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Special Theme: Develop a Child
ADB support for children
Policy and strategic framework
ADB has long recognized human development as a cornerstone
of overall social and economic development, and has
prioritized support for investments in women and children as
the most effective way to promote human development. Its
1994 population policy shows the clear link between maternal
health and child health, and between maternal education and
family size. The 1998 policy on gender and development
emphasizes the need to support activities that improve
women's access to social infrastructure services. The most
effective investment in the health and education of children
is an investment in the health and education of their mothers.
The 1999 Poverty Reduction Strategy requires resources to be
targeted on projects benefiting women and children.
The health policy, also approved in 1999, endorses the
shift in ADB's health investments toward primary health
care, the area most likely to benefit poor mothers and
children. Investments in primary health care as a proportion
of total sector investment rose from 36 percent between
1978 and 1991 to 66 percent since 1992.
The draft water policy, for Board of Directors' consider-ation
in 2001, recognizes the special role of women in ensuring
the health and well-being of families, both as principal agents
for fetching water and preventing the spread of waterborne
diseases, and as highly productive farmers and irrigators.
The draft education policy, developed in 2000, also
supports investments in women and children. ADB support
for education has shifted toward basic education-from
11 percent of the total education sector portfolio in the 1970s
and 1980s to over 40 percent in the 1990s. ADB is also a major
partner in Education for All, a global movement to ensure
availability of basic education to all children.
ADB's draft long-term strategic framework, developed
in 2000, calls for greater emphasis on social development
through direct and indirect interventions. The framework also
advocates a policy and reform program, wherever necessary,
to ensure adequate allocations for health and education and
provide access to basic social services by the poor.
ADB operations
ADB investments in education, health, and nutrition-the
sectors that most clearly target women and children-have
accounted for about 8 percent of its total lending portfolio since
1990. This proportion is low compared with other multilateral
development banks, but investment in other sectors-
microcredit, water supply and sanitation, environment, and
rural and urban development, for example-adds substantial
amounts to ADB's overall support for children. ADB's focus
on poverty reduction is increasing the flow of resources for
programs supporting the poor, especially women and children.
ADB's recent support for children has been innovative.
Two sector development program loans (Box 7)
to Indonesia in 1998 and 1999 identified policy reforms that
could lessen the impact of the financial crisis on the poor and
improve the delivery of basic social services.
Box 7: Supporting Indonesia's Children in Crisis
The Asian financial crisis left Indonesia facing rising unemployment and inflation, and a risk of reduced expenditure on social services. ADB worked closely with the Government to help provide a social safety net, and to help prevent the loss of a generation of children at risk of suffering from malnutrition and increased disease, and dropping out of school.
ADB prepared two sector development programs: to support policy reforms to improve the delivery, quality, and equity of basic education and health and nutrition services; and to ensure continued access to basic social services by the poor. The projects provided scholarships for junior secondary school, funds to enable midwives in health centers to expand outreach programs, maintain services for pregnant women, and set up feeding programs for pregnant women, infants, and young children.
To reach beneficiaries quickly, ADB funds were transferred directly to them from the Central Bank of Indonesia through the post offices. District committees determined how the funds should be allocated among schools and health centers. Schools established committees with parent and community representation to choose students who would receive scholarships. Village midwives, health center staff, and community health volunteers identified pregnant women and young children for special monitoring and coverage by outreach and nutrition programs. Monitoring by nongovernment organizations revealed that targeting was highly successful.
During the first two and a half years of implementation, 1,945,868 children received junior secondary school scholarships and 127,409 state elementary schools received block grants; 793,188 pregnant women received medical support and supplemental feeding; and 1,051,309 infants and young children received supplementary feeding. Indonesia’s investment in these women and children, with ADB support, helped save a generation at risk.
| Basic education programs in Bangladesh and Pakistan
aim to improve girls' access to education and provide incentives
for girls to remain in school (Box 8). The
Philippines' Nonformal Education Project has so far brought
literacy to 465,000 learners, primarily poor rural women, and
established an alternative system for providing the equivalent
of primary and secondary education to out-of-school youth
through flexible delivery arrangements. Services under this
Project were subcontracted by the Government to NGOs, community
groups, and local government units to ensure that they
were responsive, demand-driven, and cost-effective.
