effective but it also
addresses a key concern of parents the distance a child has to go to attend
a preschool facility. The vast majority of
children attend a facility that is less
than one kilometre from their home.
This would suggest that efforts to
increase preschool coverage should concentrate on locating small facilities within local
communities. This is further supported by the fact that 80 per cent of community based
centres remain open and active despite the lack of external financial support.
25000
20000
15000
10000
5000
0
Total
Male
Female
Pre-school (9 mont - 6 year)
February 2004
40
Total
Male
Pre-primary (5 - 6 year)
Female
Total
Male
Female
Kindergardens (9 mont - 5 year)
Situation Analysis of Children and Women in Kosovo
2.5.5
Early Childhood
Development
Girls and Minorities
Although not significant, there are
Sex ratios in preschool education
noticeable differences in enrolment
rates for boys and girls in preschool
60%
institutions.39
Of
more
concern,
50%
however, is the uneven coverage
40%
between urban and rural populations
and for certain minority groups. With
30%
the exception of the Kosovo Serb
20%
population,
where
enrolment
is
10%
estimated to be around 90 per cent, the
0%
number of children from the Roma,
Kindergaten
Pre Primary
Turkish,
Bosniak
and
Gorani
communities continues to be extremely
Boys 2002
Girls 2002
Boys 2003
Girls 2003
low. Out of a kindergarten population of
6,534, only 61 (less than one per cent) of students are from non-Serb minority communities.
In pre-primary classes, the proportion is slightly higher (two per cent). Children with special
needs are slowly being integrated into preschool institutions; however, this continues to be
the exception rather than the rule.
2.5.6
Training
One of the main constraints faced in the provision of quality early childhood development is
the lack of trained teachers and caregivers. According to EMIS figures for 2002, there are
currently 544 teachers in preschool and pre-primary education.40 This is an increase from
402 for 2001. However, over 59 per cent of teachers in pre-primary schools are considered
under-qualified. This would suggest a need for greater investment in teacher training. The
Step by Step project has trained 75 per cent of caregivers and teachers for children up to
age six, and has collaborated with Save the Children, the IRC and CRS in training 465 preprimary teachers. The objective is to ensure 100 per cent coverage within the year 2004.41
Several ECD institutions have been equipped and supplied with new materials suitable for
early learning and numerous in-service training courses for ECD teachers have been carried
out with support from international agencies. These have had considerable success in
raising awareness among teachers and developing their professional skills related to childcentred methods of teaching. The training of pre-primary teachers is integrated in the new
Faculty of Education. The new programme is practice-oriented, and based on child-centred,
interactive principles of teaching and learning. However, there continue to be insufficient
facilities to absorb newly qualified teachers. New teachers need to be recruited and existing
teachers need to have greater access to specialised training. Particular attention also needs
to be given to increasing the number of schools and teachers that cater to children from
minority communities.
2.5.7
Preschool Curriculum
The absence of standards and guidelines for the various early childhood programmes or
curricula for preschool education constitutes one of the core problems in ensuring the quality
of either formal or informal programmes for young children. Kindergartens implement their
educational activities based on two main documents: "The programme for early childhood
39
Interestingly, there are nearly twice as many girls as boys below the age of one enrolled in kindergartens.
40
The ethnic breakdown also reveals serious gaps in the system. The majority of teachers are Albanian (73
per cent) or Serb (24 percent). Only 2 per cent of teachers are from all other ethnic groups and there are no
qualified teachers for RAE Gorani and Croatian children.
41
The use of nurses to provide teaching services in crèches (birth to three years of age) however remains a
problem due to the absence of childhood development training in the curriculum.
February 2004
41
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
stage of 1978" and "The plan and programme of education in kindergarten" for the three to
seven year old age group. Both these documents focus on programme content. Their
implementation in practice follows traditional teacher-centred approaches that concentrate
on the transmission of knowledge rather than more qualitative interactions and learning. This
is clearly inappropriate for children as young as three. The treatment of children with special
needs is not included in the existing teacher materials.
Standards and guidelines for both the physical environment and the content of programmes
of preschool education in kindergartens, pre-primary classes and other early childhood
centres are urgently needed. Standards and Guidelines for Community-Based Early
Childhood Education have recently been developed by MEST in collaboration with UNICEF
and other stakeholders. In their absence, the health and well-being of Kosovo's young
children could be at risk and their development potential not realised to the full. Meanwhile,
the Ministry of Education has begun preliminary work on a curriculum for pre-primary classes
within the framework of the overall educational reform and curriculum development. This
pre-primary curriculum is due to be finalised in 2004.
2.5.8
Parental Awareness
There is a need for greater investment in raising parental awareness about the importance of
early childhood programmes that provide opportunities for stimulation and socialisation and
that enhance the development of the child. While there has been a noticeable increase in
the demand for preschool education facilities, it is not clear how much this reflects improved
awareness about the importance of early childhood development versus a need for childcare
facilities for working mothers in urban areas. Further attention needs to be devoted to
working with young mothers, especially in rural areas, to raise awareness about the
importance of early childhood and preschool programmes. While it is clear that cost acts as
a major constraint for many families, there is sufficient evidence to suggest that where
awareness has been raised, families and communities are willing to make the investments
required (as in the community-based early childhood centres mentioned above).
2.6
Policy Agenda for Early Childhood Development
This section attempts to review the degree to which the needs of young children and
mothers are being met in Kosovo. While there have been important positive steps, four main
issues for action emerge from the analysis. These are: (i) the need to address the very high
rates of infant mortality and poor quality of perinatal services (ii) the need to promote greater
participation in early childhood development programmes (iii) the need to address the low
literacy and education of young mothers, especially in rural areas, which has a direct impact
on the well-being of children and (iv) the absence of reliable data on a range of basic health
indicators.

The decentralisation of primary health care services presents an opportunity to continue
to improve the level of care being provided to pregnant mothers, babies and young
children in Kosovo.

There needs to be continued and better training of healthcare workers to raise the overall
quality of care and information being provided to pregnant women supported by quality
control mechanisms at all levels.

There is an urgent need to reach out to those groups and communities that are not well
covered by existing services. As mentioned previously, there is sufficient evidence to
suggest that the reform of the healthcare system needs to be reinforced by social
mobilisation efforts that target communities and families.
February 2004
42
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development

There is a need for greater awareness of the importance of providing proper care and
stimulation to children not only within the family but also within the wider community to
enhance social skills, tolerance and preparedness for school.

There also need to be continued efforts to increase the number of children from all
communities that have access to early childhood development programmes especially
for the three to five age group. The decision to make use of existing preschool facilities
for pre-primary classrooms has significantly increased enrolment rates in the five to six
year age group. These classes need to be expanded to ensure universal access.

A number of innovative models have been piloted with great success. In particular the
experience of community-run early childhood centres suggests that, where services are
seen to be effective, communities are more than prepared to mobilise resources to
ensure that their children have the opportunities to benefit from child-friendly services.

The absence of reliable data continues to be a serious obstacle to any form of effective
social planning in Kosovo. The lack of vital statistics, proper birth registration, and
information relating to both maternal and infant mortality remain a major challenge for
policy makers and practitioners alike. First and foremost, there needs to be a
comprehensive population census that will provide baseline data against which to plan
and measure progress.

