MILLENNIUM DEVELOPMENT GOALS ... - UNDP in Ukraine

MILLENNIUM DEVELOPMENT GOALSUKRAINE – 2010NATIONAL REPORT

UKRAINE IN 2015United Nations Millennium Declaration, adopted by 189 countries at the United Nations GeneralAssembly session in September 2000, initiated the process towards achieving the MillenniumDevelopment Goals by 2015. Two thirds of the time has passed. What are the results of our efforts? TheUnited Nations Summit on the Millennium Development Goals – a High-Level Plenary Meeting of theGeneral Assembly – will bring together world leaders to review progress, identify gaps, and committo a specific action agenda to achieve the MDGs and internationally agreed development goals. “Ourworld possesses the knowledge and the resources to achieve the MDGs. Our challenge today is toagree on an action agenda to achieve the MDGs” the UN Secretary-General Ban Ki-moon stated in hisreport in preparation for the September Summit.The Millennium Development Goals defined for Ukraine are a set of time-bound, quantitative targets,representing a vision for the country’s medium-term development. These are 7 goals, 15 targets and33 indicators.GOAL 1: Reduce Poverty (3 targets and 5 indicators);GOAL 2: Quality Lifelong Education (2 targets and 6 indicators);GOAL 3: Promote Gender Equality (2 targets and 4 indicators);GOAL 4: Reduce Child Mortality (1 target and 2 indicators);GOAL 5: Improve Maternal Health (1 target and 2 indicators);GOAL 6: Reduce and Slow Down the Spread of HIV/AIDS and Tuberculosis, and Initiatea Trend to Decrease their Scales (2 targets and 6 indicators);GOAL 7: Ensure Environmental Sustainability (4 targets and 8 indicators).The updated matrix of the targets and indicators was developed through a transparent and openstrategic planning process and forecasting of development trends by 2015. MDGs-oriented strategicgovernance will serve as a driver of the national development and strength collaboration betweengovernment institutions, civil society organizations and business community to achieve the MDGs.

MINISTRY OF ECONOMY OF UKRAINEMILLENNIUM DEVELOPMENT GOALSUKRAINE – 2010NATIONAL REPORTKyiv 2010

The Report analyses the status of achievement of the Millennium Development Goals (MDGs), presents a matrix ofthe MDG targets and indicators and sets milestones through 2015 using a wide range of informational, statistical andanalytical materials. The Report assesses obstacles to Ukraine’s dynamic development, identifies major challenges atthe current stage of the MDGs implementation and offers recommendations on optimal ways of addressing them.This publication will be useful to Government officials, ministries and other governmental agencies, heads and expertsof local executive authorities, scientists, members of public organisations and all who deal with issues of socioeconomicand human development.Photo credits:Page 13 : Stanislav Serdyuk/UNIANPage 17 : Viktor Gurniak/UNIANPage 31 : Ruslan Kanyuka/The Day NewspaperPage 34 : Kostyantyn Grishin/The Day NewspaperPage 43 : Volodymyr Tokarec/UNIANPage 54 : Oleksandr Kosarev/Participant of The Day Newspaper International Photo ContestPage 63 : Robert Fyu/UNICEFPage 68 : Taras Kovalchuk/Participant of Contest: ‘MDGs: Our Challenges. Our Commitment!’Page 75 : Andrey Skakodub/UNIANPage 89 : Natalia Levina/Participant of Contest: ‘MDGs: Our Challenges. Our Commitment!’Cover: Stanislav Serdyuk/UNIAN, Viktor Gurniak/UNIAN, Ruslan Kanyuka/The Day Newspaper, Kostyantyn Grishin/TheDay Newspaper, Volodymyr Tokarec/UNIAN, Oleksandr Kosarev/Participant of The Day Newspaper International PhotoContest, Robert Fyu/UNICEF, Taras Kovalchuk/Participant of Contest: ‘MDGs: Our Challenges. Our Commitment!’,Andrey Skakodub /UNIAN, Volodymyr Zakharov/UNDP Ukraine.This publication contains pictures from a video and multimedia contest: ‘Millennium Development Goals: Our Challenges.Our Commitment!‘ and from the annual The Day Newspaper International Photo Contest. The ‘MillenniumDevelopment Goals: Our Challenges. Our Commitment!’ contest was conducted in 2010 by the United Nations Officein Ukraine together with the Ministry of Economy of Ukraine, with support from Samsung Electronics Ukraine, TheSegodnya Newspaper, TV channel MTV and internet portal Korrespondent.net.This publication has been produced within the Millennium Development Goals – Ukraine Project, implemented bythe United Nations Development Programme in Ukraine. The views, findings and recommendations expressed in thispublication are those of the authors alone. They do not necessarily represent the views of UNDP.United Nations Development Programme (UNDP) is the UN’s global development network, advocatingfor change and connecting countries to knowledge, experience and resources to help peoplebuild a better life. We are on the ground in 166 countries, working with them on their own solutions toglobal and national development challenges. As they develop local capacity, they draw on the peopleof UNDP and our wide range of partners.Since 1993, UN Development Programme has been committed to helping Ukraine on its way to betterliving standards, prosperity and democracy. We bring best international practices to helping the Government,local authorities and communities to overcome human development challenges and implementeffective policies in Ukraine.In cooperation with our partners, we support initiatives that work to reduce poverty and improve qualityand access to basic social services. We promote democratic governance and demonstrate how principlesof transparency, accountability and quality of service can achieve tangible results in various areasof public policy and local development across the country. UNDP helps in reforming state institutions,protecting the environment and empowering women to play a more active role in decision making.In our activities, UNDP ensures a balance between policy and advocacy work, capacity-building activitiesand pilot projects.Helping to develop Ukrainian solutions to reach Ukrainian development goals.Find out more about UNDP operations in Ukraine at www.undp.org.ua.