Box 8: Educating Girls
Several ADB objectives converge in girls' education. Educating girls reduces poverty, is an essential part of achieving gender equity, is a foundation of human development, and contributes directly to sustainable economic growth.
Through loans and technical assistance, ADB is ensuring that girls are given the opportunity to go to school, and is improving the quality of the schooling girls receive. In Bangladesh, ADB is supporting a project that provides 765,000 scholarships for girls as part of a strategy to encourage families to enroll their daughters in secondary school. ADB is also funding activities designed to ensure balanced treatment of gender in textbooks, and is assisting nongovernment organizations who work with indigenous communities in developing special instructional materials for 12,000 children—boys and girls—that reflect their language and culture. ADB is also providing basic school supplies through local education committees for ethnic minority children.
In the Lao People’s Democratic Republic, ADB is funding a primary education project for ethnic minority girls who have traditionally lacked access to schooling. In its first phase, the project is targeting 300 ethnic minority villages, providing multigrade classrooms, training ethnic minority teachers, involving the community in school management, and supporting a social mobilization program to persuade parents to enroll their daughters in school.
ADB has been a major supporter of girls’ education in Pakistan where the enrollment rate of girls has lagged substantially behind that of boys. In one girls’ primary education project, ADB funded the construction of 200 community model schools for girls, providing 400,000 additional places for girls. The model schools helped upgrade the quality of teaching for another two million girls through outreach schools. They also provided special facilities—including toilets, playground equipment, and boundary walls to ensure privacy—to encourage parents to enroll their daughters. ADB has also supported the training of 10,000 female teachers to ensure a growing supply of teachers for girls.
| ADB’s response to the regional needs for child
immunization has been robust (Box 9). Immunization
programs and the control of childhood infectious diseases
are being funded in Bangladesh, Cambodia, Indonesia,
Philippines, and Viet Nam. An early childhood development
project in the Philippines and a communicable
diseases control project in Indonesia both support an
integrated management of childhood illness’ initiative,
operating at health centers and in communities to prevent
killer diseases.
Box 9: Immunizing Children
ADB’s health policy emphasizes the importance of primary health care in Asia and the Pacific, and places high priority on immunization programs. These programs are cost-effective, impact positively on public health, benefit poor children and women, and save about 500,000 lives in the region annually.
Vaccination coverage in the region is now more than 80 percent of all children, up from 10 percent in the early 1970s. The incidence of measles has dropped by 70 percent in the last decade. The western Pacific region of the World Health Organization has been declared polio-free.
However, although new vaccines for hepatitis B and hemophilus influenza B (a cause of acute pneumonia in children) are relatively low cost and effective in preventing diseases that exact a large toll on children, they have not yet been widely deployed.
Through the Asian Vaccination Initiative, ADB conducted studies in Cambodia, Kazakhstan, Kyrgyz Republic, Lao People's Democratic Republic, Sri Lanka, Tajikistan, Uzbekistan, and Viet Nam, and collected data that help policymakers expand and sustain immunization programs. Also, ADB has actively supported immunization programs through policy dialogue. Indonesia’s social protection and health and nutrition sector development programs provided resources to maintain immunization coverage during the financial crisis. In Thailand, a social sector program loan encouraged the Government to allocate additional resources for immunization. Similarly, projects in Bangladesh, Cambodia, Indonesia, Pakistan, and Viet Nam provide direct investments to strengthen immunization programs, including training health workers.
| ADB is supporting projects in women’s health
(Philippines) and reproductive health (Pakistan) that aim to
improve health services for women, especially reproductive
health care and family planning services. The projects
support integrated delivery of family planning and reproductive
health; strategies to reduce maternal malnutrition and
mortality; and national family reproductive health campaigns
focused on preventing sexually transmitted diseases.
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