There is also a need to re-focus work on early childhood development away from topdown service delivery and to focus much more strongly on social mobilisation to create
demand within communities for better healthcare and early childhood development. As
the analysis in this chapter has shown, more often than not, poor awareness and the
lack of empowerment of mothers have limited the impact of policy reforms from the top.
For genuine progress to be made in a range of health and childhood development
indicators, it is essential to reverse decades old habits and to turn parents into the most
powerful advocates for their children’s future.
February 2004
43
Situation Analysis of Children and Women in Kosovo
Early Childhood
Development
Article 28 of the CRC states
“States Parties recognize the right of the
child to education and with a view to
achieving this right progressively and on the
basis of equal opportunity …
(a) Make primary education compulsory and
available free to all;
(b) Encourage the development of different
forms of secondary education, including
general and vocational education, make
them available and accessible to every child
and take appropriate measures such as the
introduction of free education and offering
financial assistance in case of need;
(c) Make higher education accessible to all
on the basis of capacity by every appropriate
means;
(d) Make educational and vocational
information and guidance available and
accessible to all children;
(e) Take measures to encourage regular
attendance at schools and the reduction of
drop-out rates.
3. Children and the Education System
With over 50 percent of the population under the
age of 25, the importance of education for the
future development of Kosovo cannot be
overstated. The PISG has identified education as
one of its key priorities and has embarked on an
ambitious programme of reform that aims to
bring the education system in line with European
standards. That said, Kosovo has significant
challenges to overcome if it is to meet the goals
of ensuring that all children are able to complete
a full course of compulsory education and to
February 2004
44
2. States Parties shall take all appropriate
measures to ensure that school discipline is
administered in a manner consistent with the
child's human dignity and in conformity with
the present Convention;
3. States Parties shall promote and
encourage international cooperation in
matters relating to education, in particular
with a view to contributing to the elimination
of ignorance and illiteracy throughout the
world and facilitating access to scientific and
technical knowledge and modern teaching
methods. In this regard, particular account
shall be taken of the needs of developing
countries.
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
eliminating gender disparities in all levels of education by 2015 (Millennium Development
Goal).
The biggest challenge will be to oversee the continued reform of an educational system that
is suffering from the legacies of a highly centralised management system and the impact of
10 years of under-investment and the damage caused by the conflict. The efforts to revitalise
the school system are best understood at a macro-level in terms of efforts to improve
management of schools, reform the curriculum and improve teacher training. At the microlevel, these efforts have focused on promoting greater involvement of parents, teachers,
directors and local school boards in the day to day running and management of schools.
This chapter is divided into 3 main sections. The first section looks at access to schooling
and, in particular, at enrolment rates at primary, lower and upper secondary school levels. It
will examine the problem of retention in lower and upper secondary education and the
various factors that push or pull children from the classroom. Section 2 looks at the quality of
schooling and the related issue of learning outcomes. Section 3 considers the girl student,
and the degree to which she is disadvantaged in pursuing her right to education. The
chapter concludes with a review of some of the key policy priorities for ensuring access to
quality basic education.
3.1
Enrolment: Who’s in School?
As part of the former Yugoslavia, Kosovo possessed an extensive primary school network
that provided access to students from
even the most remote communities.
Prim ary School by Language of Instruction
This network of primary schools was
particularly hard hit by the conflict and
0.5%
2.4%
1.0%
the decade of neglect that preceded it.
9.5%
UNICEF estimates that approximately
45 per cent of schools were badly
damaged during the conflict and
another 24 percent suffered moderate
damage. Only 17 per cent of schools
emerged unscathed. Numerous donors
86.7%
have engaged in the successful
rehabilitation of school buildings all over
Albanian Serbian Bosnian Gorani
Other
Kosovo. Education facilities have been
improved, but given the massive
population shift from rural to urban areas after the war, there is now surplus primary school
capacity in rural areas and not enough in towns and cities. Some rural schools have had to
close, which means that for some children the distance to school is now greater. In urban
areas, overcrowding means that most schools operate at least two shifts per day and some
as many as four.42 This clearly has a negative impact on the child, given the reduced hours
in the classroom. Serious problems persist with sanitary facilities and water quality,
especially in rural areas.
Note: Primary School facilities in Kosovo accommodate both primary and lower secondary
classes. So, until recently, Grades 1 through 8 were taught in Primary Schools. Now, with
the inclusion of Grade 9 in the compulsory years of education, Grade 9 should also be
taught in primary schools (although many schools are still having difficulty in physically
42
In some areas, school overcrowding is due to a lack of planning in the construction of new school buildings:
some international organisations have supported the reconstruction of schools without taking existing
locations or migration into account. Secondary schools, in particular, tend to be overcrowded. The average
number of pupils in secondary schools is 668, as compared to 317 in primary schools and 518 in preschool
facilities. MEST/EMIS 2002.
February 2004
45
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
accommodating the extra grade). Secondary Schools cater for students in upper secondary
education, Grades 10 through 12.
Table 17 Primary and Lower Secondary School Coverage
Ethnic
Group
Teachers
2001
2002
2001
2002
Albanian
863
847
14,495
14,477
Serbian
103
92
1,242
1,392
Turkish
1
1
42
137
Bosniak
4
23
71
261
RAE
4
0
8
33
Croatian
4
1
10
10
Other
0
0
0
0
988
969
15,972
16,411
TOTAL
3.1.1
Schools
Primary and Lower Secondary School
Traditionally, Kosovo has enjoyed
Prim ary & Low er Secondary School Enrollm ent
relatively high rates of school
enrolment. The Statistics Office of
350000
Kosovo (SOK) notes that there is near
300000
universal primary school enrolment for
250000
the Kosovo Albanian and Kosovo Serb
200000
communities (97.5 per cent and 99 per
150000
cent
respectively).
However,
100000
enrolment rates for children from non50000
Serb minority communities (Roma,
Ashkalia, Egyptian,Turkish, Bosniak
0
1970-71
1978-79
1989-90
1995-96 1999-2000 2000-01
2001-02
2002-03
and others) remain comparatively low
with only 77 per cent of children
Albanians
Serbian Turkish Bosnian RAE Gorani
Croatian Total
between the ages of six and 14
enrolled in school. For girls from non-Serb minorities, this percentage is even lower at 69 per
cent. Although there is a lack of qualitative data on why children do not attend school, it
appears that economic factors play a significant role in the decision-making of parents, and
boys will often be given preference over girls. Culture and tradition also impact on the nonattendance of girls. The reintegration of returnee children remains a challenge. Teachers
receive little support or advice in working with returnee children.
Table 18 Primary and Lower Secondary School Enrolment
1970-71
Albanian
Serb
Turkish
1978-79
1989-90
1995-96
2000-01
2001-02
2002-03
172,212
251,884
304,836
268,543
264,982
296,564
283,681
317,636
64,856
54,280
42,388
40,344
14,859
15,031
13,853
?3,831
2325
1418
1890
1951
1,990
1,920
2,063
2,387
5,073
5,520
3,238
3,682
Bosniak
February 2004
1999-00
46
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
RAE
Gorani
3.1.2
307,542
349,114
310,838
286,940
1,601
88
1,758
1,105
74
?7
0
69
25
320,844
307,517
330,274
Other
239,393
2,781
351
Croatian
Total
1,370
Upper Secondary School
While Kosovo is acknowledged to have relatively high rates of primary enrolment, there is a
drop in participation in lower secondary (Grades 6 through 9 at ages 11 to 15) and this
worsens at the higher secondary school level (Grades 10 through 12 and ages 16-18). Less
than 75 per cent of children who complete the compulsory education grades 1-9 go on to
enrol in upper secondary school and the continuation rates for Kosovo-Albanian girls is less
than 55 per cent. For girls from non-Serb minority communities only about 40 per cent enrol
in upper secondary school. There are currently 153 secondary schools in Kosovo, open to all
students completing their primary and lower secondary education, although basic entrance
exams are required. The vast majority (108) are Albanian language schools although there
are 44 Serbian schools and one Turkish school.43 The lack of availability of schools that
cater to other language groups has had a severe impact on enrolment rates for minorities.
Table 19 Upper Secondary School Enrolment
2000-01
2001-02
2002-03
82,869
85,598
50,978
6,924
6,711
13,500
Turkish
125
641
248
Bosniak
361
1,089
367
RAE
166
116
17
Gorani
15
216
0
Croatian
45
69
11
Other
0
62
0
Total
90,505
94,502
65,121
Albanian
Serb
Although figures vary, it is estimated
that in 2003 there were 65,121 upper
secondary school students. This is a
large decrease from the previous year,
largely due to the reform of the
educational system where Grade 9
enrolment figures are now considered
part of the compulsory (i.e. primary
and lower secondary) school data.
However, the enrolment rates for
Grades 10 to 12 are still lower than the
previous year, which is an area of
43
Pupils in Upper Secondary School by Sex
60,000
50,000
40,000
30,000
20,000
10,000
0
2001
2002
Male
Female
2003
There is evidence to suggest that many K-Serb families prefer to send their children to secondary schools in
Serbia if the option exists. This is believed to be one of the reasons many families are reluctant to return to
the former homes in Kosovo.
February 2004
47
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
considerable concern. At Grade 10 and above, there is a dramatic decrease in girls'
participation in the education system. Currently, girls make up about 45 per cent of the
student body in secondary schools.44
The number of girls in vocational schools is still very low and enrolment patterns show
evidence of sex-based subject related ‘streaming’, i.e. female pupils do not enrol in subjects
traditionally regarded as ‘male’ domains such as mechanics.45 Teachers in vocational
schools are predominantly male which further limits female role models for girls in vocational
schools. In fact, the majority of all teachers at secondary level are male and this is one factor
deterring the enrolment of girls in Secondary Schools, particularly in the more conservative
communities. Access to upper secondary education is also limited for children from
minorities, due in large part to the lack of schools that cater to non-Albanian and non-Serb
speakers.46 There are currently 643 non-Serb minority children enrolled in secondary schools
with the vast majority coming from the Bosniak (57 per cent) and Turkish (38 per cent)
communities.
secondar
y
primary
Table 20 Education Enrolment (per cent)
Albania
n
Serbian
2000-01
92.4
4.7
0.6
1.7
0.4
0.03
0.1
0
52.2
47.8
2001-02
92.2
4.5
0.7
1.0
0.9
0.6
0.02
0.02
52.2
47.8
2002-03
96.2
1.2
0.7
1.1
0.5
0.3
0
0.01
53.0
47.0
2000-01
91.6
7.7
0.1
0.4
0.2
0.02
0.05
0
58.0
42.0
2001-02
89.6
7.0
0.7
1.1
0.1
0.2
0.07
0
56.3
43.7
2002-03
78.3
20.7
0.4
0.6
0.03
0
0.02
0
54.9
45.1
3.1.3
Turkish
Bosnia
n
RAE
Gorani
Croatia
n
Other
Male
Female
Retention Rates
Keeping children in school is a pressing
problem. Although accurate data does
not exist, the OECD has estimated that
just under a third of all children enrolled
in Grade 1 drop out before reaching
Grade 8. The true extent of drop out
through primary school will only
become apparent once the cohort that
entered school in 2000 completes the
compulsory education cycle in 2009.
This information will allow educators
and policy makers to track the progress
of children through the school system,
to pinpoint when retention rates decline
and to devise appropriate interventions
Prim ary School Drop Out Rates by Grade (All)
8 to 9
7 to 8
6 to 7
5 to 6
4 to 5
3 to 4
2 to 3
1 to 2
-5%
0%
5%
10%
15%
20%
25%
44
SOK 2002 and (MEST/EMIS 2002). See also KEC 2001, OECD 2001 on the same topic.
45
In the school year 2001-2002, only 38 per cent of vocational students were female, in the Municipality of
Mitrovicë/Mitrovica it was only 29 per cent. (SOK 2002)
46
OSCE 2002 and 2003.
February 2004
48
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
to limit the drop-out rate in late primary and lower secondary.47
A review of education statistics carried out in 2001 showed limited drop-out rates between
the ages of seven and 13 for both sexes with a dramatic drop in participation rates taking
place at age 15 (the end of compulsory education).
Using EMIS data from April 2002 and February 2003, a number of interesting observations
can be made with regard to retention rates. We see that there is increased enrolment during
the first three years of primary
Girls Prim ary School Drop-Out Rates
school.48 Retention only becomes a
2002 to 2003
problem between Grades 4 and 5.
35%
When the data is disaggregated by
30%
sex, however, a number of interesting
25%
points become clear. Between
Grades 1 and 3, enrolment rates for
20%
boys actually increase by about four
15%
per cent a year. In contrast, for girls
10%
there is a drop-out rate of
approximately one per cent between
5%
Grades 1 and 4. Between Grades 5
0%
and 8 there is an increase in drop-out
1 to 2 2 to 3 3 to 4 4 to 5 5 to 6 6 to 7 7 to 8 8 to 9
rates of about 7 per cent per annum.
The situation is especially critical with regard to girls and will be dealt with in more detail in
section 3.3 of this chapter. In upper secondary education, we have a similar picture of high
drop out rates in each year. Only 45 per cent of students manage to complete upper
secondary school (UNDP 2002). It is not clear how the considerable variations in attendance
at upper secondary schools by sex, ethnicity and geographic area are being addressed in
education policy.
The School Grant Pilot Project (SGPP) is funded by the World Bank and
implemented by the Kosovo Education Center (KEC), under the supervision of
the MEST. The project is designed to help communities reach full enrolment,
reduce dropouts, increase school attendance and increase educational
attainment in secondary level by allocating small grants to schools, subject to
successful approval by the Central Evaluation Board (established by the MEST).
So far, 22 primary and secondary schools pre-selected for participation in SGPP
have established school boards and submitted three-year rolling school
development plans. An enhanced SGPP will allocate US$4.5 million directly to
schools over the next three years.
3.1.4
Relevance
Low continuation rates from primary to
secondary school - particularly among
girls, children from rural areas and from
Num ber of Students by Sex in 1st & 4th Year of
Secondary School Education (2001)
20000
47
The Education Participation Improvement Project supported
by the World Bank aims to reduce drop out
15000
rates during compulsory education and to improve general enrolment rates in targeted schools, in particular
among children from non-Albanian and non-Serb communities.
10000
48
It should be noted, however, that this analysis has been conducted using raw data provided from the EMIS
5000
system. Given that the system has only recently been introduced, it is likely that some of the information will
contain inaccuracies. Furthermore, given that the analysis compares data for two years only, it precludes
0
drawing definitive conclusions about trends. This is a situation that
requires
further monitoring
to truly assess
First
year
Fourth year
the drop-out rate with regard to the girls.
M ale
February 2004
49
Female
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
minority ethnic groups, mainly RAE – further suggest a system that is irrelevant for large
sectors of the population. Greater emphasis is needed on ensuring the medium-term
objective of developing new broad-based programmes and on an extensive re-training
programme for the existing upper secondary teaching force. The absence of adequate
labour market data continues to constrain the badly needed reform of upper secondary and
vocational education that could increase their relevance.
Kosovo has a shortage of skilled managers (a legacy of Kosovo Albanians being excluded
from most managerial functions in the decade preceding the conflict). Therefore, it is
essential that more young people remain in school to develop the skills necessary to enable
Kosovo to grow and compete economically with the rest of Europe. As currently designed,
the secondary system in Kosovo is out of alignment with the broad-based skills, labour
flexibility and continuous learning necessary for an emerging market economy. Most parents
and pupils tend to regard secondary education as relevant only if a pupil is aspiring to enter
an academic university education.
However, new initiatives in vocational education are currently being implemented due to
collaboration between MEST and the Ministry of Labour and Social Welfare with
international support. As a result, 11 new vocational curricula have been developed and are
being applied for Grade 10.
3.2
Ensuring a Quality Education
Getting children into school is an important – but not a sufficient – condition for meeting the
commitments to education embodied in the CRC and the Jomtien Declaration.49 This section
considers the quality of schooling offered by the educational system in Kosovo. It looks in
particular at three key dimensions of quality – the physical learning environment, the learning
content and the learning processes. The interaction of these three dimensions determines
the overall quality and "child-friendliness" of students’ learning experience, and contributes
to successful learning outcomes.
3.2.1
Learning Environment
As was mentioned earlier in this chapter (see section 3.1), the school system suffered
extensive damage during the conflict. Although the majority of schools have now been
repaired with support from the international community, there continue to be serious
problems with school overcrowding, particulary in urban areas.50 The addition of Grade 9 to
compulsory education and the need to accommodate the extra grade in primary school
buildings is an added challenge. Most primary schools operate multiple shifts, which limits
the amount of schooling received by children in Kosovo. In 2002, pupils in grades 1 and 2
had an average of 722 contact hours per school year, as compared to 850–950 hours in
Western Europe and the OECD average of 800 hours.51 Depending on their age and the
grade level, children have between 3 and 4.5 hours of instruction per day. Another problem
with the shift system is that students often attend school early in the morning or in the early
evening, which has a negative effect on concentration and performance, particularly for
young children. 52
49
The Jomtien Declaration at the 1990 World Conference on Education held in Thailand marked a shift in the
world’s commitment to education and broadened the notion of a quality basic education and its delivery.
50
Despite the repairs to the school system, over 20 per cent of students reported that they were very
unsatisfied by the general hygiene and sanitation facilities in schools.
51
The World Bank, 2002.
52
In urban areas like Prishtinë/Priština, Gjilan/Gnjilane, Prizren/Prizren, Mitrovicë/Mitrovica and Pejë/Peć,
schools operate in as many as three to four shifts. (MEST 2002)
February 2004
50
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
There are over 16,000 primary school teachers and 5,474 secondary school teachers in
Kosovo. It is estimated that about one third are female and two thirds are male.
The average student/teacher ratio in Kosovo is 19.4 for primary and 18.8 for upper
secondary schools. This is below the average of 22 in most EU countries.53 However, these
figures hide significant disparities between different regions of Kosovo - while some teachers
face classrooms with up to 40 children, others have groups of four or five pupils.54
There is also a significant problem with low salaries, most teachers earn approximately €150
a month. This has resulted in low levels of motivation and high rates of absenteeism among
teachers.
There also continue to be problems
Prim ary School Teachers by Ethnicity
with minority schools. Physical
conditions tend to be poor (although
1% 0%
most are being renovated by UNMIK)
0%
2%
9%
and there is a general shortage of
teachers who can teach children in
their mother tongue. The one
exception to this pattern has been
among Kosovo Serb teachers who,
like their counterparts in the health
services, are paid by the Ministry of
88%
Education in Belgrade as well as
drawing a local salary through UNMIK
Albanian Serbian Turkish Bosnian RAE Croatian
and MEST (earning on average €500600 a month). The existence of a parallel Kosovo Serb education system run from Belgrade
has meant that Kosovo Serb teachers have had limited access to the child-centred
methodologies that are being introduced throughout the rest of the education system in
Kosovo. This is beginning to change with the integration of Kosovo Serb teachers into the
Kosovo Education Reform programme with the help of UNICEF and UNMIK.
While there is very little available information regarding the qualifications of teachers, the
MEST has begun to develop a framework for reforming pre-service teacher training.55 A new
Faculty of Education has been established, with the first cohort of 300 students due to enter
the system in 2006. In-service training courses focus on general teaching methodology, and
also on children’s rights, child protection and the psychosocial needs of children. There has
also been an emphasis on promoting child friendly teaching methodologies in primary and
lower secondary levels. Innovative use of non-financial incentives, such as learning
opportunities and acknowledgment from colleagues has served to encourage educators to
engage as (unpaid) trainers and mentors.56
At upper secondary level (Grades 10 to 12), although a considerable number of teachers
have participated in teacher-training seminars, teaching still tends to be highly academic and
teacher centred. In many cases, upper secondary teachers regard themselves as subject
53
In a paper submitted to the 2002 Kosovo Donors conference, the World Bank argued that the large number
of teachers meant that salaries consumed a disproportionately large portion of the education budget and
precluded other much needed capital investment in the school system. The report went on to strongly
recommend that student-teacher ratios be raised to 22.
54
World Bank, 2002.
55
Rural schools tend to have more under-qualified teachers than urban schools because of a general
reluctance of people to live in remote areas for very little pay. However, now that the hiring of teachers has
come under the responsibilities of municipalities as opposed to the MEST, there is greater scope for
ensuring that all teachers have minimum qualifications.
56
The establishment of the practice teaching component of the new pre-service courses within the Faculty of
Education gave an example of teachers’ engagement: numerous teachers volunteered to become ‘mentor
teachers’ and have been successfully working with faculty members and students.
February 2004
51
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
specialists and therefore hesitate to engage in training on general methodology. Pre-service
training for secondary teachers is still highly subject oriented and lacks pedagogical and
practical components.
Perhaps the biggest problem with the
school system is the lack of equipment
Availability of Equipm ent
and up to date materials. Less than
one third of students reported that they
70
had access to computers and almost
60
half the students reported that their
50
schools had no libraries. As one
40
student noted
“ …we must do
30
everything outside the school yard.
20
There isn't a library - so the novels
have to be bought. No computers and
10
internet either. We have to spend [our
0
Comp
Internet
Library
Lab
Sports space
own money] in order to use a
computer and the internet." (V.P. 16,
pupil, Prishtinë/Priština, F). The acute shortage in textbooks also remains a major barrier to
providing children with access to a quality education in Kosovo. For the new curriculum
being developed (so far Grades 1, 6, 9 and 10 are completed), there are very few text books
apart from the written text of subject curricula.
3.2.2
Learning Content
It is generally acknowledged that there is an urgent need to upgrade the quality of the
education being imparted in Kosovo schools. As mentioned earlier in this report, the school
system has been reformed to bring it into line with European standards. The introduction of
the new Grade 9 has been accomplished under immense pressure of time. The MEST is
currently assessing the academic success of the reform through compulsory testing of all
Grade 9 students. Pass rates of just over 52 per cent suggest that a critical analysis of the
curriculum, teaching materials and additional support for teachers is still required.
A comprehensive Curriculum Framework for Kosovo was prepared after the war with support
from UNICEF. The document has undergone extensive public consultation and has achieved
local and international recognition. It provides a stable basis for the development of subject
and grade specific curricula. Gender issues, children’s rights, life skills education, and health
and environmental education have been included as cross-curricula issues spreading
through all subjects and all grade levels of the new school curriculum. They are also
included in the pre-service teacher-training programme of the Faculty of Education. MEST
has developed scope and sequence frameworks for all subjects from preschool to Grade 12.
With technical and financial assistance from UNICEF, MEST's local curriculum developers,
with the technical assistance of international experts, have worked on developing subject
curricula for Grades 1, 6 and 10 due to be implemented in the school year 2003/2004.57
The need to update the curriculum to make it relevant for the 21st Century is felt by pupils
themselves. A majority of respondents in a recent survey felt that textbooks were old,
outdated and over-emphasised theory. One student went as far as to complain that, “we
need to learn about practical things because they're killing us with theory." Students also
feel that the curriculum needs to be adapted to focus on more relevant and professional
subjects, such as foreign languages and computer skills. However, from interviews with
young students, it appears that there is still a long way to go before the impact of the new
curriculum will be felt in the classrooms.
57
UNICEF has indicated its willingness to provide financial support to MEST also for the preparation of the
curricula for grades 2, 3 and 11, which are to be developed in 2003/2004.
February 2004
52
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
A central component of the strategy
has been to develop a unified Kosovo
What is Missing from the Curriculum
curriculum
that
would
cover
educational
standards
for
all
45
communities. While the process is
40
inevitably open to politicisation it is
35
30
interesting to note that there is strong
25
support for these reforms from within
20
the Turkish and Bosniak communities,
15
where schools are currently using
10
materials adapted from Turkey and
5
Bosnia and Herzegovina. In contrast,
0
for the Kosovo Serb and Gorani
Language
Comput er
Trading
Prof essional
Ot her
populations, there continues to be a
reluctance to bring their educational
systems into line with the rest of Kosovo. Most notably, Kosovo Serb language schools have
not adopted the new 5+4+3 system (5 years of primary, 4 years of lower secondary and 3
years of upper secondary) and the Kosovo Serb primary school cycle still begins at age
seven rather than six and continues until 14. Ironically, last year, the Ministry of Education in
Belgrade also began a revision of the school system to bring it into line with European
standards. However, this did not encompass the school system in Kosovo. This resulted in
the Kosovo Serb school system being left behind by both educational systems. However, as
noted earlier, there now appears to be significant progress in developing a framework of cooperation which will see the adoption of the new unified curriculum and overall education
reforms by Kosovo Serb schools as well.
One of the major constraints faced by young people seeking to enter the labour market in
Kosovo is the gap between skills sought and education. Among employers, less than 50 per
cent felt that job applicants were prepared for the jobs available and cited in particular the
need for better training in marketing, finance, accounting, and information systems
(RIINVEST SME Survey). The study cited a recent survey of prospective graduates from the
University of Prishtina Management School, two thirds of those surveyed felt that they did
not have (all) the skills necessary for the job market. In addition, the study also noted that
out of over 250,000 unemployed people registered with the Department of Labour and Social
Welfare, only 3,700 had secured jobs through the employment office and a mere 1,600 had
received some form of vocational training. This suggests a serious need to expand relevant
training opportunities for young people and to re-examine how funds invested in education
are targeted. There needs to be a greater link built between education and employment
opportunities if the problem of high drop-out rates is to be prevented in the short-term.
3.2.3
Learning Process
The last aspects of a quality education to be examined are the pedagogical methods that are
being used in schools. Despite efforts to promote more child-friendly teaching in schools,
classrooms are still very traditional. Many students feel that it is often difficult to engage with
teachers and that they are often reluctant to answer questions. As mentioned previously,
due to a lack of facilities and in particular laboratory equipment, education is still very
theoretical for many children. What is most noteworthy is that satisfaction levels appear to
decrease as children pass through the school system. Three quarters of all primary school
students appear to enjoy school and find it very satisfying. However, among students
between the ages of 14 and 17, this figure falls to around 45 per cent with an equal number
categorising their education as only “somewhat satisfying”. Students also feel that there is a
tendency to focus on examination results over more qualitative learning. Teachers are now
being encouraged to use other evaluation techniques, such as continuous assessment, but
many still favour using repetitive learning techniques. Furthermore, there is a risk that a
move toward a unified national testing system (currently being considered by the MEST) will
February 2004
53
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
disadvantage children with different learning styles and from cultural backgrounds that place
less emphasis on formal learning.
3.3
Girls' Education
This section looks at the issue of girls’
Levels of Inclusion in Education (2002)
education, which is increasingly
becoming an area of concern in
100%
Kosovo. A number of points should be
90%
noted. Despite the fact that education
80%
70%
levels for females in Kosovo have
60%
improved over the past decades faster
50%
40%
than that for males, statistics show
30%
that they still remain below the
20%
10%
corresponding levels for males. The
0%
Primary & Lower
Upper Secondary
Higher Education
adult literacy rate for females is 0.898
Secondary
compared to 0.977 for males, the
gross enrolment index is 0.593 for
M ale Female
females compared to 0.640 for males
and the educational attainment is 0.796 for females compared to 0.865 for males.
Due to limited educational opportunities in the decade prior to the conflict, there is a whole
cohort of teenagers and young adults who were deprived of an education. The Education
Gender Review cites a study conducted by KFOS and the Kosovo Education Centre that
found that in rural areas illiteracy rates for females were around 40 per cent with 14.8 per
cent totally illiterate (unable to read or write) and another 12.5 per cent with only limited
skills. However, of most concern, was that the illiteracy rates for girls aged 16 to 19 were
higher than for all other age groups, which suggest that they were most negatively impacted
by the lack of formal education during the 1990s. It is clear that special attention needs to be
devoted to this group to ensure that they are able to develop the basic educational and life
skills necessary to enable them to be active participants in the labour force and as parents.
There is also a serious problem with regard to the retention rates for girls. From Grade 5
onwards (age 11) we see a dramatic increase in the number of girls leaving the school
system. At the end of Grade 5, five per cent of girls leave school and then there is an annual
drop-out rate of approximately 10 per cent up to Grade 8, peaking in an extraordinarily high
drop-out rate of 30 per cent between Grades 8 and 9. While there is no qualitative data
about the precise causes, a number of points are worth noting. In many areas, the newly
introduced Grade 9 class is attached to upper secondary rather than primary schools
because of lack of space in primary facilities. This has consequences in terms of distance
from home, a problem exacerbated by the cost and limited availability of transport. Anecdotal
evidence from NGOs suggests that, in many rural areas, the participation rates of girls is
lower due to the hidden and opportunity costs of schooling, parental attitudes towards
education and reluctance to allow girls freedom of movement. As long as the situation
continues, there will be an increased risk that many children will simply opt out of the
educational system before completing the full compulsory school cycle. This possibility will
require careful monitoring. In upper secondary education, we have a similar picture of high
drop-out rates in each year. However, it should be noted that while fewer girls than boys
actually enrol in secondary school, a higher percentage (71 per cent) complete all three
years of upper secondary education compared to boys (58 per cent).
There also needs to be further research into education attainment levels in schools to
identify how girls are performing in the classroom. While the new curriculum and teacher
training programmes are now actively promoting gender awareness, it appears that its
impact is still not being felt in the classroom. Part of the problem is that, as girls pass through
the school system, there are fewer and fewer women teachers to act as role models. The
February 2004
54
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
Gender Review noted that women make up only one third of all teachers; most are involved
in preschool education, where women make up 56 per cent of all staff, whereas at higher
education levels they make up only 12 per cent of all staff.
Lastly, it is worth noting that while the Government of Kosovo has stated its commitment to
promoting greater involvement of women in all areas of Government, in many cases they are
unable to find qualified women candidates to fill posts. Two thirds of female students
(approximately 6200 in total) enrolled in the University of Prishtina to study social sciences
(mostly in the Faculty of Philosophy, Philology, Law and Economics) while approximately
3000 women are enrolled in natural technical science courses. Women also make up 61 per
cent of the student body in higher schools that are community-based institutions.
3.4
Policy Agenda
This chapter has attempted to highlight some of the key issues with regard to the situation
surrounding children and the education system. What is clear from the analysis is that
Kosovo faces certain important challenges if it is to meet its goal of ensuring that all children
of both sexes and from all minority groups are to secure a quality education.