Ukraine acceded to the globally recognizedMillennium Development Goals in 2000,together with 189 other countries, and assumeda political obligation to achieve them and theirimplementation targets by 2015. Today, weare only five years from 2015 – the deadline formeeting this obligation.In September 2010, a High-Level Plenary Meetingof the General Assembly will take place at theUnited Nations Headquarters, in New York, duringwhich global leaders will assess progress achieved,identify emerging challenges and confirm theirwillingness to take specific measures to achievethe MDGs.The Ministry of Economy of Ukraine, in cooperationwith the Millennium Development Goals – UkraineProject of the United Nations DevelopmentProgramme in Ukraine, has reviewed the nationalMDGs and prepared an updated system of thenational MDGs targets and indicators, consideringthe specifics of national development in a postcrisisperiod and the challenges of contemporaryglobal development. This process involvedmore than 100 representatives of Governmentinstitutions, think-tanks, United Nations agencies,international organisations, the Federationof Trade Unions of Ukraine and civil societyorganisations. It resulted in the National Report,Millennium Development Goals. Ukraine – 2010. Inthis process, efforts were made to analyse policyimplications in various domains and to generatethe updated targets for the Government until2015.Current socio-economic trends and progressmade so far towards the MDGs highlight theneed to undertake an in-depth analysis andinterpretation of specific features of Ukraine’ssocial and economic context, in order toidentify development priorities and ensureefficient measures are taken to achieve theMDGs as a component of the national long-termdevelopment strategy.We express our sincere gratitude to the expertswho contributed towards the preparation of theReport. We would also like to thank Vasyl Tsushko,Minister of Economy of Ukraine, and Olivier Adam,UN Resident Coordinator and UNDP ResidentRepresentative, for their support.MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010 3

The Millennium Development Goals are a unifying platform to address challenges faced by the poorestand to achieve social cohesion of societies across the world. At the same time, they represent a broaderagenda for the future development of nations. Millennium Development Goal targets are fully integratedinto the long-term strategies and programmes of many countries, which gear their economic, social andenvironmental policies towards these key Goals.Ukraine, having joined the United Nations Millennium Declaration a decade ago, together with 189 othercountries, has made a commitment to reaching the MDGs by 2015. There are just five years left until2015 – the deadline for fulfilling our commitments.In recent years, significant changes have taken place in the world. The number of unemployed personson the planet has grown by 34 million; for the first time in the history of humankind, over 1 billion peopleare starving; poor access to clean water and sanitation continues to present risks of deaths from infectiousdiseases. Ukraine, along with other countries, has felt the negative impacts of the recent financial andeconomic crisis, which neutralized its reconstructive growth over 2001–2007.The time for change has come. To respond to people’s expectations, we will follow a course towards reformand towards systemic modernization of the country. The Economic Reform Programme for 2010–2014,‘Prosperous Society, Competitive Economy and Effective Government,’ adopted following extensive publicdiscussion, encompasses all spheres of public life and will establish the necessary preconditions for fulfillingobligations related to the implementation of the Millennium Development Goals.Key priorities of this programme related to improving the living conditions of Ukrainian citizens are basedon the revised system of targets and indicators of the national Goals. We support any effort to look for newways to address the challenges presented by the globalized world.Ukraine is initiating large-scale economic reforms at a difficult time. At the same time, it is not only ourcountry fighting to overcome the crisis but the whole world. A search for new progressive developmentmodels is underway, for new ways to ensure human development aimed at the achievement of theMillennium Development Goals.This is a challenge for the whole global community. And it is also an opportunity for the renewal andprosperity of our country.VIKTOR YANUKOVYCHPRESIDENT of UKRAINE4MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

When 189 world leaders met at the United Nations and endorsed the Millennium Declaration in September2000, they made a strong commitment to work together to build a safer, more prosperous and moreequitable world. The Declaration was translated worldwide into a roadmap setting out eight time-boundand measurable Goals, known as the Millennium Development Goals, to be reached by 2015. Theirimportance cannot be overstated. Ukraine adapted the global MDGs at the national level in 2003.This year marks a decade of progress towards the MDGs. The results have been uneven across all Goals andwithin regions and nations. Ukraine has reduced absolute poverty and has made progress in achievingthe targets set for education, maternal health and child mortality. At the same time, the relative povertyrate remains unchanged and reducing gender inequality continues to be an area where progress needs tobe achieved. While meeting the environmental Goal is proving to be a challenge, the rapid growth of HIVinfections, the increase in AIDS-related mortality and the spread of tuberculosis also remain critical areasin reaching the MDGs.While it is clear that these are challenging times for all countries, and in particular for Ukraine, achievingthe MDGs is possible, given an adequate level of commitment, efforts and resources. Creating effectivenational policies and developing capacities and ownership are essential to further empowering the peoplein Ukraine and improving their standards of living.There is a range of tried and tested policies that can help Ukraine reach its commitments. These policiesinclude fostering inclusive economic growth, ensuring equal access to quality health and education andscaling up HIV/AIDS and tuberculosis interventions. Improving social protection targeting, increasingemployment opportunities, fostering climate change mitigation and focusing on biodiversity conservationmust continue to be regarded as absolute priorities.Let us use the next five years to improve the lives of all.OLIVIER ADAMUN RESIDENT COORDINATOR in UKRAINEMILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010 5

Acronyms AND AbbREVIATIONSAIDSCISAcquired Immune DeficiencySyndromeCommonwealth of Independent StatesODAOECDOfficial Development AssistanceOrganisation for Economic Co-operationand DevelopmentCSRDACDOTSCivil Status RegistrationDevelopment Assistance Committee(OECD)Directly Observed Treatment ShortCourse (Tuberculosis)PIRLSPISAPEIProgress in International ReadingLiteracy StudyProgramme for International StudentAssessmentPreschool Educational InstitutionEUEuropean UnionPPPPurchasing Power ParityCSWCommercial Sex WorkersSTISexually Transmitted InfectionGDPGross Domestic ProductTBTuberculosisGEIHDIHEIHIPCHIVGeneral Educational InstitutionHuman Development IndexHigher Educational InstitutionHeavily Indebted Poor CountryHuman Immunodeficiency VirusTIMSSUNAIDSUNDPTrends in International Mathematicsand Science StudyUnited Nations Joint Programme onHIV/AIDSUnited Nations DevelopmentProgrammeICFIDUILOMDGsMoHMSMNASInternational Charitable FoundationInjecting Drug UserInternational Labour OrganizationMillennium Development GoalsMinistry of Health of UkraineMen Who Have Sex with MenNational Academy of SciencesUNFCCCUNFPAUNICEFVEIWHOWTOUnited Nations Framework Conventionon Climate ChangeUnited Nations Population FundUnited Nations Children’s FundVocational Educational InstitutionWorld Health OrganizationWorld Trade OrganizationNRFNatural Reserve Fund of Ukraine6MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

CONTENTSAcronyms AND AbbREVIATIONS 6ACKNOwLEDGEMENTS 8INTRODUCTION: The MILLENNIUM DEVELOPMENT GOALS 13CHAPTER ONE: UKRAINE. DEVELOPMENT DIMENSIONS 17Economic Development in 2001–2009 18Inequality as an Obstacle to Achieving the MDGs 22Human Development 25Development Trends and Global Climate Change 26CHAPTER TWO: MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 31Goal 1. Reduce Poverty 34Goal 2. Ensure Quality Lifelong Education 43Goal 3. Promote Gender Equality 54Goal 4. Reduce Child Mortality 63Goal 5. Improve Maternal Health 68Goal 6. Reduce and Slow Down the Spread of HIV/AIDS and Tuberculosis andInitiate a Trend to Decrease Their Scales 75Goal 7. Ensure Environmental Sustainability 89ANNExES 98Annex 1. Development Goals Formulated by the United Nations Millennium Declaration 98Annex 2. Updated Matrix of Targets and Indicators of the National MDGs 101Annex 3. Progress towards Achieving the MDGs in Selected Countries 104BibLIOGRAPHY 105

AcknowledgementsThe National Report, Millennium Development Goals. Ukraine – 2010 was prepared by a WorkingGroup established by Order of the Minister of Economy of Ukraine. The general coordination of thepreparation of this Report was led by Iryna Kryuchkova, Deputy Minister of Economy of Ukraine;Ella Libanova, Director of the Institute for Demography and Social Studies and Academician of theNational Academy of Sciences of Ukraine; Lyudmyla Musina, Consultant to the Minister of Economyof Ukraine; Oleksander Savenko, Head of the Department for Social and Humanitarian Development,Ministry of Economy of Ukraine; and Natalia Sitnikova, Project Manager, Millennium DevelopmentGoals – Ukraine Project, UNDP Ukraine.This Report includes comments and proposals received during expert and public discussions. It is alsobased on the outcomes of intensive discussions among Government officials, scientists, representativesof international development organisations, non-governmental organisations and the private sectorThe following experts contributed largely to its preparation: Larysa Bochkova, Head of the MonitoringUnit of the Ukrainian Centre for AIDS Prevention; Tatiana Bolila, Specialist, Millennium DevelopmentGoals – Ukraine Project, UNDP Ukraine; Lyudmyla Cherenko, Head of the Division for Studies ofPopulation Living Standards, Institute for Demography and Social Studies, National Academy ofSciences of Ukraine; Nadia Dmytrenko, Deputy Head of the Department for Social and HumanitarianDevelopment and Head of the Unit for Social Standards and Reforms, Ministry of Economy ofUkraine; Hanna Herasymenko, Senior Research Fellow, Institute for Demography and Social Studies,National Academy of Sciences of Ukraine; Yevhenia Kalishenko, Associate, Millennium DevelopmentGoals – Ukraine Project, UNDP Ukraine; Olga Karmazyna, Head of Division, Department for Statisticsof Services, State Statistics Committee of Ukraine; Joanna Kazana–Wisniowiecka, UNDP DeputyResident Representative; Yevhen Khlobystov, Head of the Division for Sustainable Development andEcological Security, Council for Productive Forces of Ukraine, National Academy of Sciences of Ukraine;Oksana Khmelevska, Senior Research Fellow, Department of Social Policy, Institute for Demographyand Social Studies, National Academy of Sciences of Ukraine; Yuriy Kobyshcha, Technical Officer,STI/HIV/AIDS Strategic Information, WHO Office in Ukraine; Olena Makarova, Deputy Director, Institutefor Demography and Social Studies, National Academy of Sciences of Ukraine; Anatoliy Maksyuta,First Deputy Minister of Economy of Ukraine; Valeriy Muntian, Deputy Minister of Economy of Ukraine;Pavlo Onyshchenko, Head of the Department for Strategic Planning, Ministry of Economy of Ukraine;Oksana Ovcharuk, Expert, UNDP Ukraine; Ricarda Rieger, UNDP Country Director; Katerina Rybalchenko,Senior Programme Manager, UNDP Ukraine; Natalia Rynhach, Leading Research Fellow, Institute forDemography and Social Studies, National Academy of Sciences of Ukraine; Ani Shakarishvili, Coordinator,UNAIDS Ukraine; Olena Sherstyuk, Child Development Officer, UNICEF Ukraine; Oleksiy Stelmakh, Headof the Division of Humanitarian Development, Department for Social and Humanitarian Development,Ministry of Economy of Ukraine; Natalia Vlasenko, Deputy Head of the State Statistics Committee ofUkraine; and Andriy Volkov, Head of the Sustainable Development Division, Department for Social andHumanitarian Development, Ministry of Economy of Ukraine.We would like to express our sincere gratitude to the specialists who participated in activities of theWorking Group. The following people made significant contributions to the preparation of this Report:Tuya Altangerel, Policy Specialist, MDG SupportTeam, Poverty Group, Bureau of DevelopmentPolicy, UNDPVictoria Andreevska, Communications Officer,United Nations in UkraineLidia Andruschak, Social Mobilization and PartnershipAdvisor, UNAIDS UkraineNatalia Astapova, Social Policy and MonitoringOfficer, UNICEF Ukraine8MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Olga Balakireva, Head of Division for MonitoringStudies of Socio-Economic Transformation, Institutefor Economics and Forecasting, NationalAcademy of Sciences of UkraineInna Barchuk, Consultant, Millennium DevelopmentGoals – Ukraine Project, UNDP UkraineNatalia Bielkina, Head of the Division for SpecializedAgencies and Functional Commissions,Department of the United Nations and OtherInternational Organisations, Ministry of ForeignAffairs of UkraineOksana Biletska, Head of the Division for Analysisand Forecasting of Social and Cultural Developmentof Regions, Ministry of Culture andTourism of UkraineKim Boermans, Programme Analyst Poverty Reduction,UNDP Europe and the CIS, BratislavaRegional CentreInterna Bondar, Chief Research Fellow, Divisionfor Strategic Planning, Forecasting, Regulationof Economic and State Target Programmes,Scientific and Research Economic Institute,Ministry of Economy of UkraineOlena Chumakova, Chief Specialist, Division forHumanitarian Development, Department forSocial and Humanitarian Development, Ministryof Economy of UkraineAlexander Domaranskiy, Deputy Head of Secretariat,Committee on Education and Science,Parliament of UkraineRuslan Doroshkevych, Deputy Head of Departmentof Financial Policy, Head of Division ofPension Policy and Wages, Administration ofthe President of UkraineYuriy Feshchenko, Chief Tuberculosis Specialistand Pulmonologist, Ministry of Health ofUkraineNatalia Gahovych, Research Fellow, Institute forEconomics and Forecasting, National Academyof Sciences of UkraineYulia Galustyan, Leading Research Fellow, Institutefor Economics and Forecasting, NationalAcademy of Sciences of UkraineValentyn Garaschenko, Chief Specialist of Divisionfor Preventing Negative PhenomenaAmong Youth, Ministry of Ukraine for Family,Youth and SportsValeriy Gladkiy, General Director, Analytical CentreBESTHalyna Goleusova, Head of the Social SecurityDepartment, Federation of Trade Unions ofUkraineVasyl Golovinov, Chief Consultant of the Committeeof Education and Sciences, Parliamentof UkraineIgor Gorbasenko, Head of the Board, InternationalAssociation of Journalists ‘Health withoutBorders’Vladimir Gordeiko, Project Manager, Governanceof HIV/AIDS Project, UNDP UkraineNataliya Gorshkova, Head of the MacroeconomicsDepartment, Ministry of Economy ofUkrainePaola Gosset, EditorRoo Griffiths, EditorSergiy Grytsenko, Communications Officer,UNDP UkraineSerhiy Gubin, Director of the National Press Club‘Ukrainian Perspective’Nadiya Gryhorovych, Head of the Departmentfor Labour Statistics, State Statistics Committeeof UkraineOksana Guziy, Chief Specialist of the Divisionfor Promoting Gender Equality and CombatingHuman Trafficking, Ministry of Ukraine forFamily, Youth and SportsBarbara Hall, Consultant EditorOlena Heylo, Technical Officer, TB Control Programme,WHO Office in UkraineBalazs Horvath, Regional Poverty ReductionPractice Leader for Eastern Europe and CentralAsia, UNDP Bratislava Regional CentreAnna Ilchenko, Chief Specialist of Division forSustainable Development, Ministry of Economyof UkraineTatyana Ivanenko, Deputy Director of Departmentof Promotion of Youth Development,Ministry of Ukraine for Family, Youth and SportsIrina Kalachova, Head of Department of ServicesStatistics, State Statistics Committee of UkraineIvanna Karabyts, Chief Specialist of Division ofAnalysis and Forecasting of Social and CulturalDevelopment of Regions, Ministry of Cultureand Tourism of UkraineAndriy Klepikov, Executive Director, ICF ‘InternationalHIV/AIDS Alliance in Ukraine’Antonyna Klymenko, Head of the Departmentfor Social and Economic Protection, Trade Unionof Education and Science Employees ofUkraineLarysa Kobelyanska, Project Manager, Equal Opportunitiesand Women’s Rights Programme,UNDP UkraineVictor Kolomiyets, Programme Manager, UNFPAUkraineMaria Korenyako, Expert, World Bank OfficeUkraineSergiy Kondryuk, Deputy Chairman, Federationof Trade Unions of UkraineAcknowledgements 9