There continue to be significant disparities in terms of girls' education with retention rates
in lower secondary school remaining poor and limited participation in higher secondary
education for girls from the Kosovo Albanian and non-Serb minority communities.
Particular attention needs to be given to developing interventions that will persuade
families and communities to allow girls to continue in the education system. This could
include the development of mentor schemes and other support mechanisms, such as the
development of training programmes and job placement advice for girls who remain in
school.

Kosovo needs to build on the very high rates of enrolment for Kosovo Albanian and
Kosovo Serb primary school students and target the needs of other minority groups.
While Turkish and Bosniak students appear to be faring better than others, there is an
urgent need to increase the enrolment rates for RAE children. Given that there appear to
be considerable difficulties faced by this community within the formal school system,
consideration should be given to extending the catch-up class system that has been
used to meet the needs of children who were not in school over the previous four years.

There is also a need to address the quality of education in schools. In particular, there is
a need to increase the number of contact hours in schools which maintain multiple shifts.
Currently, overcrowding is undermining what is otherwise a very promising situation with
regard to enrolment.

The international community should focus its investments during the next three to five
years on building effective and sustainable institutions in the education sector and
related fields. Effective and sustainable institutions are crucial to sustaining long-term
reforms. At present, the performance of most institutions is weak due to a lack of
capacity in the areas of administrative and management skills, in particular skills related
to planning, organising and implementing processes. Public trust in institutions working
in education needs to be improved, especially through transparent procedures and
continuous communication with stakeholders (e.g. parents, teachers, school directors,
children themselves and future employers).

Capacities that have been built in previous initiatives could be utilised more efficiently if
planning occurred across the (mental) boundaries of projects or affiliation with one
particular organization or NGO. For example: local trainers experienced in modern
teaching methodology could be included more effectively in the development and
implementation of the new subject curricula and training of their colleagues. Links to the
Faculty of Education or the Child Friendly School Initiative would be other means to
February 2004
55
Situation Analysis of Children and Women in Kosovo
Children and the Education
System
strengthen the curriculum reform and to support networking among local stakeholders on
various levels.