Tatiana Kovalova, Chief Specialist of the Divisionof Social Standards and Reform, Ministry ofEconomy of UkraineNatalia Kozlova, Deputy Head of the Division ofHumanitarian Development, Department forSocial and Humanitarian Development, Ministryof Economy of UkraineGenadiy Kulikov, Chief Research Fellow, Divisionof Social and Economic Issues, Institute for Economicsand Forecasting, National Academy ofSciences of UkraineIrina Kurylo, Head of the Division of DemographicProcesses Quality, Institute for Demographyand Social Research, National Academy of Sciencesof UkraineElla Lamah, Head of the Department of Familyand Gender Policy and Organisation of HealthCare, Ministry of Ukraine for Family, Youth andSportsValentyna Latik, Head of the Department of SocialStrategy Development, Ministry of Labourand Social Policy of UkraineVytaliy Lehkov, Chief Specialist, Federation ofTrade Unions of UkraineRoman Levin, Senior Research Fellow, Institutefor Economics and Forecasting, National Academyof Sciences of UkraineKlavdia Maksimenko, Programme Manager Advisor,UNDP UkraineIgor Mantsurov, Director, Scientific and ResearchEconomic Institute of the Ministry of Economyof UkraineOlga Martynyuk, Chief Specialist, Department ofAgriculture and Environment Statistics, StateStatistics Committee of UkraineVasyl Melnyk, Head of the Division of Epidemiologicaland Organisational Problems of Phtisiopulmonology,National Institute of Tuberculosisand Pulmonology of F. YanovskyJock Mendoza-Wilson, Director of Internationaland Investor Relations, System Capital Management,Head of the Organisational Committeeof Global Compact (2006–2009, 2010–2011)Vladimir Mikhalev, Policy Advisor, UNDP BratislavaRegional CentreKoh Miyaoi, Gender Team, Practice Leader forEastern Europe and Central Asia, UNDP BratislavaRegional CentreInna Motrych, Head of the Division for Monitoringof Anti-Tuberculosis Activities, UkrainianCentre for Tuberculosis Control, Ministry ofHealth of UkraineValentyna Nidzelska, Head of the Departmentof State Education Standards, Kyiv BusinessLyceumNatalia Nizova, Director, Ukrainian Centre forAIDS Prevention, Ministry of Health of UkraineJohn O’Brien, Regional Technical Advisor,UNDP Bratislava Regional CentreAnna Olefir, Education Economist, World BankOffice in UkraineNatalia Orlovska, Head of the Division for Familyand Demographic Policy, Ministry of Ukrainefor Family, Youth and SportsOlena Osinkina, Senior Expert, Analytical CentreBESTInna Osypova, Head of the Department ofHousehold Survey, State Statistics Committeeof UkraineOlena Ovchynnikova, Executive Associate tothe United Nations Resident Coordinator andUNDP Resident RepresentativeValentyna Pedan, Deputy Director, Departmentof Motherhood, Childhood and SanatoriumCare, Ministry of Health of UkraineVladyslava Pekarska, Intern, UNDP UkraineNatalia Petelyna, Chief Specialist, State SocialService, Ministry of Ukraine for Family, Youthand SportsNatalia Pidlisna, Executive Director, Coalition ofHIV Service OrganisationsVadym Pishcheyko, First Deputy Head, State StatisticsCommittee of UkraineIgor Pokanevych, Head, WHO Office in UkraineOleksander Polusmyak, Head of Division forAnalysis and Forecasting of Educational Institutions,Ministry of Culture and Tourism ofUkraineOlga Popova, Leading Research Fellow, Institutefor Economics and Forecasting, National Academyof Sciences of UkraineVyacheslav Potapenko, Consultant to the Memberof the Parliament of UkraineOlga Prokhorenko, Specialist on Gender Issues,Department for Family and Gender Policy, Ministryof Ukraine for Family, Youth and SportsOleg Prokopenko, Head of Department for Agriculturaland Environmental Statistics, StateStatistics Committee of UkraineNatalia Protasova, Head of Education Department,National Academy of PublicAdministrationMykola Puzyrin, Head of the Department ofProtection of Labour and Environment, ChiefTechnical Inspector of Labour, Federation ofTrade Unions of UkraineNina Pydluzhna, Deputy Director of Departmentof Social Development, Ministry of Labour andSocial Policy of Ukraine10MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Bogdan Pydverbytskiy, Head of Division for NegativePhenomena Prevention among Youth,Ministry of Ukraine for Family, Youth and SportsOlga Rodenko, Chief Specialist of the Division forFamily and Demographic Policy, Departmentfor Family and Gender Policy and Organisationof Health Recovery, Ministry of Ukraine forFamily, Youth and SportsMykhailo Rohozha, Head of the Division for HumanitarianEducation, Department of HigherEducation, Ministry of Education and Scienceof UkraineVytaliy Rudenko, Chairman, Public Movement‘Ukrainians against TB’ FoundationOlga Sakalska, Head of Department for SociallyDangerous Diseases, Committee to CounterHIV/AIDS and Other Socially Dangerous Diseases,Ministry of Health of UkraineOlena Sakovych, Youth and Adolescent DevelopmentOfficer, UNICEF UkraineInna Samchenko, Deputy Director, Departmentfor Statistics of Services, State Statistics Committeeof UkraineSerhiy Savchuk, First Secretary of the Departmentof the UN and other International Organisations,Ministry of Foreign Affairs of UkraineShombi Sharp, Regional HIV/AIDS Practice Leader,Europe and the CIS, UNDPYuliya Shcherbinina, Public-Private PartnershipOfficer, United Nations in UkraineLubov Shnerenko, Head of the Department forDevelopment of Entities of Social Work in theRegions, State Social Service for Family, Childrenand Youth, Ministry of Ukraine for Family,Youth and SportsNatalia Shumar, Chief Consultant of the Committeeon Education and Science, Parliament ofUkraineIhor Shumylo, Executive Director on Economic Issues,National Bank of UkraineBen Slay, Senior Economist, UNDP Bratislava RegionalCentreOleksiy Slenzak, Senior Project Coordinator inEnvironmental Protection, World Bank Officein UkraineOksana Smetanyna, Director, Ukrainian Centrefor Tuberculosis Control, Ministry of Health ofUkraineNina Solomatina, Head of the Department forEconomic Protection, Federation of Trade Unionsof UkraineSvitlana Spesyva-Ukhova, Deputy Director ofthe Department for Household Budget Surveys,State Statistics Committee of UkraineLyudmyla Storozhuk, Deputy Director, UkrainianCentre for AIDS Prevention, Ministry of Healthof UkraineAnatoliy Stovbun, Chief Specialist, Technical Inspectorof Labour, Federation of Trade Unionsof UkraineDenis Strekozov, Head of Division of Analysis andPlanning of Strategic Development Administrationand Economics of Management of Nature,Ministry for Environmental Protection ofUkraineOlena Suslova, Coordinator on Gender Issues,Parliament Development ProjectYuliya Svavolya, UN Coordination Analyst, UN Officein UkraineMarcin Swiecicki, Director, EU/UNDP Blue RibbonAnalytical and Advisory CentreViktoria Syryachenko, Country Officer, WorldBank Office UkraineTatiana Tarasova, HIV/AIDS Officer, UNICEF inUkraineDudley Tarlton, Regional HIV/AIDS ProgrammeAdvisor, Europe and the CIS, UNDPGeorgiy Truhanov, Deputy Head of the CentralCommittee, Trade Union of Education and ScienceEmployees of UkraineLyudmyla Udova, Senior Research Fellow, Institutefor Economics and Forecasting, NationalAcademy of Sciences of UkraineOlga Varetska, Head of the Division for Monitoringand Evaluation, ICF ‘International HIV/AIDS Alliance in Ukraine’Sergiy Volkov, Senior Programme Manager,UNDP UkraineValeriya Voytenko, Deputy Head of the Divisionof Macroeconomic Forecasting, Ministry ofEconomy of UkraineTetyana Yasko, Head, All-Ukrainian Trade Unionof Workers and Entrepreneurs in Trade, Cateringand ServicesNatalia Zabolotna, Chief Specialist of the Divisionfor Economic Analysis, Ministry of Economy ofUkraineLubov Zadoyenko, Head of the Division for DemographicStatistics, State Statistics Committeeof UkraineAlexandra Zayarna, Sustainability Manager, SystemCapital ManagementPaola Zhorzhat, Specialist in Gender Policy forEastern Europe and Central Asia, UNDP BratislavaRegional CentreVolodymyr Zhovtyak, Head, All-Ukrainian Networkof People Living with HIV/AIDSIgor Zhylyayev, Deputy Director of the CommitteeSecretariat, Committee on Education andScience, Parliament of Ukraine Acknowledgements 11

INTRODUCTION:THE MILLENNIUM DEVELOPMENTGOALS

The United Nations Millennium Declaration,adopted by 189 countries at the UnitedNations General Assembly session in 2000, initiatedthe process towards achieving the MillenniumDevelopment Goals (MDGs) by 2015. TheseGoals were set by the world community to addressthe starkest inequalities in global humandevelopment. The Goals include reducing hungerand poverty, achieving access to education,promoting gender equality, reducing maternaland child mortality, slowing down the spread ofHIV/AIDS and other infectious diseases, ensuringenvironmental sustainability and harmonizingforeign aid to developing countries.The internationally agreed framework of theMDGs contains eight Goals, 21 targets and 60 indicatorsto measure progress. The MDGs are a setof time-bound, quantitative targets representinga common vision for development. To helptrack progress on the commitments made in theMillennium Declaration, international and nationalstatistical experts selected relevant indicatorsto be used to assess progress over the periodfrom 1990–2015. In 2007, the MDG monitoringframework was revised to include new targetsagreed by member states at the 2005 WorldSummit and recommended in 2006 by the UnitedNations Secretary-General.In close collaboration with agencies and organisationswithin and outside the United Nationssystem, the United Nations Statistics Division coordinatesdata analysis to assess progress madetowards the MDGs and maintains the databasecontaining data related to the selected indicators,as well as other background data intendedto supplement these. National statistics servicesprovide information to the international statisticssystem after checking its accuracy to ensurecomparability. When national statistics servicesdo not provide updated data on time, or do notproduce the data required for an assessment ofprogress on the indicators, authorized agenciesmake estimates based on the data available on relatedvariables or by using other methodologies.Since periodic assessment of progress towardsthe MDGs began, the international statisticalcommunity has been concerned about the lackof adequate data in many parts of the developingworld to assess progress on the MDG indicators.At the same time, the monitoring requirementsthemselves have helped focus attention on thisshortcoming and have raised awareness on theurgency of launching initiatives for statisticalcapacity building. The official list of MDG indicators,effective as of 15 January 2008, is providedin Annex 1.United Nations reports on progress towardsachieving the MDGs are published annually andcontain analysis of actual statistical data for all regionsof the world, allowing for an understandingof how humanity is moving towards achievingthese Goals. The reports also present estimatedachievements on a world scale and trends in specificregions.In 2000, the United Nations Millennium Declarationset Goals to be achieved by 2015. Two-thirdsof this time has passed. What are the results ofthis consolidated effort? In 2010, the UnitedNations Summit on the Millennium DevelopmentGoals – a High-Level Plenary Meeting of theGeneral Assembly – will bring together worldleaders to review progress, identify gaps andcommit to a specific action agenda to achievethe MDGs and internationally agreed developmenttargets. Heads of states and governments,together with leaders of civil society, foundationsand business, are expected to announce new initiativesto accelerate progress.In preparation for the Summit, at which Ukraine’sprogress is to be presented, the Ministry ofEconomy of Ukraine, in cooperation with theUNDP Millennium Development Goals – UkraineProject, reviewed the national MDGs and elaboratedan updated system of targets and indicators,taking into account the specifics of nationaldevelopment in a post-crisis period and currentchallenges in global development. This processinvolved more than 100 representatives ofGovernment institutions, think-tanks, UnitedNations agencies, international organisations,the Federation of Trade Unions of Ukraine andcivil society organisations. It resulted in the newNational Report, Millennium Development Goals.Ukraine – 2010. In this process, efforts were madeto analyse policy implications in various domainsand to generate the updated targets for the Government until 2015. These will be used in governmentalpolicy documents as a medium-termperspective.14MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