The international community should further concentrate on building capacity among
Kosovar stakeholders throughout the education system to advocate for and contribute to
meeting the rights of women, children and all ethnic groups. This recommendation
addresses the need for continued awareness-raising, both on an institutional and a
societal level, to include children’s and women’s rights as cross-cutting issues in all
processes of policy development and decision making. Advocacy in these areas should
not be limited to institutional or individual roles, and has to become a common part of
public discourse.
4. Young People
This chapter looks specifically at challenges facing Kosovo in meeting the right of
adolescents and young people to good health, the development of their capacities, and in
ensuring their effective participation in society. The World Health Organization defines
adolescence as covering the 10 to19 age group that accounts for approximately 22 per cent
of the total Kosovo population, or about 415,000 people. UNICEF and its partners have
focused on adolescence as: “that period in a child's life in which there is a unique window of
opportunity to break a range of vicious cycles that perpetuate structural problems that
undermine child rights, and that are passed down from one generation to the next, like
poverty, gender (and ethnic) discrimination, violence, and poor health and nutrition.” 58
Young people in Kosovo have lived through a period of tremendous instability and change. It
is a generation that was mostly educated in the parallel system with little expectation of
future jobs and opportunities. It is a generation that was caught up in the conflict, either as
refugees or otherwise affected by the war. Where previous generations lived in relative
isolation, young people today have access to satellite TV and the Internet, which have
fundamentally transformed attitudes and behaviour. These changes are now being
manifested in a number of different areas relating to how young people view their rights and
responsibilities within society. Perhaps most importantly, this is the generation that will
provide Kosovo's future leaders and decision makers.
The next section looks in brief at some of the major health issues that affect young people in
Kosovo and explores two critical areas of concern – lifestyle (including the use of tobacco,
alcohol and drugs) and sexual and reproductive health (including attitudes about HIV/AIDS).
The final section in this chapter looks at the issue of youth participation within the family and
society. Unless otherwise specified, the data cited in this chapter is drawn from a survey of
young people commissioned by UNICEF and conducted by Index Kosova in September
2003.
4.1
Young People's Health
Not surprisingly, most young Kosovars still retain a positive outlook on life. Of those
interviewed, 75 per cent of children below the age of 13 said that they were very happy. This
figure declines to 65 percent for those aged between 14 and 18. However, by the age of 18
only 45 per cent describe themselves as happy with another 47 per cent claiming to be
neither happy nor unhappy. More troubling, however, was that only 38 per cent of people
from non-Serb minority groups felt that they were happy with a full 20 per cent describing
themselves as unhappy. While there are a number of factors that impact a child’s happiness,
most of the older children specifically raised financial concerns as the most likely reason not
58
UNICEF, ‘Towards a Global Agenda for Children Beyond the Year 2000: A Vision, Key Transformations, and
the Strategic Role of UNICEF’, The UNICEF Tarrytown Futures Group, October 1998.
February 2004
56
Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
to be happy. This would suggest that young people are beginning to develop serious
concerns about their prospects for finding work, especially in an environment of economic
uncertainty. Most young people feel that they are generally in good health but will concede
that a number of factors such as environmental pollution, poor nutrition and poverty have a
negative impact on the health of the general population.
There has not been any in-depth study of the psychological impact of the conflict and the ongoing tensions on young people in Kosovo. However, there is a strong sense that many
young people have still not properly dealt with the consequences of the conflict and the
violence that they witnessed. This is true for both Kosovo Albanians and Kosovo Serbs.
Focus group discussions with Kosovo Serb respondents did, however, reveal high levels of
aggression and acceptance of violence tied to insecurity and a general feeling of
powerlessness.
4.1.1
Tobacco Consumption … time to kick the habit?
Despite the fact that most young people cite tobacco as a major health risk, the number of
young people who actually smoke in Kosovo is high. Of all those interviewed, 20 per cent
described themselves as smokers, although this figure is probably an under-estimation of
the actual levels of smoking among young people.59 The figure rises to 34 per cent for those
aged 18 and above. Perhaps of most concern, however is the fact that a significant number
(15 per cent) of children aged between13 and17 also identified themselves as smokers.
While the prevalence of smoking is a well known phenomenon in the Balkans, it nonetheless
represents an important public health risk that needs to be addressed.
The survey also provided some insights into the influence of peers and adults. A third of all
respondents cited the fact that smoking is permitted everywhere as a contributing factor to
having started smoking. One in three smokers also claimed that they were encouraged to
start smoking by the example of their parents/other members of the family. In children
between the ages of nine and 14, this figure was 50 per cent. This would suggest that there
is clear need to also target parents and families with information regarding the importance of
setting a positive example to young children. An extremely large number of smokers also
emphasised that smoking made interpersonal communications easier. The exchanging of
cigarettes is seen to build a more communicative and open relationship with peers.60 The
study also briefly explored the impact of various anti-smoking campaigns on young people. It
appears that these campaigns have most impact on children under the age of 14, with over
57 per cent citing their influence as one reason for not smoking. Most young people also felt
that a ban on smoking in public places and a crackdown on the sale of tobacco products to
minors would also help to reduce the likelihood of them becoming smokers. What emerges,
therefore, is a mixed set of priorities among young people that understands the harm that
cigarette smoking causes while at the same time seeing it as an almost unavoidable way of
life.
4.1.2
Alcohol and Drugs
Unlike tobacco consumption, however, alcohol consumption appears to be much less of a
problem in Kosovo. While almost one in five respondents has consumed beer, only 6.4 per
cent of those have drunk spirits. While this figures is most likely an under-estimation of
consumption rates it nevertheless suggests that alcohol use among young people is much
less prevalent than in other in European countries. It should be noted however, that while
59
A WHO sponsored rapid assessment on substance use among young people conducted in 2001 found that
25 per cent of students in schools were smokers and that among young people frequenting cafes and bars
more than 60 per cent smoked.
60
The offering of cigarettes is a common form of social greeting and hospitality in Kosovo and it may well be
that young people are in effect mimicking the actions of adults, and identifying it as a sign of growing up and
developing “mature” relationships.
February 2004
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Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
alcohol consumption is considerably lower among females than males, it is much higher
overall among the Kosovo Serb population.
There appears, however, to be an increased prevalence of drugs in Kosovo. A 2001 study
conducted by the WHO found that most drugs were readily available, in part due to Kosovo
having become a transit route for drugs being shipped to Western Europe. According to the
study, while cannabis use was lower than in other European countries the use of heroin and
other pharmaceuticals61 among young people was higher. The study also found marked
differences in usage between young people who were in school compared to those who
were not. While tobacco and alcohol use was
reported by about 25 to 30 per cent of all
Article 33 states that
young people in school, with the exception of
"States Parties shall take all appropriate
cannabis (4.4 percent) and pharmaceuticals
measures, including legislative,
(8.8 percent) there was very low usage (less
administrative, social and educational
than one per cent) of all other drugs. In
measures, to protect children from the illicit
contrast, among the out-of-school population,
use of narcotic drugs and psychotropic
substances as defined in the relevant
71 per cent and 60 per cent reported the use
international treaties and to prevent the use
of tobacco and alcohol respectively. This
of children in the illicit production and
group was also seven times more likely to
trafficking of such substances".
have smoked cannabis. There was also a
marked increase in the use of all other
substances with around seven to 10 per cent
of those interviewed admitting to using heroin, pharmaceuticals and cocaine. This adds
another worrying dimension to the problems with secondary school enrolment and retention
noted in the previous chapter. Not only is there a growing cohort of young people who are
effectively being left behind and marginalised within society due to a lack of education, they
are also increasingly at risk of developing habits that will further limit their opportunities to
develop into productive adults and parents.62 The study also noted that there were
increasing signs that younger heroin users were beginning to inject the drug (as opposed to
sniffing it) and that there was evidence that many intravenous drug users (IDUs) shared
needles. In other parts of Europe, HIV/AIDS infection among IDUs is as high as 80 per cent
and this is a major emerging risk factor in Kosovo that needs urgently to be addressed by
policy makers and the public health system.
However, despite the fact that there appears to be a growing availability of drugs in Kosovo,
attitudes towards their use remains cautious. In the survey conducted by Index Kosova, only
one respondent reported using drugs. The vast majority of respondents claimed not to have
used drugs and demonstrated high levels of awareness about the negative impact of drugs.
However, it should also be noted that 150 people from Northern Mitrovicë/Mitrovica have
been admitted to drug rehabilitation clinics in Serbia, which would suggest that the incidence
of drug use is significantly higher among young Kosovo Serbs. Almost 75 per cent of all
respondents from all age groups felt that there was a need to ensure that there was better
information available to young people about the negative impact of drugs to enable them to
make sensible decisions. This would suggest that further investment in information and
education campaigns may well help to stem the growing prevalence of drug use.
4.2
Sexual and Reproductive Health
The issue of sexual and reproductive health is another issue of concern for adolescents.
While most people still marry relatively young, there has been a gradual rise in the marriage
61
It is still very easy to obtain pharmaceuticals without a prescription in Kosovo, at least in part due to the large
number of unlicensed pharmacies in operation.
62
Among known drug users in Prishtinë/Priština, over two thirds had used heroin, cocaine and ecstasy. This
suggests that there is a growing drug sub-culture that has emerged in the last few years.
February 2004
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Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
age in Kosovo.63 This in turn has resulted in greater pre-marital sexual contact. Data from
the 2003 PSI KAP study shows that Kosovars are becoming sexually active at a younger
age than has previously been the case. The study found that almost 70 per cent of males
and 60 per cent of females in the 15 to 22 age group had sex before the age of 18 compared
to 30 per cent of males and 20 per cent of females between the ages of 40 and 49.
4.2.1
Low Contraceptive Use
As documented by a number of studies, the use of contraception in Kosovo is extremely low
by European standards. The 2000 DHS survey found contraceptive use among women
below the age of 19 was one per cent (although 65 per cent of women claimed not to be
sexually active). Among those aged 20 to 24, there is a minor increase in use to about 6.1
per cent. Equally worrying was the fact that out of the 12 per cent of women who had never
heard of any form of contraception, half were under the age of 25. The combination of
greater sexual activity and poor levels of awareness is likely to result in an increase in early
and unwanted pregnancies. This is a trend that will have a particularly heavy impact on
young girls, both in terms of health risks and the ability to continue with their education and
careers. The continued social stigma of having children out of wedlock combined with limited
access to family planning services has seen a rise in unsafe abortions. An increase in early
pregnancy rates is a major concern given the already low levels of female participation in
higher education and the work force. Young people in Kosovo share this concern about early
pregnancy, with over 50 per cent of respondents feeling that it is a serious problem.64 As will
be discussed in the next section, low condom usage also has significant implications for the
possible spread of HIV/AIDS among young people in Kosovo.
The survey also revealed that many young people had not heard about sexually transmitted
infections (STIs). On average, 25 per cent of respondents from both sexes and among
urban and rural dwellers had not heard about STIs. However, there were noticeable
differences among the different ethnic groups. Only 10 per cent of Kosovo Serb young
people had no knowledge of STIs compared to 25 per cent of all Kosovo Albanian young
people and an alarming 61 per cent of respondents from other minority groups. This would
appear to confirm that there is an urgent need to target these groups with basic life skill
classes that will enable them to make better decisions regarding their sexual health and
behaviour.
Related to this last point is the question of how young
people obtain information on sexual and reproductive
health issues. The vast majority of respondents from all
age groups and ethnic backgrounds (78 per cent) said
that TV was the main source of information regarding
STIs and HIV/AIDS. Less than 10 per cent of those
interviewed had ever discussed STIs with a doctor or
other health professional and less than 20 percent had
discussed it within the family. The reliance on third party
sources for information is not in itself a problem, but it
does suggest that within the bounds of a traditional
society, young people find it difficult, or are reluctant, to
discuss important matters such as sexual behaviour in an
open matter with adults. This was confirmed in part by the
“Here is the mistake of my
parents. All day long they work, I
don’t see them all day and when
they come home they go to
sleep. And when should I talk to
them? From whom should I learn
something? They simply do not
have the time for me. Quite
simply a parent should talk with
the child, because we are now
living in a time when all kinds of
dangers are near. It was different
before the war because we were
isolated. There is no shame, all
things should be discussed."
(Tringa, Pupil 18 Prizren/Prizren).
63
The average age of marriage is 25 for males and 21 for females which is considerably lower than in other
parts of Europe.
64
However, the survey did not reveal whether this concern was a general perception about the problem as it
relates to society in general or whether it was a reflection of concerns about themselves and their peers.
There was also a marked difference between communities with only 23 per cent of Kosovo Serb
respondents claiming that early pregnancy was a major problem.
February 2004
59
Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
fact that over 70 per cent of those interviewed felt that parents should play a much larger
role in discussing issues of sexual health and practices with their children. The lack of youthfriendly medical services, where young people might be able to discuss sexual health and
pregnancy in a confidential environment, is another barrier to ensuring improved knowledge
and behaviour.
4.3
HIV/AIDS
Kosovo is not yet a high prevalence area for HIV/AIDS compared to other parts of Eastern
Europe - a total of 47 AIDS cases have been reported to the government since official data
began to be collected in 1986. There has, however, been a marked increase in the number
of new HIV/AIDS cases being reported (12 new cases in 2001, five in 2002 and seven in
2003). Currently, the majority of AIDS patients are males between the ages of 30 and 39.
Until 1997, the total number of AIDS-related deaths in Kosovo was 19 and by the end of
2002 there were 25 reported cases of people living with AIDS (it should be noted that antiretroviral treatment is not yet available). Due to the lack of a functioning STI-HIV surveillance
system, data on HIV prevalence is limited but most estimates suggest that it is less than 0.1
per cent, making Kosovo a low epidemic country.65 However, a number of factors suggest
that there is potential for this to change. This includes Kosovo’s emergence both as a transit
and receiving point for trafficked women, a young and mobile population, an increase in
availability of drugs, and a rise in intravenous drug use, as well as rapidly changing social
mores and sexual behaviour. In addition, there is a very large international presence, mostly
working in Kosovo without spouses or other family members, and many from countries with
high HIV prevalence rates.
This recognition that HIV/AIDS poses a growing threat for Kosovo has seen the government
take a number of important steps to address the situation before it becomes a major public
health and social issue. The most notable has been the creation of the Kosovo AIDS
Committee (KAC), bringing together a cross section of representatives from the Ministries of
Health, Education and Youth, the Kosovo Protection Corps, international agencies, NGOs,
religious organisations and the private sector. In addition, the Ministry of Health has created
an HIV/AIDS office and appointed an HIV/AIDS officer under the Ministry's budget. The
KAC and the HIV/AIDS Office have overseen the development of a four-year strategy for
HIV/AIDS prevention in Kosovo which was completed at the end of 2003.
4.3.1
Knowledge and Behaviour
Young people in Kosovo have been identified as a major vulnerable population for
contracting HIV. Changing behaviour patterns including greater sexual activity, use of drugs
and alcohol and a large out-of school population combined with low levels of knowledge
about HIV/AIDS represent a major challenge for organisations working with young people in
Kosovo. A Knowledge, Attitude and Practice (KAP) study in 2000 among 209 high school
students of 30 secondary schools and performed by the WHO with support from IPH,
revealed that among youth aged between14 and 19, knowledge of HIV was extremely low
and HIV positive persons were highly stigmatised. (As evidence of the degree of
stigmatisation, only 14 per cent responded that they would want to continue lessons in the
same class with an HIV-infected person. Of the remainder, 11 per cent said they would
switch classes while 75 per cent claimed that they would demand that the infected person be
removed from the class).
The study found that although 75 per cent of the participants knew about transmission via
sexual intercourse, less than 50 per cent were aware of transmission through the re-use of
needles, infected blood transfusions or breastfeeding. As was mentioned earlier, condom
65
Blood products have been screened for HIV and syphilis since 1986. Voluntary Counselling and Testing
Services have been available in Prishtinë/Priština since early spring 2003.
February 2004
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Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
use was low among those who were sexually active with less than 41 percent using them on
a regular basis. The absence of any "youth-friendly" health service where young people can
feel comfortable going for advice, counselling and treatment is a matter for concern.
4.3.2
More Needs to be Done
A number of recent studies have shown some positive signs with regard to HIV awareness.
Of respondents in the Index Kosova Study, 85 per cent claim to have heard of HIV though a
sizeable majority (12.5 per cent) still had not heard about HIV.66 While awareness levels
were high among Kosovo Albanians and Kosovo Serbs, over 40 per cent of respondents
from other communities had not heard about the HIV virus. Again, there continues to be
mixed knowledge about how to avoid contracting HIV with only 60 per cent of young people
correctly identifying condoms as one way of reducing the risk of infection. Interestingly, two
thirds of those interviewed would not wish to take an HIV test, suggesting that fear and
stigmatisation around HIV are still strong in Kosovo. This in turn suggests that there is a
strong likelihood that young people will not discuss issues relating to sexual health with their
partners and are also likely to practice unsafe behaviour.
As with STIs, around two thirds (69.9 per cent) of respondents have received their
information from TV and about one third (34 per cent) in school. Only 10.9 per cent have
gained information concerning the AIDS virus from their families. Even more worrying
however, was that less than 10 per cent of people in either community had heard about HIV
from a doctor or nurse.
Overall, it appears that the HIV risk among young people is tied to a number of related
factors, including a lack of proper knowledge and awareness about the extent of the risk and
means to avoid risk. There is also a suspicion that even when young people do possess
adequate knowledge, they lack the confidence and ability to put it into practice on a regular
basis. For example, the KAP survey carried out by PSI revealed that approximately 20 per
cent of girls did not insist on condom use because their partners do not like them. Among the
Kosovo Serb community we also see an increase in overall high risk behaviour (multiple
partners, high rates of drug and alcohol use) that is tied to a sense of fatalism and limited
opportunities.
4.4
Youth and Participation
The active participation of young people within the family, in political life and as actors in civil
society is one of the guiding principles of the CRC and a child-centred approach to
development. The extent to which young people and, in particular, adolescents are
integrated and effectively participating in society or being marginalised can be a valuable
indicator of how democratic development is progressing. The development of a functioning
and accountable political and social system is central component of the benchmarks that
have been set by the international community as a basic prerequisite for discussions
concerning Kosovo’s final status. Given the extent of social political and economic change
taking place in Kosovo, this is an issue that takes on increased relevance for agencies
working with children and young people. This next section will look at the extent to which the
66
Raw data from the PSI KAP survey, however, found that over 95 per cent of Kosovo Albanians interviewed
and 100 percent of Kosovo Serbs interviewed had heard of HIV. However less than 50 per cent of Kosovo
Albanian young people knew the difference between HIV and AIDS (for Kosovo Serbs the figure was 76 per
cent). Among the Kosovo Albanian population, only 60 per cent of respondents correctly identified that the
virus could be carried in semen and only 43 per cent knew that it could be carried in vaginal fluids (which is
less than the 75 per cent reported in the 2001 WHO survey). Only 32 per cent also said that it could be
carried in breast milk. Among Kosovo Serbs, however, while knowledge about transmission through sex was
on average higher than in the Kosovo Albanian population, less than 25 per cent knew that the virus could
be transmitted through blood, compared to 80 per cent in the Kosovo Albanian population. Just under 80 per
cent of Kosovo Serbs also thought the virus could be transmitted through sweat.
February 2004
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Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
voice of youth is now being heard in Kosovo and will examine the perceptions of young
people regarding their participation within the family. Subsequent sections will explore the
interaction of young people with civil society and the political system.
4.4.1
“Democracy” in the Family
The family has always played an important role in Kosovo and still remains the focus of most
people’s lives. Until recently, power within the family followed strict patriarchal lines with men
making decisions and young people deferring to their elders. However, there are signs that
this is changing, albeit gradually. The majority of young people felt that their opinions were
taken into account within family decision-making structures with over half of Kosovo
Albanians (50 per cent) feeling that their opinions were heard a lot. A significant though
lower percentage (37 per cent and 28 per cent respectively) of Kosovo Serb young people
and those from other minority groups also agreed. Overall, there were very positive feelings
across all communities and age groups and between urban and rural dwellers. The most
dramatic changes have been among residents of Prishtinë/Priština where over 80 per cent of
those interviewed felt that they had a significant say in family decisions. It is also worth
noting that 57 per cent of young women interviewed felt that their voices were heard which is
a significant change in a society where traditionally men have made all the decisions. The
one exception to this positive picture was among non-Serb minorities where 37 per cent of
those interviewed felt that their opinions mattered very little within family decision-making
structures.
A corollary to these positive changes has been the extent to which young people feel able to
consult their parents about major issues that impact their lives. Almost 70 per cent felt
comfortable discussing school related problems with their parents though a slightly lower
percentage (54 per cent) felt comfortable discussing conflicts with their teachers (which
suggests that while old traditions are indeed changing there is still an expectation that young
people will respect and defer to authority figures). Young people also look to parents for
guidance regarding work and future life decisions with over 75 per cent feeling that there
was a lot of scope to discuss these issues with parents. Again however, among non-Serb
minorities, around one third of those questioned on a range of issues felt unable to discuss
important issues with their parents.67
The one exception to this otherwise positive picture relates to sexuality and personal
relationships. Less than half of those interviewed felt that they could discuss the choice of
partner with their parents and only 20 per cent would feel comfortable having a discussion
on other sexual matters. Overall, however, there appears to be a heartening movement
towards young people feeling more comfortable asserting and sharing their views with their
parents as compared to previous generations. While it is probably true that family
relationships are still quite conservative compared to elsewhere in Europe, the fact that there
are now fewer barriers suggest that there is significant potential to work within family
structures to address many important issues that relate to youth in Kosovo.
4.4.2
Youth and Society
The picture of growing youth participation in different aspects of society is, however, less
strong outside the family. Within schools, slightly more than 20 per cent of those surveyed
felt that their opinions mattered with regard to decisions taken by school authorities
(although around 50 per cent of those interviewed did feel that they had some say). Perhaps
not surprisingly, within peer groups there is a stronger degree of consultation with over 87
per cent feeling that their opinions mattered among friends. There is also room for
improvement in the degree to which young people's opinions are heard within the immediate
67
The survey did not, however, explore this issue further so it is not possible to say why this might be the case.
For example, it might well be due to the absence of parents more than traditional views that limit the degree
to which children are able to discuss issues.
February 2004
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Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
community (neighbourhood) with the largest percentage (47 per cent) of young people
feeling that there views were rarely taken into account. This perhaps suggests the degree to
which the broader sense of community is weakening in Kosovo with growing urbanisation.
More rural residents (23 per cent) felt that they had a significant impact on decision-making
compared to urban residents (12 per cent).
4.4.3
The Role of Youth Organisations
Civil Society Organizations (CSOs) play a critical role in constructively engaging youth in
their communities. They also provide settings where opinions can be expressed and where
adolescents can begin to develop the skills that will enable them to feel a greater sense of
participation and ownership over issues relating to their lives. On the surface it appears that
there is strong involvement of young people in civil society and the NGO sector. There are a
large number of NGOs and organisations that cater to young people in Kosovo. The Kosovo
Youth Network (KYN), which is an umbrella body, has 97 member organisations. The vast
majority are voluntary, with more than 80 per cent of organisations having less than five paid
staff (around 60 per cent are wholly volunteer run). Most NGOs are less than two years old
and are still finding their feet in terms of organisational development and maturity. There
were mixed feelings about the degree of influence and impact that such organisations have.
In theory, these organisations could represent an important means of engaging young
people and for providing a platform for the articulation of a youth-centred policy agenda. The
impact of youth organisations on policies and programmes thus far has been limited and the
lack of sustainable sources of funding for youth- based NGOs is a major problem. It should
be noted, however, that this reflects a general pattern throughout the NGO sector in Kosovo
which is still quite small and dependent on external support.
Perhaps a more serious long term problem has to do with the levels of participation among
young people in civil society generally. A closer examination shows that in many cases these
organisations represent a small handful of people. Only 18 per cent said that they were a
member of a youth organisation or NGO, with a slightly higher participation rate for males
over females. This gap is all the more concerning given that less than 50 per cent of young
people felt that their opinions were taken into account by decision-making bodies. This
feeling of powerlessness was particularly acute in young people from minority communities
who continue to feel cut off from opportunities to engage with issues that they see as
important for changing their lives.
4.4.4
The Need for Space ….
As part of an attempt to provide spaces
Influence on Policy-Making
for young people to meet and to provide
them with access to basic facilities (e.g.
60%
computers and internet access), the
international
community,
in
the
50%
aftermath of the war, funded a number
40%
of youth centres throughout Kosovo as
30%
part of a general policy of supporting
20%
civil society activities. Having opened
10%
with a flourish however, many youth
centres are finding it increasingly
0%
N o ne
So me
A lo t
Ot her
difficult to survive now that international
funds have dried up. For the most part,
Dept of Youth Other central government institutions
M unicipalities
these centres have not been able to tap
into existing governmental funds for youth activities. Four youth centres have already closed
or have severely cut back on their activities. The one positive exception has been the youth
centre in Gjilan/Gnjilane which was able to secure alternative premises from the Municipality.
February 2004
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Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
The closure of many centres has created a tremendous amount of frustration among young
people and is seen as evidence of the lack of commitment on the part of local government to
support activities that benefit young people. This fact is particularly troubling given that a
number of centres had begun to branch out their activities to offer informal courses and work
placement schemes that had employed hundreds of young people. The closure or simple
lack of youth centres represents a missed opportunity to engage with young people, and to
encourage opportunities for mutual learning and activism at the community level.
4.4.5
Relationship with Governmental Institutions
On average about 10 per cent of those surveyed felt that their interests and needs were
taken into account by decision-making bodies in Kosovo, compared to 45 per cent who felt
that this was not the case. What was particularly worrying was that fully 15 per cent of those
interviewed felt that their views were not taken into account at all. This feeling was
particularly high among Kosovo Serbs (31 per cent) who feel doubly marginalised as both
young people and as part of a minority community. In fact, interviews with Kosovo Serbs
revealed a sense of abandonment and a feeling that it was almost futile to attempt to change
the status quo through some form of organising. A similar percentage also felt that young
people were not adequately consulted with regard to policies that specifically addressed the
needs of youth. In both cases, there were no noticeable differences between males and
females or by age or ethnic group.
For the Department of Youth (within the Ministry of Culture, Youth and Sports), high on the
agenda is the creation and passage of a Youth Law and the implementation of Values Based
Leadership training for young people. The sustainability of youth centres is a priority concern
but there continues to be a gap between the intentions of government officials and
institutions and action on the ground. In particular, while there is a commitment to
maintaining youth centres there are no funds available at the local level that can be used for
this purpose. Furthermore, it appears clear that the need to engage with young people is not
perceived as a priority in many municipalities and lines of accountability continue to be
blurred. Young people and NGOs perceive the Department of Youth as being proactive and
open while, in contrast, at the municipal level there is a much more negative impression of
the commitment to meeting the needs of young people. This disaffection is almost always
tied directly to the very tangible issue of the closure of youth centres. Only three
municipalities appear to have positive relationships with youth groups in their communities
(Gjakovë/Đakovica [Gjakovica], Pejë/Peć and Gjilan/Gnjilane).
February 2004
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Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
4.4.6 The Source of Decision-Making Power
Given the somewhat mixed experiences of young people in their interactions with
institutions, it is perhaps not surprising to detect an emerging cynicism about how decisions
are made in Kosovo. There appears to be strong sense that processes are less important
than connections, family ties and “knowing the right person”. This is an opinion that is
particularly evident among young people who are members of parties, forums or political
organisations, and also among civil society activists, although the latter have more faith in
work and dedication. The vast majority of young people (80 per cent) feel that success and
power is linked to connections or family origins. In large measure this is understandable,
given that Kosovo has always placed considerable stock on strong family ties and
connections and, that these habits still persist in the new Kosovo. However, it should be a
concern if the leaders of tomorrow start believing that this is the way it has to be. One of the
keys to the future success of Kosovo will be the emergence of a genuine meritocracy that
rewards endeavour and ability. It is particularly important if we are to avoid the ethnic-based
rivalries and tensions where the success of one group can only come about at the expense
of, and through the failure(s) of another.
4.4.7
Media and Youth
Article 17 of the CRC states that
"…States Parties recognise the important function performed by the mass media
and shall ensure that the child has access to information and material from a
diversity of national and international sources, especially those aimed at the
promotion of his or her social, spiritual and moral well-being and physical and
mental health. To this end, States Parties shall: (a) Encourage the mass media to
disseminate information and material of social and cultural benefit to the child and in
accordance with the spirit of article 29…"
Amidst a growing sense of frustration that young people are not being able to play an active
part in the shaping of a new Kosovo, there are some very notable exceptions. Among all
public institutions, the media is recognised as devoting a significant portion of time to young
people. Approximately two thirds (67 per cent) claim that national TV dedicates sufficient
time and space to youth. It should though be noted that there is a sharp difference of opinion
among the Kosovo Serb population. Less than 30 per cent feel that youth issues receive
enough space on national TV (this reflects an ongoing lack of attention to minority issues in
most media in Kosovo).68
However, as has been noted in earlier sections of this chapter, it is clear that for the vast
majority of Kosovars, the media, and television in particular, plays a formative role in shaping
opinions and passing on crucial information. It is the one area where young people feel that
they have a forum which engages with their ideas. This would suggest that there is
considerable scope for building on this positive state of affairs and to use the media as a
means of reaching out to disaffected youth and for building ties between communities.
Continuing to provide media space will also be an important means of enabling youth to find
their voice within society and to feel that they too have a stake in the future of Kosovo.
68
Article 17 also goes on to require states parties to, “Encourage the mass media to have particular regard to
the linguistic needs of the child who belongs to a minority group or who is indigenous” which is clearly not the
case in Kosovo. Kosovo Serb youth are again caught between two governments, neither of which is willing to
take on the full responsibility of ensuring that young peoples’ issues are given due time and space in the
media.
February 2004
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Situation Analysis of Children and Women in Kosovo
Adolescent and the Education
Space for Youth Issues
The influence of the m edia on youth
+2 (very high) to -2 (very low )
50
0.7
0.6
40
0.5
30
0.4
20
0.3
0.2
10
0.1
0
National Local TV National
TV
Radio
4.5
Local
Radio
Dailies
0
Weeklies Monthlies
National Local TV National
TV
Radio
Local
Radio
Dailies WeekliesM onthlies
Policy Agenda for Youth
Given the vital importance of youth for the future of Kosovo, it is crucially important that
policy makers begin to systematically engage with young people. From the analysis of
opinions presented above, a number of key issues emerge.

Above all, young people from all communities need to feel and believe that they have a
stake in the future growth and prosperity of Kosovo. High rates of youth unemployment
and an education system that is failing to prepare people to lead productive lives will act
as a breeding ground for resentment among youth from all communities. There is,
therefore, an urgent need to reach out to young people, to hear and address their
concerns. Education and training need to relate to future employment opportunities.

The formation of youth councils and other representative bodies that provide a platform
for young people to interact with decision-making bodies (envisaged as part of the Youth
Policy that is being developed) represents an important opportunity for increasing the
sense of ownership that is currently lacking.

There is also a clear need (and opportunity) to build on the emerging civil society and to
actively support and promote youth groups and NGOs that specifically address youth
issues. As the experience of the Youth Centres has shown, there is an important need
for a space that young people can call their own and take ownership of. But these
organisations require both financial and technical support to enable them to grow and
develop if they are to be genuinely representative of young people in Kosovo.

The development of a strong youth NGO sector will also provide an institutional
counterpart to local and governmental authorities that seem indifferent or unable to
systematically reach out and engage with young people. This is particularly true at the
municipal level.

There is also an opportunity to build on the last four years, such as continuing to promote
young people's participation in TV and radio, and to provide a forum for young people to
come together to share their experiences and knowledge. However, it is clear that steps
need to be taken to ensure the participation of young people from minority groups who
feel totally excluded from mainstream media.