The overall objectives of this Report are to: (1)raise the public’s awareness of the importanceof the MDGs and their linkages to their livelihoodsand those of future generations; (2) informGovernment institutions, civil society and the publicon how the MDGs can inform their activities; (3)link the MDGs and strategic planning processesby ensuring that indicators and national targetsare integrated into strategic planning documents;(4) facilitate debates between national and internationalcommunities on future development; (5)emphasize to the Government, civil society andthe business community the necessity of specificactions aimed at achieving the MDGs (first of allon poverty alleviation); and (6) strengthen coordinationand collaboration between Governmentinstitutions, civil society organisations and thebusiness community to achieve sustainable humandevelopment.To achieve the MDGs, it is important to consolidatethe efforts of the three components of society– Government, business and the public.Establishing partnerships between Governmentand business and increasing dialogue betweenthe state and society are key to this. These relationshipsare based on the following principles:the state assumes responsibility for achieving theMDGs, improving the population’s living standardsand ensuring social protection and, as a result,obtains legitimacy and public support; thestate guarantees property rights, a favourablebusiness climate and the promotion of business,in compliance with state-established rules andregulations; and a balance between society andcapital is created, on the principle of ‘honest business– supporting its interests and actions bysociety.’Effective cooperation between social partners –the state, employers, trade unions and the public– and an optimal balance and division of responsibilitiesbetween the state, business andcommunities should accelerate human development.Efforts should take into account challengesrelated to the MDGs, global development, engagementof domestic businesses in Europeanmarkets, cooperation with foreign investors andgrowing competition in the global market. Corporatesocial responsibility – as the active engagementof entrepreneurs, using their experienceand knowledge, in socio‐economic policydevelopment – is a key to this. This requires compliancewith generally accepted world standardson social responsibility, transparency and willingnessto be accountable to the community.Creating mechanisms for achieving consensusbetween the Government, business and civil societyshould help ensure implementation of theMDGs and necessary reforms in Ukraine. INTRODUCTION: MILLENIUM DEVELOPMENT GOALS 15

CHAPTER ONEUKRAINE:DEVELOPMENT DIMENSIONS

This chapter presents an analysis of the social andeconomic development of Ukraine in 2000–2009.It reviews economic development trends, inequalityissues, challenges of global climate change and humandevelopment in the country.Economic Developmentin 2000–2009In 2000–2007, Ukraine demonstrated rapid economicgrowth – at an average of 7.5 percent peryear (Figure 1).Economic growth was supported by positivechanges and reforms in domestic economicpolicy and was influenced by: (1) a significantincrease in domestic consumer demand, basedon a stable increase in household incomes anddynamic growth in the availability of consumercredits; (2) a significant increase in exports,stimulated by global and regional economicgrowth; and (3) relatively strong investmentdemand.As a result, during 2000–2007, the gross domesticproduct (GDP) of Ukraine increased cumulativelyby almost 77.7 percent and labour productivityby almost 72 percent, which in general surpassedthe growth figures of developed countries.However, as with any economic system thatstarts its recovery after a long period of sharpdecline, growth was mainly extensive. First ofall, production capacities expanded, which statisticallydistorted (increased) indicators of labourand capital productivity. The significantFigure 1. Real GDP Growth, 1993–2009, %20092008200720062005200420032002200120001999199819971996199519941993‐22.9‐15.1‐10.0‐12.2‐14.2‐3.0‐1.9‐ 0.22.32.77.97.35.25.99.69.212.1‐25.0 ‐20.0 ‐15.0 ‐10.0 ‐5.00.0 5.0 10.0 15.018MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

initial depreciation of the national currency anddeclining unit labour costs increased the pricecompetitiveness of Ukrainian production. Acceleratedlabour productivity growth was not accompaniedby processes common to developedcountries, whereby a change in developmentdynamics is possible as a result of new hightechnologies being introduced into production,i.e. growth depends on scientific and technicaladvancement.Box 1. According to the International LabourOrganization (ILO) data, labour productivity inUkraine (based on GDP in purchasing power parity(PPP)) was US $ 10,900 in 2007, comparedto US $ 63,800 in the United States,US $ 54,900 in France, US $ 42,600 in Germany andUS $17,900 in the Russian Federation.In addition, some structural changes took place inUkraine during the pre-crisis period; and the shareof the services sector in the economy increased(to 22.8 percent in 2007 against 17.2 percent in2001). However, these changes were not guidedby a consistent strategic policy framework.Overall, these trends – a decrease in the share ofthe industrial sector and an increase in the shareof the services sector in gross output – fully correspondwith global economic trends in transitionaleconomies. The national economy structuregradually transforms into a structure like those inhighly developed countries, in which the servicessector plays a dominant role. However, some imbalancesare observed in the development of theservice sector.Trade demonstrated extremely high growth ratesduring 2001–2007 (15 percent on average duringthe period), which significantly exceededGDP growth rates (7.5 percent). This led to an increasein the share of trade in both GDP and thegross value-added of the services sector.Increased output volumes of industry and trade,increased incomes and growth in housing constructionand mortgage credits stimulated thedevelopment of economic activities in the realestate sector, including leasing (residential andnon-residential). As a result, growth rates for realestate transactions, leasing, engineering and servicesprovision to entrepreneurs also exceeded averageGDP growth and amounted to 116 percentduring the period.The financial sector also had a significant impacton the development of the services sector and onthe economy in general. The growth rates of thefinancial services sector amounted to, on average,123 percent during the period, whereas itsshare in GDP increased to 5.9 percent in 2007,against 2.6 percent in 2001. This can be explainedby factors on both the supply side (active entry offoreign banks into the domestic market, pursuingaggressive policies to gain a market share) andthe demand side (the rise of a consumer class,which actively started to improve its own housingand living conditions through access to creditschemes).During this period, the industry sector also developedrapidly, owing to a favourable foreigneconomic business environment and growth inconsumer credits, which supported an increase inboth domestic and foreign demand for industrialgoods. However, growth in this sector was notcharacterized by modernization and restructuring.Other factors, such as the price of importednatural gas, influenced industry dynamics during2005–2007. The price of natural gas influencedprices in the manufacturing industries thatdepend most on natural gas.Increased production averaged 9.5 percent as aresult of both restrictive and stimulating factors,whereas the share of industry in GDP remainedalmost unchanged, at 27.1–27.5 percent during2001–2007. Here, some disparity within sub-sectorsremained, owing to a lack of investment andinnovation programmes to modernize manufacturing.Raw material industries and industrieswith low levels of processing technology prevailed.These industries made up Ukraine’s mainexports. At the same time, industries focused onthe domestic market gradually decreased theirmarket share, leaving space for imported goods.In particular, the technological structure of productionin Ukraine during this period differedsignificantly from that of developed economies,where sectors with a high share of intermediateconsumption and with low value-added donot influence on the macroeconomic situationsignificantly.CHAPTER ONE. UKRAINE: DEVELOPMENT DIMENSIONS 19

Table 1. Rate of Decline in Industrial Production, September–December 2008, %IndustrySeptember October November December2008 against 2007, month to monthMetallurgy –20.7 –39.9 –52.3 –44.4Chemical and petrochemicalindustriesProduction of coke and oil-refiningproductsMining operations (except productionof fuel and energy)–6.0 –22.6 –33.7 –36.7–20.7 –40.9 –11.8 –5.2–10.2 –28.3 –55.2 –42.3Industry overall –5.2 –19.9 –31.0 –28.0In sum, Ukraine’s economic development in 2000–2007 was influenced by a combination of factors.On the one hand were some positive economictrends, caused by a favourable foreign businessenvironment. On the other hand, given that manufacturingdid not undergo modernization andreconstruction during the period of growth, allchanges were spontaneous and caused by market-determinedfactors. Therefore, Ukraine didnot capitalize on nine years of GDP growth by restructuringand modernizing its industry.As a result, abrupt changes in development trendsemerged in August 2008. Most Ukrainian exporterslost their foreign sales markets as a result ofthe decline in world demand for Ukrainian goodsand the abrupt decline in prices of raw materials.For the first time since 2000, a rapid declinein the manufacturing volumes of export-orientedindustries was observed.Data from September to December 2008, comparedwith those of the corresponding periodof 2007, show a significant rate of decline in theproduction of leading industries. Through thechain of inter-industry relationships, this caused adecline in the production of coke and oil processingproducts and in the extraction of mineral resources(Table 1 and Figure 2).The effects of the abrupt decline in productionwere observed at the end of 2008, with recoveryand a return to previous production levels likelyto be a complex process.Ukraine’s abrupt industrial slowdown resultednot only from declining demand in foreign marketsbut also from deterioration in the foreignbusiness environment.The decrease in metallurgical production wasalso caused by a significant decrease in domesticdemand, first of all by major consumers of metallurgicalproducts, such as in the machinery buildingand construction sectors. However, negativetrends were observed not only in the manufacturingsector but also in other areas of the economy,particularly in services and trade, which serve asindicators of business activity. The number of privatedeposits decreased, as did the nominal volumeof credits provided to both legal entities andprivate persons. The situation in the banking sectorworsened under currency destabilization.The global economic crisis, which started in 2008and spread to Ukraine, highlighted structural deficiencieswithin the national economy and revealedthe risk of relying mainly on the export ofraw materials. The decline in the banking sector,which was unable to mitigate the effects of theeconomic crisis when national producers were inextreme need of financial resources, was an additionalfactor that stimulated a decline in industryand other types of economic activity.As such, it seems that industry was highly dependenton the global business environment. Thesector’s performance in 2008–2009 (a decline by26.0 percent, including 21.9 percent in 2009 and5.2 percent in 2008) was caused by accumulatedsystemic shortcomings. The sector’s growth hadled to the development of closely related typesof economic activity, mainly wholesale trade andtransport, which later suffered significantly from a20MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Figure 2. Annual Rates of Declinein Industrial Output, 2009, %Figure 3. GDP Growth Ratesfor Selected Countries, 2009, %-10,3-10,8-3,6-5,7-5,9-2,4United StatesPolandTurkeyRomaniaUnited KingdomRussia-18.0-15.1-14.8-14.1-7.1LatviaUkraineLithuaniaEstoniaRomania-13,9-14,6-15,8-15,8-16,3-17,4EU-27LithuaniaLatviaSpainGermanyHungary-6.3-5.2-4.9-4.9-4.7HungaryJapanUnited KingdomGermanySlovakia-21,2-21,9-17,5-17,9-18,2-18,4SloveniSwedenBulgariaItalyFinlandUkraine-4.2-4.1-3.6-2.6-1.4EU-27Czech RepublicSpainUnited StatesNorway-25,9Estonia1.7Poland-30 -25 -20 -15 -10 -5 0Source: State Statistics Committee, Eurostat, NationalStatistics Services publications.decrease in output in 2009 (16.9 percent and 9.3percent, respectively).As a consequence, the GDP declined by 15.1 percent,which was among the steepest in the worldin 2009. (Growth slowed down in nine months of2008 from 6.3–2.3 percent, i.e. the decline in thefourth quarter was 7.8 percent.)A country’s progressive and dynamic developmentshould rely on inclusive economic growth,-20 -15 -10 -5 0 5Source: State Statistics Committee, Eurostat.giving greatest consideration to the population’sneeds and interests. It should also fully considerthe population’s incentives to engage in productivelabour activities, to help people realizetheir own potential as well as obtaining decentremuneration for their labour. Reforms are onlysuccessful when their objectives and tasks arealigned with the population’s interests and expectations.CHAPTER ONE. UKRAINE: DEVELOPMENT DIMENSIONS 21