This chapter also outlined the extent to which rapidly changing social values combined
with a lack of knowledge and awareness about healthy life style choices represents a
major concern for young people. There clearly needs to be much more widespread
dissemination of information around reproductive health, sexual education, prevention of
STI and HIV infection, unwanted pregnancy and other life skills.
February 2004
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Situation Analysis of Children and Women in Kosovo

Adolescent and the Education
An important part of ensuring better sexual health will be the provision of youth-friendly
health services that will allow young people to obtain the information and guidance they
need to protect themselves and make sensible choices.
5. Protection from Violence, Abuse, Exploitation and Discrimination
Child protection is a complex issue requiring action across several sectors and at various
levels - many of the issues discussed in this chapter have been touched upon elsewhere in
this report. This chapter begins with a brief overview of the concept of child rights and then
looks at the steps taken by the government to promote and safeguard child rights in Kosovo.
The remainder of the chapter is divided on the basis of four key protection issues namely,
protection from exploitation (child labour and the trafficking of young girls), abuse (most
notably domestic violence), deprivation (children without parental care and children in
conflict with the law) and discrimination (based on gender, ethnicity and disability).
5.1
The Concept of Child Rights
As members of the human family, children have inalienable human rights and freedoms that
are inherent to the dignity of the human person. They are entitled to benefit from special
protection and assistance, to be informed about their rights in an accessible and proactive
manner, to develop their personality, abilities and talents to their fullest potential and to grow
up in an environment of happiness, love and understanding.
The Convention on the Rights of the Child (CRC) and the Convention on the Elimination of
all forms of Discrimination against Women (CEDAW) have been widely ratified and are
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Situation Analysis of Children and Women in Kosovo
Protection from Violence, Abuse,
Exploitation and Discrimination
mutually reinforcing, especially in the promotion and protection of the human rights of girls
and women and in the prevention of discrimination on the basis of gender. Both are part of
the Constitutional Framework for Self-Government in Kosovo (UNMIK Regulation No. 2001).
The CRC recognises the human rights of children, defined as persons up to the age of 18
years. Children's rights have to be implemented without discrimination of any kind. All
actions and policies should be guided by the best interests of the child and aim to promote
the survival, development and participation of the child. The participation of children should
always be sought as appropriate to their age. In the light of the CRC, children are no longer
seen as recipients of services or beneficiaries of protective measures. Rather, they are
human beings with rights and it is these rights and not just their needs that should be
respected and addressed.
Four principles guide the implementation of the CRC:

Non-discrimination: All children are entitled to the rights and freedoms set forth in
the Convention on the Rights of the Child "without distinction of any kind, such as
race, colour, sex, language, religion, political or other opinion, national or social
origin, property, birth or other status".

Best interests of the child: In all decisions affecting children, the best interests of
the child should be given primary consideration.

Survival and development: Child development is a holistic concept. The
enhancement of a child’s health must be associated with his or her spiritual, moral
and social development where the child’s personality, talents and abilities are
promoted to their fullest potential in a manner that is compatible with the dignity of
the human person.

Respect for the views of the child: This principles affirms the value of the child as a
fully-fledged person having the right to access information and freely express views
in all matters affecting him or her, having those views respected and given due
weight.
5.2
Policies and Legislation
The Ministry of Labour and Social Welfare - Department of Social Welfare is committed to a
co-ordinated and comprehensive response to promote child protection, which incorporates
community action to:

prevent and reduce the abuse and neglect of children or young people in the
community

provide support to families experiencing difficulties

respond to reports of risk of harm to ensure that the safety of children and young
people is effectively addressed and appropriate support is provided
The Department of Social Welfare recognises that there are common features that enable
consistent procedures to be developed and implemented within a best practice framework.
As such, the Department has developed a Child Protection Manual for use by the Centres
for Social Work, a procedural manual for child protection cases. It recognises that physical
abuse, emotional abuse, neglect and child sexual assault will require different and
specialised responses. The Department of Social Welfare, within the Ministry of Labour and
Social Welfare, has the ‘lead responsibility’, administered through the Centres for Social
Work, for providing and co-ordinating the community response where intervention is
necessary for the care and protection of children and young people. The Centres for Social
Work have wide-ranging statutory powers to enable them to carry out their role in protecting
children and young people from abuse and neglect on behalf of the community.
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Protection from Violence, Abuse,
Exploitation and Discrimination
The role of the Police Service in child protection is to recognise report and investigate child
abuse and neglect. The police are responsible to assist wherever possible in ensuring the
safety and security of children and young people, their families and the workers in agencies
involved in child protection intervention. The role of the Ministry of Health in child protection
is to recognise and report children and young people who are suspected to be at risk of
harm and to provide medical examinations for children and young people who have
experienced abuse or neglect. The role of the Ministry of Education, Science and
Technology in child protection is to promote the safety, welfare and well-being of children
and young people whether they are students, apprentices or trainees in schools, colleges,
workplaces or programmes conducted by the Ministry under the auspices of the Department
of Education. Ministry of Education employees are responsible for recognising and reporting
children and young people, suspected to be at risk, to the Centres for Social Work.
Advocacy and lobbying by the main international agencies and NGOs involved with child
rights has led to the appointment of Child Rights Co-ordinators in almost all municipalities
during 2003 (to date 28 of 30 municipalities have such co-ordinators). This has been
accompanied by capacity-building and training to allow for the development of municipallevel analysis and development of plans of action for children.
5.3
Child Labour
While there are no statistics regarding
working children in Kosovo before
Child Labour Activities
1999, child labour has long been an
established practice particularly in
rural areas and is regarded as an
accepted means to integrate children
into the family and kinship network. In
fact, helping the family is seen to be
paramount to a child's healthy
development. It is not seen as
hazardous to the health of a child and
may even be viewed as serving
her/his best interests.
However, in
post-conflict Kosovo, the number of
children who are engaged in some
form of employment has become a major concern and requires further attention and study,
especially in the context of ensuring equal protection and access to education.
5.3.1
Nature and Extent
The 2000 World Bank Living Standards
Measurement Survey (LSMS) provides
some baseline data for understanding the
extent of child labour in Kosovo. The survey
estimated that approximately 4.5 per cent of
children between the ages of 10 and 14
were engaged in some form of employment
(paid and unpaid). The study also found that
the majority of children were engaged in
agriculture, followed by household work and
petty trade.
Case study of night work on the street,
Two siblings, Merita and Fatmir, ages 10 and
13 years old, travel every day from Penush, an
Albanian village in Podujeve/Podujevo, to
Prishtinë/Priština to work. Every day they have
to travel for more than one and a half hours by
bus. At 8:00 am they start selling cigarettes in
the streets of Prishtinë/Priština and return at
23:00 to their home. They work seven days a
week and do not rest on weekends. During
school year, they work less but still stay out
late on the street. They have no other choice,
A background paper prepared by CARE for
they say, as their father is unemployed and the
this report documents a number of important
family needs the money they make. But the job
is not easy and not safe. Both do not feel
issues that provide greater context to child
secure at night, especially since some
“skinheads” attacked them in the street and
stole all the money they had made during the
February 2004
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Situation Analysis of Children and Women in Kosovo
Protection from Violence, Abuse,
Exploitation and Discrimination
labour in Kosovo.69 Perhaps the most worrying finding is the age at which children begin to
enter the labour force. Approximately 40 per cent of all children start working before their
tenth birthday and there were several cases of children beginning work before they reach the
age of five. While it has been common for (very) young children from rural areas to engage
in household work and agricultural activities, especially as herdsmen, the study found that
more than 30 per cent of working children under the age of 10 work in selling activities either
on the street or in shops and markets.
Article 32 of the CRC states that
"… States Parties recognize the right of the child to be protected from economic exploitation and
from performing any work that is likely to be hazardous or to interfere with the child's education,
or to be harmful to the child's health or physical, mental, spiritual, moral or social development."
This phenomenon of very young
children working on the street is
Age of Entry into Labour Force
particularly troubling for a number of
25
reasons. First, the ages of nine to ten
20
years are critical for children to remain
connected to the official educational
15
system and there is evidence to
10
suggest that upwards of 10 per cent of
young working children are absent
5
from school on a regular basis. The
0
second concern is the vulnerability of
4
5
6
7
8
9
10
11
12
13
14
15
young children to exploitation and
Age
violence. As can be seen from the text
Girls B o ys A verage
box above, young children are at risk
of bullying and theft and they lack the
strength and emotional maturity to protect themselves from attacks. The number of children
below 10 years old working after 10 pm is approximately 12 per cent and around 45 per cent
of these children are under the age of 13. An increasing number of these children do not feel
safe at their work locations and have reported being victims of criminal activities.
There are also some important sex-related differences that are worth noting. While boys
predominantly work in the selling and trading of items in public places, girls mostly work at
home. Boys on average start work at an earlier age and work more hours per day than girls.
This leads to an overall perception of female child labour being both less frequent and less
severe. However, the survey showed that girls are also more likely not to receive any
financial remuneration for their work and are more likely not to attend school. The survey
also found that a significant number of girls were engaged in more visible and harsher forms
of child labour, such as late night work or work on the street.
5.3.2
Ethnic Differences
The study also shed light on the
experiences of working children from
different ethnic communities. While children
from the Kosovo Albanian and Kosovo Serb
communities show broad similarities with
regard to employment, it was equally clear
that Roma, Ashkalia and Egyptian (RAE)
children are more likely to be involved in
physical and other dangerous activities,
Arife is a Roma girl from Prizren/Prizren town.
She doesn’t know how old she is because she
has never been to school but her friends say
she is about 12 years old. She is one of many
children who missed school because her
parents could not afford to send her. Education
is too expensive, they told her. Arife lives at
home and does the housework all day long,
seven days a week. As she said, she cannot
take a day off since she takes care of her
younger brothers and sisters and they need her
69
full attention.
This is because
her mother
is not
Due to the non-representative nature of the survey sample
it is not possible
to draw definitive
conclusions
do everything,
she says.
She
thatbe
about child labour patterns in Kosovo. However, theable
studytodoes
point to important
trends
thatsays
should
explored further.
she has no big plans for her future. She will
have to do the same things as she does now.
She just has to get married and have her own
children.
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Situation Analysis of Children and Women in Kosovo
Protection from Violence, Abuse,
Exploitation and Discrimination
including the collection of cans and garbage which involves significant health risks. In
addition, unlike other working children, RAE children are far more likely to have a loose
connection to formal schooling - of the children surveyed, over 30 per cent of children from
the RAE community no longer attended school. This is particularly true for girls who are
more frequently likely to work within the home (see box).
5.3.3
Access to Education
percentage
One area where the study revealed
that the experience of working children
School Attendance Rates Working Children
differs significantly from expected
norms is in the area of education. In
100
part because of the shift system in
urban primary schools, the study
80
found that the vast majority of children
60
interviewed were not only in school
but claimed to be performing well.70
40
While no major differences between
20
girls
and
boys
were
found,
disaggregating
by ethnicity did
0
highlight
significant
differences.
Kosovo
Serb
working
children
reported a 100 per cent rate of school attendance while Kosovo Albanian working children
reported a 94 per cent rate of school attendance. This should not be seen as evidence that
child labour has no impact on the performance of children in school. Roughly 10 per cent of
working children have at some point stopped, left, interrupted or repeated some elements of
school. According to survey data, more than 90 per cent of working children in Kosovo reentered school at some point while less than 9 per cent have completely discontinued their
education. In contrast almost 40 per cent of RAE working children reported no school
attendance; a statistic that is truly alarming because of the potential long-term and
devastating effects it has, not only on the children but also on the entire community.
Another point of interest has to do with the family and economic background of the children
interviewed. Unlike other working children in South Asia and Africa, most working children in
Kosovo have strong ties to family. The overwhelming majority of the working children
interviewed (99 per cent) reported that they have some type of family support. Virtually none
of the surveyed working children in Kosovo indicated that they are shelter less or that they
live on the streets. The fact that these children do have existing family support structures is
an important consideration for any preventive or normative intervention that might be
designed to prevent and combat child labour in Kosovo. The study also found that most
working children did not come from the poorest strata of society and that less than 10 per
cent of those surveyed indicated that their contribution to the family income was crucial for
the family’s survival. Again, the one exception to this case was within the RAE community.
Child labour is a complex phenomenon in the context of Kosovo. While there are few
examples of the egregious forms of child exploitation that should never be tolerated, it is also
clear that the sheer prevalence of working children requires the attention of agencies
concerned with the overall welfare of children in Kosovo. Perhaps the most urgent need is to
focus on broadening our understanding of the extent and consequences of child labour. This
will require meaningful strategies and studies that will provide accurate qualitative and
quantitative data about the nature and extent of children's work and its relationship to
education. In particular, it is important that data on child labour behaviours and conditions
can be disaggregated according to gender, age, and ethnicity.
70
Of course it should be noted that a child’s perception of performance might not accurately reflect
the impact of working on their educational achievements.
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Situation Analysis of Children and Women in Kosovo
Protection from Violence, Abuse,
Exploitation and Discrimination
Also, much more information regarding the type of work children perform (in particular the
more "invisible" forms of child labour), the number of hours children spend working, the
impact of child labour on children’s school success and health, needs to be collected. This
will allow for a deeper understanding of why children are not in school and the reasons that
they do not attend school. The importance of an effective system of birth registration,
including the issuing of birth certificates, should also be taken into account in order to allow
for better opportunities at identifying and reaching the "unreachable" and out of school
children.
5.4
Commercial Sex Work and Trafficking
Since the end of the conflict, Kosovo has become a
major centre for commercial sex work and the trafficking
of young women and girls, despite the efforts of a
number of international and local NGOs. What is of
especial concern are the growing number of minors
being trafficked and the rise in the number of Kosovars
who are being discovered in commercial sex work or as
victims of trafficking themselves. While exact data is
difficult to obtain, the Trafficking and Prostitution
Investigation Unit (TPIU) is the main institution that is
concerned with monitoring and interdiction, working
alongside a number of international and local NGOs.
5.4.1
Article 34 of the CRC states that
States Parties undertake to
protect the child from all forms of
sexual exploitation and sexual
abuse.
a. The inducement or coercion
of a child to engage in any
unlawful sexual activity.
b. The exploitative use of
children in prostitution or
other unlawful sexual activity.
c.
The exploitative use of
children
in
pornographic
performances and materials.
Article 35 states that
Extent
States Parties shall take all
The IOM, which works primarily with women from other
appropriate national, bilateral and
countries who have been trafficked to Kosovo, has
multilateral measures to prevent
assisted 381 victims between 2000 and 2003,
the abduction of, the sale of or
approximately 10 per cent of whom were under the age
traffic in children for any purpose
of 18. While the majority of minors (defined as being
or in any form.
below the age of 18) were from Romania, fully one
fourth of minors being trafficked were from Kosovo, the
youngest of whom was 10 years of age. IOM’s statistics
show a progressive increase in the number of Kosovo
women and girls that have become victims of
trafficking.71 This trend is also confirmed by figures from the TPIU, which reports that minors
constituted around 12 to 14 per cent of all cases. In the first six months of 2003, the TPIU
handled 16 cases involving minors from Kosovo which represents a sharp increase over the
numbers for 2001 and 2002.72 The TPIU also reported that five victims (from the RAE
community) were under the age of 10.
The most alarming statistics are recorded by the Centre for the Protection of Women and
Children. The centre assisted 271 Kosovo victims of trafficking between 2000 and December
2002. Four victims were trafficked to France and seven to Italy, while the rest were
trafficked internally (i.e. within Kosovo). This suggests that the issue of internal trafficking,
which is far less visible than international trafficking is perhaps of more long term concern for
Kosovo. The most disturbing statistic from this report is the percentage of girls who were
under the age of 18. Over a third of the victims were between the ages of 11 and 14 and
71
In 2000 – 0 victims; 2001 – 5 victims; 2002 – 8 victims.
72
In 2001 the TPIU reported 131 cases with 21 (16 per cent) involving minors. In 2002 there was a noticeable
decrease in numbers with only 53 victims of which six (11 per cent) were minors.
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Situation Analysis of Children and Women in Kosovo
Protection from Violence, Abuse,
Exploitation and Discrimination
another 50 per cent were between the ages of 15 and 18. In total, the number of cases
reported involving minors was 219.73
The lack of a unique database on victims of trafficking has complicated efforts to discern a
clear picture of the extent of trafficking in Kosovo. There is also a need to pay more attention
to the tremendous psychological damage suffered by victims of trafficking. A recent IOM
report details the use of regular and systematic violence and rape on the part of brothel
owners. Furthermore, most women have only limited access to medical services and in over
one third of cases are forced to have sex without a condom.
5.4.2
Awareness
A study on child trafficking by Save the Children explored the question of how families would
respond if offered the opportunity to seek employment overseas (which has traditionally
been a major means of "recruiting" victims). While the majority said that they would only trust
a family member or no-one, a large minority were more open to accepting the offer if the
person was somehow "known to them". This suggests that there is an urgent need to
strengthen public awareness among both children and families regarding some of the tactics
being used by international traffickers. The study also found that awareness levels about
child trafficking were low among secondary school age children and overall understanding of
the nature of the problem is poor. Many children spoke about trafficking in the most general
terms as an illicit trade. The study also identified the lack of information within the family to
be a serious problem, with many children never having discussed the issue with their
parents and most information being gained anecdotally from media sources. The lack of
awareness was reinforced by responses to the question of accepting employment
opportunities overseas, where many respondents appeared open to the offer without being
able to articulate how they would distinguish between legitimate offers and those that could
result in trafficking.
5.5
Domestic Abuse
Given Kosovo’s recent past of conflict and social dislocation, attempts to understand the
nature and extent of domestic violence and in particular the abuse of children is complicated.
Despite advances in the status of women, Kosovo is still essentially a patriarchal and
traditionalist society. The prevalence of large extended families and the use of informal
dispute resolution mechanisms, especially in rural areas, all serve to disguise the true extent
and depth of domestic violence in Kosovo. Furthermore, the lack of effective formal
mechanisms for dealing with domestic violence and reluctance on the part of police and
social workers to intervene in situations of violence within the family has further hindered
efforts to document and understand the causes of domestic violence within Kosovo. It is also
acknowledged that, as in other countries, victims of violence often feel powerless to speak
out against abuse or to change their circumstances. In Kosovo, this is further exacerbated by
situations where the rights of women and mothers are limited. In situations where a mother
chooses to leave an abusive relationship, there is a strong likelihood that she will lose
access to her children who will remain the responsibility of the father's family. In addition, the
lack of social protection schemes for women and children who are victims of violence limits
the ability of victims to leave an abusive relationship.
The biggest obstacle to dealing with domestic violence is the lack of clear strategies and
mechanisms within the Centres for Social Work for handling victims of violence. Due to a
lack of resources and alternatives for victims of violence there is still a tendency to try to
effect reconciliation within the family. There is also a lack of clear knowledge that the role of
73
Save the Children study on Child trafficking in Kosovo suggests that CPWC reports do not distinguish clearly
between cases of violence, abuse and trafficking.
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Situation Analysis of Children and Women in Kosovo
Protection from Violence, Abuse,
Exploitation and Discrimination
the social worker is to be an advocate for the best interests of the child, rather than to act in
"loco parentis" and to make decisions on behalf of the child regardless of their needs and
preferences.
5.5.1
Extent
There have been a number of attempts to document the extent of domestic violence in
Kosovo. UNIFEM conducted a survey of 215 women on violence within the family. Of the
women interviewed, approximately 23 per cent reported some form of domestic abuse
(which is higher than in the UK for example, where one in five, or 20 per cent, of women
report domestic abuse). The study also found that abuse was more likely (42 per cent) to
happen to women who were between the ages of 35 and 54 years of age. The study also
found a higher incidence of domestic violence within urban society than in rural areas. This
is an interesting departure from conventional beliefs that rural communities are more
conservative and patriarchal (and hence more accepting of violence). There was also a high
rate of marital rape reported (18 per cent). Interestingly however, there appeared to be little
or no correlation between violence against women and mistreatment of children.
The study also had some very interesting insights into the causes of violence. Rural women
in particular felt that broader restrictions placed on them, including not being allowed to go to
school or to work, were manifestations of violence and that this non-physical violence and
other forms of societal coercion (i.e. lack of freedom to chose partners) creates an
atmosphere in which violence occurs and is tolerated.
The other main source of information
with regard to domestic violence
comes from the work of the Centre for
the Protection of Women and Children
which runs several shelters across
Kosovo that cater to abused women
and their dependents. The Centre
treated a total of 1,485 cases of
domestic violence against women and
children in 2002. The centre also
reported providing shelter for 146
victims of violence for a total of 1,683
nights.
Dom estic Violence Cases CPWC 2002
A more recent study conducted as
background research interviewed 76 children between the ages of 12 and 17, revealing that
there was still a relatively high frequency of physical punishment (slapping etc.) used to
discipline children. One third of those interviewed claimed that they had been hit by their
parents at some time.74
5.6
Children without Parental Care
The separation of a child from its parents is not a new
phenomenon in Kosovo where traditional attitudes stigmatise
children born out of wedlock. A young, unmarried pregnant
woman who cannot turn to her partner or her family for support
may often resort to abortion or to abandoning the newborn baby
in the maternity ward. However, research by the Institute of
Social Policy argues that one needs to better understand child
separation as a product of a number of different factors. These
Article 25of the CRC
states that ..
States Parties recognize
the right of a child who
has been placed by the
competent authorities for
the purposes of care,
protection or treatment of
his or her physical or
mental health, to a
74
The sample was not representative so the results presented should be seen asperiodic
indicative. review of the
treatment provided to the
child and all other
circumstances relevant
February 2004
79
to his or her placement.
Situation Analysis of Children and Women in Kosovo
Protection from Violence, Abuse,
Exploitation and Discrimination
include low levels of social and economic development and, in particular, the limited access
to education for young women and lack of responsibility among young men who father
children. The report argues that child separation is tied to lack of knowledge about
reproductive health among young women. It also points out that traditional practices
regarding unmarried mothers are also directly correlated to restricting the ability of pregnant
women to obtain proper medical advice and care.75
Provision for children without parental care is varied. The primary legal bodies that are
responsible for the protection and welfare of these children are the Centres for Social Work.
The Centres are responsible for either facilitating the reunion of the child with its family
(which often requires counselling within the extended family), or arranging either adoption or
foster care as appropriate. In addition, there are now two specialist homes that can
accommodate children and ensure that abandoned children receive proper care while
alternative provision is made. This represents a marked improvement on the previous and
common situation of children remaining indefinitely within hospitals while a more permanent
solution was worked out. A continuing problem, however, appears to be the lack of training
and awareness among many social workers as to the rights of abandoned children. In
particular, there is a need for further training to ensure that it is the best interests of the child
that guide proceedings, rather than expediency. Case management practices remain
rudimentary at best, and there is limited contact and supervision once a child is no longer
under the care and jurisdiction of the Centres for Social Work. This opens up the risk of
children being placed in unsafe environments.
Table 21 Children without Parental Care
Year
No. of
children
Sex
F
Mother
known
M
Yes
Status
No
Reunion
Adoption
Care
Unknown
Dead
1999
24
13
11
20
4
1
4
0
16
3
2000
67
37
30
67
0
12
37
14
0
4
2001
75
29
46
75
0
19
25
27
2
2
2002
50
26
24
50
0
5
11
32
4
0
Total
216
105
111
212
4
37
77
73
22
9
Source: Gynaecological and Obstetrics Clinic Prishtina
The research carried out by the Institute of Social Policy also provided insight into other
pressures felt by young mothers. As mentioned before, there continues to be tremendous
social pressure on unwed mothers to give up their children, regardless of the wishes of the
person involved. This situation is exacerbated by the fact that in many cases, mothers lack
the material support required to raise a child as a single parent. The vast majority of mothers
have, at most, a primary school education and are not employed. The study argues that
there is a direct causal link between the lack of education and early (and unplanned)
pregnancy. Many of the young mothers interviewed lacked basic knowledge about
reproductive health and were not prepared emotionally and psychologically for the
ramifications of pregnancy (including the possibility of having to drop out of school, forgo
employment opportunities, or even be disowned by their family). This would suggest that
greater emphasis needs to be placed on educating young girls about the risks of early
pregnancy and also to increase the availability of youth friendly and confidential clinics
where girls might seek advice and contraception that is not available elsewhere. Boys also
need to be made aware of their responsibilities and the need to protect their partner from
75
Additional research is also needed to identify those children who are not living under parental care due to the loss of family members
during the conflict.
February 2004
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Situation Analysis of Children and Women in Kosovo
Protection from Violence, Abuse,
Exploitation and Discrimination
unwanted pregnancy and/or infection. A survey of young people conducted by Index Kosova
in 2003 confirms that in matters relating to sexual relations and pregnancy, there is a marked
lack of communication between children and their parents and that general knowledge about
basic reproductive health was poor.
Within the broader context of very traditional attitudes
towards gender relations in Kosovo, the studies raise
concerns about how current understanding of parenting
responsibilities focuses on mothers only. This ignores the
fact that in most cases mothers have been unable to keep
and care for their child because the fathers have refused to
accept their responsibilities. It is common for the father to
either refuse to acknowledge paternity or, in cases where
there are no doubts about paternity, to provide (financial)
support to the mother.
5.7
Article 18 of the CRC
states that …
States Parties shall use
their best efforts to ensure
recognition of the principle
that both parents have
common responsibilities for
the
upbringing
and
development of the child.
Juvenile Justice
Justice in Kosovo is a reserved power of the
Article 40 of the CRC states that
SRSG and does not fall under the purview of
“States Parties recognize the right of every
the PISG. Following the end of the conflict,
child alleged ….. having infringed the penal
the administration of justice and basic
law to be treated in a manner consistent with
services for the benefit of juveniles no longer
the promotion of the child's sense of dignity
functioned effectively. The conflict destroyed
and worth, …… and which takes into account
all existing institutions for juveniles, including
the child's age and the desirability of
a police service specialised in the handling of
promoting the child's reintegration and the
juvenile cases, a juvenile court system, a
child's assuming a constructive role in
social work system and facilities for the
society.”
disposition of juvenile cases. As a result,
there is a serious risk that children and
young offenders will end up being treated as adults. While accurate data remains somewhat
difficult to obtain, it appears that a significant number of children are involved in criminal
matters and will require special assistance. In 2000, approximately 3,461 children were
involved with the police. Of these 1,737 were suspected of criminal activity and another 935
were the victims of criminal activity. Furthermore, the OSCE reported that approximately 180
juveniles were indicted for serious offences and that approximately 23 per cent of all serious
crime involved people under the age of 18.
This would suggest that there is an urgent need to continue to work with law enforcement
officials and members of the criminal justice service to ensure that they are trained to handle
juvenile offenders in keeping with the CRC and other human rights standards. Following the
opening of the Kosovo Police Service (KPS) Training School in Vushtrri/Vučitrn, training
materials for the policing of juveniles were developed with support from UNICEF. As a result
of this training, the KPS now includes a three-hour training component on the policing of
juveniles for all new police recruits. The first 4,000 police officers graduated from the
academy in 2001. There needs to be continued monitoring and follow up to assess the
impact of the training and to refine it based on the practical experience and lessons learned
in the field.
The bigger problem, however, has to do with how the judicial system treats young offenders
even though the Department of Justice is a UN responsibility. While the Department of
Justice has appointed juvenile court judges there are still no prosecutors that are trained to
handle juvenile cases. Furthermore, a draft Juvenile Justice Bill, completed in 2002 after
exhaustive consultation both within Kosovo and internationally, that clearly delineates the
treatment of young offenders and recommends the use of mediation and other diversions for
dealing with juvenile crime has still not been approved by the SRSG (Office of Legal Affairs).
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This document would have laid the ground for a system-wide reform of how children were
dealt with by the law.
5.7.1
Children Deprived of Liberty
Currently
young
offenders
are
Num ber of Convicted Juveniles by Offence
incarcerated in one of two prisons.
The Lipjan/Lipljan centre is a
10
correctional institution that is used to
8
accommodate male juveniles, adult
females and mentally ill males. Each
6
group is held in a separate block and
4
has no dealings with the other
2
inmates. Nonetheless, this policy is in
0
violation of international norms and
Article 37(c) of the CRC which states
Murder
Complicity in murder
Attempted murder
that “every child deprived of liberty
Sexual assault
Robbery (theft with violence)
Theft
shall be separated from adults unless
Petty theft
Assault
Kidnapping
Traffic ?
it is considered in the child's best
interest not to do so ..” and require
juveniles to be held in separate facilities with the aim of receiving treatment and training
opportunities prior to being reintegrated into society on completion of their sentence.
However, young offenders at Lipjan/Lipljan are provided with time for recreation, sport and
other leisure activities, as well as basic education. The school is organised and supported by
the MEST, but has financial difficulties which are affecting teachers’ salaries, purchase of
basic school materials, etc. The curriculum is not complete and includes only three
subjects.76 Some juveniles have been held in Dubrava prison, Kosovo’s maximum security
facility, and which should not, under any circumstances house young offenders.77 In 2002,
there were a total of 154 juveniles incarcerated in Kosovo (121 at Lipjan/Lipljan and 33 at
Dubrava respectively). While complete figures for 2003 are not available, the current number
stands at 192 inmates in Lipjan/Lipljan and an additional 14 in Dubrava.78 It appears that the
majority of inmates at Lipjan/Lipljan are in pre-trial detention, a further indication that the
justice system is not handling juvenile cases expeditiously.
In 2003, there were two cases of female juveniles in Lipjan/Lipljan - a major problem as
there are no dedicated facilities for them and they are held in isolation from their female
peers. They are usually housed with adult women and may be excluded from the regular
education programmes provided for juvenile males if it is deemed likely to be problematic or
even traumatic for the girls.
It should also be noted that of the 11 "convicted" juveniles, seven have received sentence of
between five to 10 years. It appears from this evidence that over 60 per cent of all juvenile
offenders have received sentences that contravene the recommendations in the proposed
juvenile justice bill, which proposes that young offenders receive sentences that are at most
half those of adults or held until the age of 18 (whichever is shorter).
Most striking is that almost 50 per cent of offences are related to theft. These are offences
that should be given custodial sentences only in the most extreme cases, which suggests
76
According to Centre’s officials, there exist drawn plan that following school year starts with 5 (five) subjects,
introducing approximately the same system as in community schools. This program would include five levels
of teaching, depending of the age of juveniles: (1) juveniles from 1 – 8 classes; (2) juveniles from 8-12
classes; (3) for detainees from 1 -12 classes; (4) for male juveniles 1-12 classes and (5) for juveniles with
mental disabilities – special schooling.
77
However, juvenile offenders were housed in a separate wing from adults and there was no interaction
between the two groups.
78
These have now been relocated to Lipjan/Lipljan following a recent prison riot and fire.
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that the best interests of the child are not being served adequately by the judicial system.
The more concerning statistic is that the remaining offenders have been involved in crimes
of violence and further research is suggested to explore the circumstances behind such a
high incidence rate.
5.8 Children with Disabilities
Article 23 of the CRC recognizes that
“… mentally or physically disabled child should enjoy a full and decent life, in
conditions which ensure dignity, promote self-reliance and facilitate the child's active
participation in the community …
They have the right to special care, which should be provided free of charge,
whenever possible, taking into account the financial recourses of the parents or
others caring for the child. It should be designed so to ensure that the disabled child
has effective access to receive education, training, health care services, rehabilitation
services, preparation for employment and recreational opportunities.”
5.8.1
Extent
As with so many other sectors in Kosovo, available data on the numbers of children with
disabilities is limited. The most reliable figures come from Handicap International, which
estimates that there are around 2000 mentally and/or physically disabled children in Kosovo
- out of a total of about 18000 disabled people – but feel that this figure is probably higher in
reality. According to WHO 10 per cent of the population can normally be classified as
disabled. Part of the problem has to do
Children w ith Special Needs
with societal attitudes towards children
with disabilities, and there are still many
14%
taboos connected with having a
41%
14%
disabled child. Evidence suggests that
in more remote rural villages, disabled
children are hidden away and do not
15%
attend school or have access to basic
16%
or rehabilitative healthcare. It is
common for parents to feel that
physical disability mental disability multiple deaf blind
educating a child with disabilities is
futile given that they will be unable to
find work as adults. A study of 300 children with disabilities carried out by the local NGO,
Handikos, found that the vast majority of children suffered from some form of physical
disability (41 per cent) with approximately 16 per cent of children suffering some form of
mental disability. An equal proportion (14 per cent) was found to be either deaf or blind.
5.8.2 Access to Education
There are a number of projects that aim to facilitate the integration of disabled children into
the regular school system. The Ministry of Education is working on a project with Handicap
International which established "attached classes" for disabled children in some existing
regular primary schools. Teachers, who normally do not work with disabled children, are
trained in how to work with mentally disabled pupils. The UNICEF child-friendly school
project provides another opportunity for the MEST to integrate disabled children into regular
school classes.79 However, only 16 per cent of children with special needs attend regular
school. Others are in special schools, while the vast majority remain at home. There also
79
Interview MEST, Interview Spahiu, UNICEF
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continues to be a serious disparity in the treatment of boys and girls with special needs. In
2002, out of 518 registered students, two thirds were boys and one third were girls. This
would suggest the need for further action and awareness-raising regarding the need to
provide educational opportunities to all children with disabilities.
5.8.3
Special Schools
There are seven special schools in Kosovo including a school for the blind in Pejë/Peć, a
school for the deaf and one for mentally retarded children in Prizren/Prizren, a school for
mentally disabled children in the south of Mitrovicë/Mitrovica and, in Mitrovicë/Mitrovica
North, one school divided into two branches - one is a part of a normal primary school where
there is a department for children with special needs, and the other is in a private house,
where there is lack of space and poor conditions and is attended by 40 children on a daily
basis. The staff is described as well trained and professional. There are also children’s
homes in Shtimë/Štimlje and Gracanica, caring for 18 children, most of whom were initially in
the Shtimë/Štimlje Institution for adults. The Ministry of Labour and Social Welfare directly
administers these institutions. The children in these institutions, Kosovo Albanian, Serb and
Roma children between the ages of three and 18, are both mentally and physically
disabled.80
5.8.4
Teacher Training
There are currently only 100 special education teachers in Kosovo. Given the low level of
attendance of special schools, the ratio of 1:5 is considered adequate for now. It is however,
possible that with greater access and availability of special education services a greater
proportion of children with special needs would be able to receive some form of education.
Equal access to all levels of education for children with special needs remains a major issue,
especially in rural areas and in minority communities. Although overall enrolment rates have
increased, they still indicate that only a small proportion of the estimated number of children
with special needs has access to formal education.81 Financial constraints limit the provision
of additional in-service training, transport services, equipment for additional special needs
classrooms, as well as the purchase of special materials and teaching aids.
While the model of special schools and of attached classrooms in regular schools is widely
accepted, full inclusion of children with special needs is still a long way from being
achieved.82 It will take at least 4 to 5 years until the first students from the new pre-service
program for Special Needs Education will graduate. Perhaps most crucially there needs to
be a significant change of parental and public attitudes, and attitudes among educators in
particular, to ensure that the rights of all people with disabilities are respected.
5.9
Minorities
Given Kosovo's recent troubled history, it is perhaps
not surprising that ethnicity remains a highly
polarising factor in Kosovo. The goal of a multiethnic and integrated Kosovo remains a priority for
the international community and for the PISG – its
success or lack thereof will be a key determinant of
final status. From the perspective of child rights,
discrimination in its many forms has been identified
as an important special protection issue. The focus
80
Article 30 of the CRC states that
In those States in which ethnic,
religious or linguistic minorities or
persons of indigenous origin exist, a
child belonging to such a minority or
who is indigenous shall not be denied
the right, in community with other
members of his or her group, to enjoy
his or her own culture, to profess and
practise his or her own religion, or to
Interview Radovanovic, Save the Children Mitrovicë/Mitrovica North
use his or her own language.
81
Approximately 15 per cent of all children with special needs in Kosovo (600 of the estimated total of 4000).
82
Which is the case not only in Kosovo but in all countries that aim for a model of inclusion.
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on children is also important in terms of the future, the need to break from the past, and to
promote a culture of respect and understanding in Kosovo.
5.9.1
Ethnic Composition
There are six distinct minority groups living in Kosovo - Serbs, Bosniaks, Goranis, Turkish,
Croatians, and Roma, Ashkalia and Egyptians (RAE). In addition, a significant number of
Kosovo Albanians also live in areas where they constitute the minority population, facing
similar problems with regard to freedom of movement and access to services.
By far the largest group is the 100,000 Kosovo Serbs who still reside in Kosovo. Around
36,000 live in the traditional Serb-dominated north in the municipalities of
Mitrovicë/Mitrovica (north), Zubin Potok/Zubin Potok and Leposavić/Leposaviq which
together constitute about 18 per cent of Kosovo territory. The remaining 64,000 Kosovo
Serbs are scattered in other areas of Kosovo, living for the most part in isolated communities
with limited freedom of movement and little involvement in most aspects of social, political
and economic life.83 The Slavic Muslim community define themselves variously as Bosniaks,
Torbesh, Muslim or Gorani. The largest group is the Bosniak community which, prior to the
conflict, numbered around 67,000 - an estimated 35,000 Bosniaks remain in Kosovo. The
majority are concentrated in Prizren/Prizren town and in villages in that Municipality.84
The total number of Turkish people in Kosovo has decreased from approximately 20,000 to
around 14,000 in the post-conflict period, largely due to economic migration.85 An estimated
12,000 Turks live in Prizren/Prizren Municipality. The Turks have experienced relatively
fewer ethnically based confrontations with other communities in Kosovo. They are for the
most part well integrated with other ethnic groups, and are represented in decision-making
structures and enjoy freedom of movement and expression.
It is estimated that there are approximately 30,000 Roma, Ashkalia and Egyptians living in
Kosovo. Although the three communities maintain a clear and separate identity, with most
Ashkalia and Egyptian children speaking Albanian, while the Roma speak Serbian, they
share similar socio-economic status.
5.9.2
Access to Services
The most obvious manifestation of discrimination relates to the ability of children to access
basic healthcare services and educational opportunities. As has been discussed in Chapters
2 and 3, children from minority communities have a very mixed experience with regard to
services. On the surface, it would appear that Kosovo Serb children living in Northern
Mitrovica enjoy access to both educational and healthcare services. Mitrovicë/Mitrovica
hospital offers secondary and tertiary treatment. All the children attend school and there are
regular health checks and immunisation of school children. The quality of education,
however, remains poor due to school over-crowding.86 There also continue to be problems
with materials and outdated teaching methodologies, due both to the limited resources and
the unwillingness of Kosovo Serb authorities to allow teachers to participate in Kosovo-wide
83
The Kosovo Serb community is perhaps the group most affected by the lack of resolution to the issue of final
status. While their general preference would be for Kosovo to remain part of Serbia, it is also clear that local
efforts to engage more fully in Kosovo are constrained by the fact that Belgrade has been reluctant to
support co-operation with PISG institutions such as the MEST and IPH. To recognise the legitimacy of these
institutions would constitute a de facto acceptance that Kosovo is not tied to decisions taken in Belgrade. As
a result, we have a situation where Kosovo Serb schools neither followed Kosovo in the adoption of 5+4+3
school cycle nor were they included in similar reforms being carried out in the rest of Serbia.
84
Other population concentrations are to be found in Peja/Pec (4000) Vitomiricë/Vitomirica (2100)
Pristina/Prishtine (1000) Mitrovicë/Mitrovica (2000-3000).
85
Amnesty International 2003
86
Prior to the conflict there were 8 schools in the whole of Mitrovicë/Mitrovica. After the war all staff from the 6
schools in the south was merged into one school, in one building, in one of the existing schools in the North.
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training schemes (though as mentioned previously, there has been a notable improvement in
this regard). For Kosovo Serb children not living in Mitrovicë/Mitrovica, however, the
situation is less positive. While most children attend primary schools there are problems
with lack of materials and high rates of teacher absenteeism. For children wishing to
continue on to secondary school, the only option is to travel under armed escort to schools in
Northern Mitrovica and other Serb majority areas, or to Serbia itself. Access to healthcare
follows a similar pattern with basic services available locally but all other cases dealt with
exclusively in North Mitrovica or in Serbia itself.
In contrast, both Bosniak and Turkish children are relatively well integrated and do not face
overt discrimination within either the healthcare or educational systems.87
Neither
community is discriminated against based on the use of their languages in public institutions.
The main constraint is the limited availability of textbooks in Turkish and Bosnian, which
have to be imported and adapted for use in Kosovo. The situation is similar for the Gorani
community, although this group is less well-off and confined mostly to Dragash/Dragaš
Municipality.
The least well integrated and most discriminated group continue to be the Roma, Ashkalia
and Egyptian community, particularly with regard to education. Large numbers of RAE
children either never enrol in school or drop out before the completion of the primary school
cycle. In Pejë/Peć, it is estimated that up to 50 per cent of children do not attend school or
drop out before age 12. Low levels of adult education, cultural attitudes, an inability to afford
out-of-pocket school expenses, high incidence of early marriage for girls (around age 14),
and child labour are all contributory factors. Another significant factor influencing the low
rates of participation among RAE children is the lack of flexibility of the educational system
which is based on a standard curriculum that depends on regular attendance. Many RAE
children temporarily drop out of the school system and find it difficult to rejoin classes having
fallen behind other students. Immediately after the conflict, “catch-up” classes were made
available for RAE children who were displaced during the war and it appears that this policy
was quite successful in enabling children to re-join the school system.
6.0
Gender Discrimination
Throughout this report, the issue of gender discrimination has emerged as one of the key
issues that continue to impact the well-being of children. Starting from motherhood through
birth and early childhood development and in access to schooling, young women and girls
face serious discrimination relative to the male population. The clearest and most troubling
manifestation of gender discrimination is within the education sector. As discussed in
Chapter 3, while most girls receive some schooling, they are at a far higher risk of dropping
out or being withdrawn from school as they grow older. The inability of girls to access a
quality education goes on to influence a number of other major areas, such as their
reproductive health, parenting skills, participation in the labour force and in the political
arena. Despite a commitment to gender participation, both the international community and
the PISG have failed to prioritise and promote the involvement of women in government.
However, there is a strong civil society movement that is lobbying hard for gender equity,
with some success.
The Kosovo Women's Network (KWN) is a network of more than 40 women's NGOs from all
over Kosovo. The KWN includes women's groups from various ethnic communities and
provides support and mentoring to Roma women's NGOs and to the Network of Serbian
Women's Groups of Kosovo. There is also the Kosovo Women's Initiative (KWI) which was
established by UNHCR after the war, and which works in partnership with the KWN.
87
However, it should be noted that many Turkish girls, especially those living in rural areas, are withdrawn
before secondary school. However, this is related more to gender-related discrimination.
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With support from UNIFEM, the KWN brought various women's groups together during 2002
to prepare "The Kosovo Action Plan for the Achievement of Gender Equality" through public
debate and discussion - a process which was endorsed and launched by the Prime Minister.
The Action Plan was completed in 2003. The Assembly of Kosovo has established a
Commission for Gender Equality, and Gender Officers have been appointed in every
municipality. The Gender Equality Commission submitted a draft Law on Gender Equality to
the Assembly in September 2003. It has now passed its second reading in Parliament.
In late 2003 and early 2004, in anticipation of the next round of general elections to be held
in late 2004, the KWN organised a campaign "Political Parties Work for Women". Meetings
were held with women in all 30 municipalities and the issues and concerns of girls and
women identified. Based on the outcome of these meetings, a campaign is being launched
to incorporate women's problems, concerns and ideas into the electoral platforms of the
various political parties. Some of the major concerns expressed by women across Kosovo
are unemployment, girls' dropping out of school, and inadequate maternity leave. Also of
concern are the lack of services and facilities for early childhood care and development, as
well as, the lack of women in decision-making positions, violence and discrimination at home
and in the workplace, too few youth centres, prostitution, drug abuse, inheritance issues and,
lack of transparent and non-corrupt public institutions.
In an important move towards encouraging inter-ethnic respect and understanding, the KWN
and the Serbian Women's Network "Zora" have come together to host a series of joint
workshops as part of a programme for women's political and economic empowerment.
During 2004, four workshops will be held in Kosovo and two in Serbia.
UNIFEM has conducted "Gender Mainstreaming" training sessions, including legal training
for male and female Kosovar lawyers, in order to strengthen appreciation and use of
CEDAW and other international human rights instruments.
6.1 Policy Agenda
Child protection issues in Kosovo remain an area where much needs to be done, particularly
in terms of genuinely increasing awareness of the concept of rights for children and the
many different manifestations that exist. While it is difficult to prioritise one over the other,
what becomes clear from the analysis is that much remains in terms of understanding how
issues such as discrimination against a minority group or on the basis of gender, and
practices such as child labour represent fundamental violations of the rights of children. As a
result, there are a number of areas which require further attention. These include:

Widespread advocacy campaigns to promote the concept of children's rights plus
targeted lobbying and campaigns to highlight specific rights abuses.

The continued provision of technical advice and support to the Office of the Prime
Minister for inter-ministerial co-ordination to address children's issues.

Policy advice and technical assistance to social welfare and justice departments to
ensure best practice in addressing the needs and rights of children who are victims of
abuse, violence or exploitation, deprived of family care, or in conflict with the law.

Awareness-raising among parents and service providers concerning the rights of
children with special needs, and practical support to service providers.

Awareness-raising among parents, especially in poor communities, of the dangers of
child labour that is detrimental to their children's health and development.
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Situation Analysis of Children and Women in Kosovo
List of Indicators
List of Indicators
Indicator
Measure
Source
Baseline value (year)
Under-five mortality rate
Probability of dying between birth and exactly five years
RIIVEST (2001)
of age, per 1,000 live births
35-40.5 p. 1000
Infant mortality rate
Probability of dying between birth and exactly one year
IOM/UNFPA/SOK
of age, per 1,000 live births
35 p. 1000 (1999)
29.1 p. 1000
UNICEF (2001)
Perinatal mortality rate
(2000)
UNICEF (2003)
27.1 p.1000 (2002)
NIPHK (2003)
Measles coverage 1-15 years
Proportion of children age 1-15 immunised against WHO / NIPHK (2002)
measles
MR campaign Coverage
WHO/NIPHK/UNICEF
Annual number of deaths of women from pregnancy- UNICEF (2001)
related causes, when pregnant or within 42 days of Kosovo Obstetric Gynaecologic
termination of pregnancy, per 100,000 live births
Association (2002)
Maternal mortality ratio
Child birth care
Proportion of birth attended by skilled personnel
Antenatal care
Percentage of women 15-49 with a birth in the previous UNICEF MNSS 2001
year attended at least once during pregnancy by skilled
UNICEF ANC Survey (2003)
health personal
Birth registration
Percentage of children whose birth is registered
Exclusive breast-feeding
Percentage of infants < 4 months (120 days) of age who
are exclusively breastfed
UNICEF MNSS (2001)
Statistical Office of Kosovo
(2003)
Tuberculosis immunisation coverage
Percentage of one year old children immunised against
NIPH (2003)
tuberculosis
February 2004
Source
90
99 per cent (2003)
23 p.100 000 (2000)
21 p.100 000 (2002)
95 per cent (2001)
95 per cent (83 per cent Institute of
Social Policy)
99 per cent (2003)
85 per cent (2003)
12 per cent
Percentage of children 0-59 months who had acute Not available
respiratory infections (ARI) during the two weeks
preceding survey needing assessment and were taken
to an appropriate health provider
Measure
67 per cent (2002)
UNICEF MNSS 2001
Care Seeking for ARI
Indicator
89 per cent (2002)
98.5 per cent (2002)
Baseline value (year)
Situation Analysis of Children and Women in Kosovo
List of Indicators
DPT immunisation coverage
Percentage of one--ear old children immunised against NIPH (2003)
diphtheria, pertussis and tetanus
WHO/NIPHK (2003)
97 per cent OPV1 – 87 per cent OPV3
Polio immunisation coverage
Percentage of one year old children immunised against NIPH (2003)
polio
WHO/NIPHK (2003)
97 per cent OPV1 – 87 per cent OPV3
Measles immunisation coverage
Percentage of one-year old children immunised against
N/A
measles
Not applicable Measles immunisation
scheduled between 12 – 18 months
Iodised salt consumption
Percentage
iodised salt
UNICEF MNSS 2001
84 per cent
Underweight prevalence
Proportion of under-fives who fall below minus 2 and
below minus 3 standard deviations from median weight- UNICEF MNSS 2001
for-age of NCHS/WHO reference population
5.4 per cent
Proportion of under-fives who fall below minus 2 and
below minus 3 standard deviations from median height- UNICEF MNSS 2001
for-age of NCHS/WHO reference population
10.1 per cent
Proportion of under-fives who fall below minus 2 and
below minus 3 standard deviations from median weight- UNICEF MNSS 2001
for-height of NCHS/WHO reference population
4.4 per cent
Children completing compulsory education (Grade 9)
Percentage of children
compulsory education
73 per cent
Girls reaching Grade 9
Percentage of girls entering first grade of primary school
SOK 2001
who eventually reach Grade 9
58.1 per cent
Net primary school attendance rate
Percentage of children of primary school age attending
SOK
primary school (disaggregated by sex and ethnicity)
97 per cent SOK
Net lower secondary school attendance rate
Percentage of children of lower secondary school age
SOK 2001
attending school (disaggregated by sex and ethnicity)
85 per cent
Net upper secondary school attendance rate
Percentage of children of upper secondary school age
SOK 2001
attending school (disaggregated by sex and ethnicity)
59 per cent
Child labour
Percentage of children 5-14 who are currently working
Not available
(paid or unpaid, inside or outside the home)
Stunting Prevalence
Wasting prevalence
Indicator
Adult literacy rate
February 2004
of
households
consuming
successfully
Measure
adequately
completing Gender Review
SOK/MEST/UNICEF 2002
Source
Percentage of household residents age 15 and over who
Education Gender Review
are able to read a letter or newspaper
91
Baseline value (year)
14 per cent of rural women compared
with 4 per cent of rural men are illiterate.
26 per cent of girls age 16-19 are
Situation Analysis of Children and Women in Kosovo
List of Indicators
relatively illiterate with 9.5 per cent being
totally illiterate.
Knowledge of preventing HIV/AIDS
Percentage of young people who correctly state 3 main
PSI KAP Survey
ways of avoiding HIV infection
Under analysis
Attitude to people with HIV/AIDS*
Percentage of young people expressing a discriminatory
PSI KAP Survey
attitude towards people with HIV or AIDS
66.5 per cent (2003)
Young people who know where to be tested for HIV
Percentage of young people who state knowledge of a
PSI KAP Survey
place to be tested
31.4 per cent (2003)
Total child disability rate
Proportion of children aged less than 15 years with some
Not available
reported physical or mental disability
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Conceptual framework
The Problem
Kosovo’s children are not getting a healthy start in life
Manifestations
High maternal mortality
High rates of infant mortality and morbidity
High maternal death rates due to preventable
pregnancy and delivery complications
High perinatal and neonatal death rates due to
preventable infections, avoidable low birth weight and
birth complications
Low participation in preschool activities
Immediate Causes
Poor Quality of ANC services
Poor quality of essential obstetric care procedures
Poor primary healthcare services especially in rural areas and
over-reliance on specialist treatment
Poor quality of essential perinatal and new-born care
procedures
Very low rates of enrolment in preschool education facilities
Poor primary healthcare services especially in rural areas
High numbers of children, especially in rural areas, cared for
within the home
Incomplete immunisation coverage
High rates of ARI caused by air pollution
Lack of access to secondary / tertiary healthcare facilities for
minority / marginalised communities
Inadequate quality of nutrition
Lack of facilities in all languages
Limited use of health services by certain population groups, in
particular RAE population
Low incidence of exclusive breast feeding during first six
months of life and generally inappropriate feeding patterns
Long distances to travel to go to preschool facilities
High rates of abortion / Low use of contraception (UNFPA)
Poor hygiene practices
Insufficient number of preschool institutions (non-existence of
kindergartens in rural areas, and lack of pre-primary classes
and community-based ECE Kosovo-wide)
Micronutrient deficiencies Vitamin A, Iodine and Iron
High incidence of water-born diseases
Risky / unhealthy behaviours, smoking, alcohol and drug
abuse
Risky / unhealthy behaviours, smoking, alcohol and drug
abuse
Lack of trained and qualified teachers/ facilitators
Underlying Causes
Lack of legislation / policies / guidelines on standardisation of
health care practices
Lack of legislation / policies / guidelines on standardisation of
health care practices
Poor health policy planning
Poor health policy planning
Poor management and lack of definition of competencies and
responsibilities
Poor management lack of definition of competencies and
responsibilities
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93
Low levels of parental awareness with regard to the
importance of early childhood development
Situation Analysis of Children and Women in Kosovo
Conceptual framework
Poor communication between different levels of the health
system, both horizontal and vertical
Poor communication between different levels of the health
system, both horizontal and vertical
Discrepancies in urban / rural distribution of human resources
Discrepancies in urban / rural distribution of human resources
Lack of quality control mechanisms / systems
Lack of quality control mechanisms / systems
Low level of knowledge attitudes and practices in reproductive
health and nutrition among women of childbearing age
Low level of knowledge of parents / community on health and
nutrition issues affecting infants and young children
Poor levels of knowledge and attitudes among RAE
community
Aggressive marketing of inadequate food items, in particular of
baby formulas.
Lack of escort and low frequency of transportation for
minorities living in IDP camps and enclaves
Exclusion / slow integration of RAE minority
Lack of demand for proper / better health services
Lack of demand for proper / better health services
Lack of preschool curriculum, neither the one for overall
preschool education, nor
differentiated ones for
kindergartens, pre-primary classes or CB ECE
Over reliance of ANC on specialised service, high-tech
equipment and private practitice and low awareness of the
importance of qualitative and regular ANC
High drop-out rates, missed opportunities and long intervals
between doses of EPI vaccines, leading to inefficiencies in EPI
coverage
Caregivers at home (mothers, grandmothers, sisters, etc) do
not have enough knowledge in child development, nutrition,
health & hygiene)
Lack of adequate counselling on all aspects of pregnancy and
poor monitoring of pregnant mothers
Lack of awareness on environmental issues, air pollution and
ARI
Lack of in-service training of preschool teachers
Low level of knowledge, attitudes and practices in reproductive
health and nutrition among women of childbearing age
Insufficient information, education and communication on
pregnancy and importance of quality and regular ANC.
Short stay of mothers in maternities after delivery
Inadequate feeding patterns
Personal hygiene of pregnant women
Low level of knowledge and education on hygiene practices
within the community
Low access to safe drinking water in many rural communities
and schools
Basic Causes
Poor economic status
Poor economic status
Poor health planning and budget misallocations
Poor health planning and budget misallocations
Poverty / Economics
Poverty / Economics
February 2004
94
Lack of understanding about the importance of preschool
education by policy makers
Situation Analysis of Children and Women in Kosovo
Conceptual framework
Lack of accurate data – Census, and or poor birth registration
practices among all communities
Lack of accurate data – Census, and or poor birth registration
practices among all communities
Financial resources limited both at family & community level
Cultural and traditional issues
Cultural and traditional issues
Culture and tradition
Security issues
Security issues
Political situation
Political situation
Low level of health education / awareness
Low level of health education / awareness
The Problem
Kosovo’s children are not getting a quality education
Manifestations
February 2004
95
Situation Analysis of Children and Women in Kosovo
Low enrolment and high drop-out rate, especially
among minorities
Conceptual framework
Low completion rate of compulsory education
among girls
Low access to vocational and secondary education
Immediate Causes
Lack of access to education in mother tongue for minorities
Outdated materials and lack of facilities (e.g. computers,
libraries and laboratories)
Lack of appropriate vocational and secondary school
infrastructure, especially in rural areas
Harassment, and lack of readiness of school teachers, parents
and communities to accept minority children
Pedagogical methods still
knowledge-based testing
Lack of incentives and motivation to complete secondary
education
Child labour
Low learning achievement
Parents not willing to send children to school
Direct and opportunity costs
rely
on
memorisation
and
Distance from home to school / lack of schools
School overcrowding and poor physical infrastructure
Underlying Causes
Insufficient qualified teachers, especially for minorities
Lack of role models for girls, including teachers and peers
Low investment and appropriate policies in vocational and
secondary school education
Insufficient appropriate measures to facilitate schooling for
disadvantaged children from minorities (e.g. catch-up classes)
Focus on early marriage and child-rearing over employment /
career
Lack of qualitative vocational and secondary school education
that will equip young people to meet the demands of the
labour market
Lack of unified curriculum acceptable to all communities Lack
of adequate textbooks
Family preferences to give opportunities for further education to
boys
Lack of gender-sensitive vocational and secondary school
education
Poor family economic situation
Limited opportunities to enter the labour market
Lack of education facilities near communities
Poverty at family, municipality & central level
Lack of adequate policies on minority education
Low parental education and awareness
Low parental education level and awareness
Basic Causes
Political situation
Low economic situation in Kosovo
Poverty
Traditional prejudice against RAE minorities
Culture and Tradition
Transition of society from a socialist to a market economy
system
February 2004
96
Situation Analysis of Children and Women in Kosovo
Conceptual framework
Residue of the conflict in Kosovo
Tradition and culture
Low levels of economic development
The Problem
The needs of adolescents are being ignored
Manifestations
February 2004
97
Situation Analysis of Children and Women in Kosovo
High risk of STIs and / HIV AIDS
Conceptual framework
High levels of smoking, alcohol and drug use
Lack of opportunities for youth participation
Immediate Causes
Low knowledge of sexual and reproductive health issues
High levels of drop out and “spare time” among young people
Youth centres closing down
Low knowledge and use of contraception
Growing and easy availability of psychoactive substances
Overall weak Youth NGO sector
Poor negotiation skills (especially among girls) and low self
esteem
Strong peer pressure and acceptance of smoking as a sign of
adulthood
Insufficient access and coverage in the media for youth from
minority communities
Greater sexual activity among young people (due to rising age
of marriage)
Lack of awareness on drug use and its consequences
Increase in other high risk behaviour
High level of prostitution and increasing trafficking of human
beings
Underlying Causes
Traditional values limit discussion of sexual behaviour within
the family
Absence of restrictions on smoking in public places
Very low governmental expenditures on youth services
Lack of youth friendly health services
High incidence of parental smoking thereby setting poor
example for children
Lack of interest and resources at the municipal level to fund
youth activities
Lack of life skills based education
Growing disillusionment
Funding from INGOs is decreasing
Unwillingness to discuss HIV with partners and low levels of
voluntary testing (stigmatisation re HIV)
Influence of western media and behaviour patterns (especially
with greater mobility of youth today)
Traditional values that place great stock on age
Lack of effective policies and strategies
Lack of effective legislation and policies
Lack of effective legislation and policies
Lack of effective surveillance systems
Lack of youth friendly health services (counselling)
Lack of life skills based education
Basic Causes
Low level of education of parents
Youth a low priority for policy makers
Society in transition
Patriarchal family system
Poverty
February 2004
98
Situation Analysis of Children and Women in Kosovo
Conceptual framework
The Problem
Children in Kosovo are subject to exploitation
Manifestation
Increasing incidence of child labour
February 2004
Increase in children being trafficked in Kosovo
99
Situation Analysis of Children and Women in Kosovo
Conceptual framework
Immediate
In order to help meet family needs (RAE community) and to help mothers (girls children
spend insufficient hours in school
Demand for sex services
Desire among children to earn supplemental income
Underlying
Most schools run multiple shifts due to overcrowding
Low levels of awareness among children and parents about the risks of trafficking
Lack of sufficient alternative spaces (e.g. youth centres) and activities that cater to
children
Tradition of young children being “promised” to future husbands in RAE community
Poor enforcement of existing child labour laws in Kosovo
Lack of adequate child protection schemes to monitor all children at risk
Parental acceptance of children working as a means to integrate them into a family and
kinship network
Poor implementation of legislation (i.e. no policies or plans of action created)
Tolerance of working children by employers and general public
Kosovo becoming a transit country and destination country for trafficking in human beings
and illegal goods (drugs) and the absence of effective border controls
Basic
Low levels of economic development
Traditional practices in certain communities
Lack of education and awareness
February 2004
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Situation Analysis of Children and Women in Kosovo
Conceptual framework
The Problem
Children in Kosovo are subject to abuse
Manifestation
Children are being abused at home
Children are being abused in public institutions
Immediate Causes
Corporal punishment of children at home
Corporal punishment of children at school
One in four women is physically or psychologically abused by husband or other family
member
Overcrowded schools (esp. in urban areas) places a premium on maintaining control in
classroom
Underlying
Traditional child rearing practises which focus on discipline and obedience
Outdated pedagogical methods (i.e. not child-centred)
Lack of implementation of a referral system to protect child victims of abuse
Inadequate monitoring of public institutions
Lack of reliable data on incidence of all forms of domestic violence
Lack of awareness on the rights of the child among children, parents and teachers.
Basic
Hierarchical family structures Traditional social structures
Society in transition
Low status of women in society
February 2004
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Situation Analysis of Children and Women in Kosovo
Conceptual framework
The Problem
Children in Kosovo are subject to discrimination
Manifestation
Gender
Disability
Ethnicity
Immediate Cause
Parents prioritising boys over girls (indication of sex
selective abortions and marginally lower rates of
immunisation)
Lack of schools and trained teachers to cater to children
with disabilities
Lack of access of children from minorities to basic services
Lack of gender sensitive education and materials in
schools
Lack of access to integrated services
Restricted freedom of movement and general insecurity
Lower rates of participation in secondary and higher
education and limited access to training schemes and job
market for girls and women
Lack of resolution on final status of Kosovo
Underlying Cause
Women have limited rights within marriage (i.e. women
move in with husbands and children are considered wards
of fathers)
Poor quality of social work facilities and other institutions
dealing with children with special needs and lack of
specialised training programmes
Recent armed and political conflict
Lack of strong advocate for women’s rights in civil society
Weak community participation and stigmatisation of
disability
Lack of ethnic integration
Low number of women employed in the public sector and
only one minister out of ten is a woman
Lack of awareness about the rights of children with
disabilities
Lack of tolerance
Basic Causes
High levels of discrimination within society
Historical ethnic division
Patriarchal society
Lack of economic development
Poor level of education
The Problem
February 2004
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Situation Analysis of Children and Women in Kosovo
Conceptual framework
Children in Kosovo are victims of deprivation
Manifestation
Children deprived of parental care
An increasing number of children are deprived of liberty
Immediate Causes
Babies being abandoned at hospitals
Rising incidence of petty crime among young offenders
Intense pressure from family and community to give up children born out of wedlock
Lack of alternative non-custodial measures for young offenders
Lack of adequate social support systems to enable young couples or mothers to raise
children without support from families
Children are held in closed facilities/high level security (i.e. lack of specialised facilities to
hold (convicted) young offenders
Underlying
Lack of sex education at schools and limited contraceptive use leading to higher rates of
teenage pregnancy
Lack of integration services
Stigmatisation of children born out of wedlock
Lack of cooperation between services, including the police, CSWs, and social workers in
correctional facilities
Fathers face no pressure socially or from the legal system to take responsibility for their
children
The applicable legislation does not comply with international standards
Lack of access to services and youth friendly health services
Lack of awareness of human rights
Basic
Traditional – i.e. conservative - views and beliefs regarding children born outside of
marriage (and of sexual activity among the young)
February 2004
Judicial system is still weak and lacks expertise in critical areas (e.g. lack of specialised
juvenile prosecutors and judges)
103
Situation Analysis of Children and Women in Kosovo
Bibliography
Bibliography
1. "Anthropometric Nutritional Survey, Kosovo" - Action Against Hunger. 2000a. (January 2000).
2. "Infant feeding and Weaning Report, Kosovo" - Action Against Hunger. 2000b. (January 2000).
3. Akademia e Shkencave dhe Arteve e Kosovës (ASHAK). 1996. "Shqyrtim multidisiplinor i
mundësive zhvillimore të Kosovës". ASHAK, Prishtinë/Priština 1996.
4. Autoriteti Qendror i Kosovës. 2000. "Buxheti i Kosovës për vitin 2000" (Dhjetor 2000).
5. ANC KAP Survey UNICEF 2003
6. Centre for Protection of Women and Children Annual Report 2002, Prishtinë/Priština 2003
7. "Social Protection in Kosovo - Towards a Strategy" - Department of Health and Social Welfare
(DHSW). 2000. (December 2000).
8. "Buletini statistikor vjetor: Tregues themelorë të arsimit në Kosovë për vitin 2000/20001" - Enti i
Statistikës së Kosovës (ESK), 2001 (Maj 2001).
9. Government of Kosovo Consolidated Budget 2003
10. "General Review of Psychological Support and Services Provided to Victims of Trafficking" - IOM
Kosovo (September 2003)
11. “Research on Youth in Kosovo” - Hasnije Ilazi (Prioni, SIDA and Ministry of Culture, Youth and
NRA – Department of Youth. (December 2002)
12. Health Policy for Kosovo (Department of Health and Social Welfare)
13. Health Situation Analysis Report Kosovo, UNICEF August-September 2003
14. Human Development Report for Kosovo (UNDP, 2002)
15. "Damage Assessment: Water, Final Report" IMG. 2000b. (February 2000).
16. "Domestic Violence against Children in Kosovo: Prevention, Intervention and Rehabilitation”
Kosovar Research and Documentation Institute (KODI) on behalf of UNICEF 2003
17. Inter-Agency Sub-Group on Poverty (IASGP). 2000. "Qualitative Poverty Assessment – Kosovo,
Review of Secondary Materials" (November 2000).
18. International Management Group (IMG). 2000a. "Water and Sanitation Assessment" (February
2000).
19. International Organization for Migration (IOM). 2000. "Kosovo Demographic, Socio-economic and
Reproductive Health Survey - Basic Results" (May 2000).
20. International Rescue Committee (IRC) et al. 2000. "Kosovar Albanian Health Survey Report"
(September 1999).
21. Joint Committee on the Return of Kosovo Serbs. “Framework for Return 2001” (January 2001).
22. Kosovar Strategy for HIV/AIDS Prevention, 2003 – 2007 Kosovar AIDS Committee
23. Kosova Education Center (KEC). 2000. "Education in Kosovo: Figures and Facts", KEC,
November 2000.
24. Kosovo, Federal Republic of Yugoslavia: Transitional Support Strategy (World Bank 02/07/2002)
25. Living Standards Measurement Survey (World Bank 2000a)
26. Malcolm, Noel.1998. "Kosovo: A Short History". London, Macmillan Paperback, 1998.
27. Medium-Term Public Expenditure Priorities - DRAFT (World Bank, October 2002)
28. Mother Theresa Society (MTS). 1999. "Data and Organization", MTS, Prishtinë/Priština 1999.
29. Mounzer, Fatfat. 2000. "Youth Organizations and Clubs in Kosovo" (3 October 2000).
February 2004
104
Situation Analysis of Children and Women in Kosovo
Bibliography
30. NORMA Association for Legal Aid for Women. 2001. Interim Report.
31. Organisation for Security and Co-operation in Europe. Voters’Voices. September 2000.
32. Population Services International (PSI). 2001. Knowledge, Attitudes and Practices Regarding
HIV/AIDS and Antenatal Care in Kosovo (January/February 2001).
33. Population Services International (PSI). 2003. Knowledge, Attitudes and Practices Regarding
HIV/AIDS and Kosovo (December 2003)
34. Premier Urgence (PU) Aide Humanitaire International. 2001. "Kosovo: Water Supply in Rural
Areas" (February 2001 – Intermediate Report).
35. Qendra e Arsimit e Kosovës (QAK). 2000. "Shifra dhe fakte për arsimin e Kosovës ", QAK, Nëntor
2000.
36. Research Report on Abandoned Children in Kosova, Institute of Social Policy, Prishtina, March
2003
37. RIINVEST (Institute for Development Research). 1998. "Economic Activities and Democratic
Development of Kosova", Riinvest, 1998.
38. RIINVEST Labour Market Survey 2002
39. Health Situation Analysis Report 2003 Skender Kutllovi and Shepnd Elezi, UNICEF (2003)
40. Study on Children from Minorities in Kosovo, Danish Refugee Council on behalf of UNICEF
(2003)
41. Statistics Office of Kosovo Labour Force Survey 2001
42. RIINVEST. 1999a. "War Consequences on Family Economies and Businesses - Survey
Outcomes" (December 1999).
43. RIINVEST. 1999b. "War Consequences on Family Economies and Businesses" (December
1999).
44. Savezni Zavod za Statistiku. 1986. "Yugoslavia 1945-1985: Statistical Review”, Federal Statistical
Office. Belgrade, 1986.
45. Savezni Zavod za Statistiku. 1993. "Population of the Census of 1991, by Age and Sex", Vol. 4,
Belgrade, 1993.
46. Science and Technology, UNICEF)
47. Situation of People with Disability in Kosovo: Survey Summary, Handicap International 2002
48. Spiegel, P. and P. Salama. 2000. "Kosovo Albanian Health Survey Report" (September 1999).
49. Statistics on Education in Kosovo 2001 (Statistics Office of Kosovo, Department of Education)
2001
50. UNICEF 2002 Small Arms and Youth in Kosovo: Assessment Report
51. UNICEF and OSCE. 2001. Young Voices: Opinion Survey of Children and Young People. GfK
Group
52. UNICEF. 1999. "Working Document on Adoption", Internal Memorandum, Prishtinë/Priština 1999.
53. UNICEF. 2000a. "Youth in Kosovo: A Situation Analysis" (October 2000).
54. UNICEF. 2000b. "Kosovo Report on Follow-up to The World Summit for Children".
55. UNICEF. 2000c. "National Report on Follow-up to the World Summit for Children - Federal
Republic of Yugoslavia Statistical Report".
56. UNICEF. 2001a. "School Water and Sanitation Database".
57. UNICEF. 2001b. "Juvenile justice in post-conflict situations. The Kosovo experience" (March 2001
- Draft).
February 2004
105
Situation Analysis of Children and Women in Kosovo
Bibliography
58. UNIFEM “No Safe Place: An Assessment of Violence against Women in Kosovo” (2000)
59. UNIFEM. 2000a. "Statistics on Violence Against Women in Kosovo" (Spring, 2000).
60. UNIFEM. 2000b. "Women at Work" (2000).
61. United Nations Population Fund (UNFPA) and IOM. 2000a. "Demographic and Socio-Economic
Survey"
62. UNMIK/UNICEF. 2000. "Youth in Kosovo - A Situation Analysis" (3 October 2000).
63. WHO, 2001. "Kosovo Perinatal Data" (January - December 2000).
64. World Bank (WB). 2000a. "Conflict and Changes in Kosovo: Impact on Institutions and Society"
(Draft - December 2000).
65. World Bank (WB). 2000b. "Kosovo, Federal Republic of Yugoslavia (Serbia and Montenegro):
Economic and Social Reforms for Peace and Reconciliation" (Draft - June 2000).
66. World Bank. 2001. Kosovo Poverty Assessment.
67. World Health Organization (WHO), 2000. "Survey on the Knowledge, Attitudes and Practices
regarding HIV/AIDS and other Sexually Transmitted Diseases in Kosovo".
68. Child Labour on the Rise in Kosovo? A Study on Working Children, Sigrid Maurer 2003
69. Substance Use and Young People in Kosovo: Report of the WHO/UNICEF Rapid Assessment
and Response programme Wouter de Jong, Aliriza Arenliu, Martin Donoghoe 2003
70. WHO and IPH: Survey on the Knowledge, Attitudes And Practices Regarding Hiv/Aids and Other
Sexually Transmitted Diseases in Kosovo, 2000
71. Survey Among Youth in Kosovo Index Kosova on behalf of UNCIEF September/October 2003
72. UNICEF 2003 Education for Minority Children in Kosovo (internal report)
73. Situation Analysis of Preschool Education in Kosovo Pranvera Kamani and Gerda Sula on behalf
of UNICEF 2003
74. Situational Analysis of Education in Kosovo Universalia on behalf of UNICEF and MEST
75. Kosovo and the Millennium Development Goals (draft) Marc Johnson UN Country team Kosovo
2003
76. Report from Baby Friendly Hospital Initiative (BFHI) assessment in Kosovo June 2003
February 2004
106
Situation Analysis of Children and Women in Kosovo
February 2004
45
Bibliography