Inequality as an Obstacleto Achieving the MDGsSince Ukraine achieved independence in 1991,its previously egalitarian society has been characterizedby very high levels of inequality, whichrelates to incomes, access to basic social services(information, communications, education, healthcare, social services, etc), health status, life expectancy,living conditions and quality of life andthe access to labour market.The modern interpretation of inequality assumesexclusion along not only economic but also social,political and ethno-cultural lines. Differentgroups of the population can suffer from particulartypes of inequality as a result of violations oftheir rights; however, the most critical is a combinationof several types of inequality. Extremelynegative and threatening phenomena, such asexclusion of population groups from public life(social exclusion), polarization and marginalization,occur as a result of the cumulative impactsof different types of inequality.Within the context of the MDGs, the most obviousform of inequality relates to Goal 1: ReducePoverty, namely, income inequality, which is reflectedby the existence of poor and rich groupsin the population. Income inequality deepens inequalityin relation to access to key social services(quality health care, education and housing) andresources (financial, particularly credit, land, etc)and to the exercise of fundamental rights in general(rights to health, life and security). At the sametime, income inequality itself is a consequence ofother types of inequality. In particular, childrenfrom poor families, who do not have sufficient accessto quality education, more often live belowthe poverty line. Meanwhile, a significant numberof those with higher education do not work intheir area of specialization or work in unskilledjobs. From 1999, a stable direct correlation hasbeen observed between education and incomelevels. This includes inequality in life expectancyowing to an inability to maintain a healthy lifestyle,lack of access to quality health care servicesand lack of a clean environment. Consequently,children from poor families have a higher risk ofpremature death or illness and fewer opportunitiesto realize their potential.High inequality and poverty levels cause socialtension and conflicts and increases in crime. Theconsequences of these, particularly under conditionsof political instability, are an increase ineconomic risks and decreased attractiveness ofthe country’s investment environment. This inevitablyslows down economic growth. On theother hand, inequality is an indicator not only ofcriminalization but also of corruption. Economicinequality is a barrier to democratic reforms.Income inequality often causes macroeconomicinstability. Significant inequality in the populationis a factor of poverty, and requires a large-scalesecondary redistribution of income through socialtransfers which, other things being equal, could affectthe budget deficit and also inflation (which affectsthe income of poor groups of the populationmore strongly, exacerbating inequality).Economic buoyancy caused significant – andquite positive – structural changes in terms of inequalitywithin the population: wage income hasincreased notably (from 20.9 percent in 1999 to41.6 percent in 2008), as has income from entrepreneurialactivities (from 2.4 percent to 7.9 percent).At the same time, income from unregisteredeconomic activities, which reached 42.6 percentat transition, (more than wages, pensions and incomefrom private subsidiary plots combined), iscurrently at only 17.9 percent. The importance ofincome from private subsidiary plots has not onlysignificantly decreased but also now counters inequality,since these remain a source of incomepredominantly for the poor population. The incomesof the poor have approached those of theaverage population. However, the economic crisisof 2008 to 2009 had an impact on these structuralchanges.Inequality in the context of Goal 2: EnsureQuality Lifelong Education deserves special attention.Quality education can be a major cushionagainst shocks and, at the same time, is an extremelyimportant factor in economic inequality.At present, socio-economic status is closely relatedto educational level in Ukraine: among peoplewho have completed higher education, 11 percentare poor, 35 percent have an average incomeand 7.5 percent are rich; among those who havecompleted only general secondary education (i.e.without systematic professional training), 29 per-22MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

cent are poor, 18 percent have an average incomeand 2 percent are rich.Higher education decreases the risk of povertyby 2.3 and increases the probability of obtainingan average income by 1.6. Also, it significantly influencesstandards of living, particularly consumerbehaviour. Furthermore, the share of people whosave is higher among those with higher education– 14 percent against 6 percent of those withoutsecondary education. Individuals with highereducation spend a larger share of funds (even iflimited) on educating their children; 90 percent ofpeople with higher education construct houseswith bank credit.A direct relationship between educational leveland competitiveness in the labour market is alsoobserved in Ukraine. It is worth noting the significantimpact of high levels of vocational andeducational training on increased economic activity.Even at over 70 years of age, 3.4 percentof the population with higher education stillwork, compared with 0.5 percent of those withouthigher education. A higher level of educationprovides better opportunities in the labour market:only 4.5 percent of people with higher educationare unemployed compared with 7.9 percentof people with incomplete higher educationand 15.6 percent with secondary education. Theshare of employees and employers is directlyproportional to educational level. There are threetimes more employers among those with completedhigher education than among those withsecondary education.Modern life is characterized by the rapid spreadof advanced information and communicationtechnologies in all spheres of life. They spreadfastest among those who can access informationalresources. Since information resources are notdecreased through sale or use, simplification ofaccess to them could contribute towards solvingone of the major problems of human development– overcoming inequality of access to differentsocio-economic and socio-cultural benefits.This would enable all members of society to accessappropriate knowledge on their social andeconomic environment, rules of behaviour andhealthy lifestyles and, finally, their rights.With respect to Goal 3: Ensure Gender Equality,education also influences gender disparities inemployment. Employment of women with secondaryeducation is significantly lower than thatof men (after reaching retirement age, uneducatedwomen stop working completely). The situationis less straightforward for people with highereducation, at least those over 45 years of age.In addition, among people with higher educationwho leave the labour force at a later age, womenof 65–69 years of age work more often than menof the same age, despite reaching the retirementage five years earlier.Gender disparities in relation to the risk of unemploymentdiffer according to the age group. Menover 50 are at significantly more risk of job lossthan women of the same age group, althoughthis is related to different retirement ages for menand women. Meanwhile, the gap between ruraland urban populations in relation to unemploymentrisks is generally wider. The high risk of unemploymentamong urban youth is caused bya lack of jobs for unskilled workers: a significantshare of the urban population attends school andreceives professional training up to 24 years ofage, unlike the rural population, which enters thelabour market significantly earlier.Inequality also means unequal responsibilities.Some population groups and some individuals,for different reasons, feel more able to take responsibilityfor their own lives and for the lives oftheir family and friends who largely depend onthem. Others prefer to wait until their problemsare resolved by others, mainly putting the onuson the authorities and the state.Dissatisfaction with the results of economic transformation(particularly, with increased inequality)has not resulted in increased citizenship and hasinstead generated despair and feelings of futilityamong certain population groups. This has resultedin a lack of motivation, most notably amongyouth. In January 2009, 35.1 percent of householdsinterviewed during a state Household Budget Survey(36.8 percent in 2007 data) felt that the stateshould be (fully or mostly) responsible for theirwell-being and only 9 percent thought that theythemselves should ensure their own well-being.Three-quarters of the population aged 15–49 citedlow income as the main reason for them postpon-CHAPTER ONE. UKRAINE: DEVELOPMENT DIMENSIONS 23

Table 2. Unemployment Risks by Age Group, 2008, %Men compared withwomenRural populationcompared with urbanpopulationAge groupsOn average15–24 25–29 30–39 40–49 50–5996.3 98.6 116.3 95.2 131.4 108.269.1 91.7 113.7 91.9 107.7 85.1ing having a child, but only 46 percent expressedthe intention to make an effort to increase their income.Only 35 percent of the population thoughtthat their life (fully or mostly) depended on themalone, and only 16 percent had adapted to the newlife conditions.Residents of certain regions and of rural areas aremore vulnerable to labour market disparities. Thelabour migration system is poorly developed, asa result of an inadequate road and transportationnetwork, hence inaccessibility of jobs withina 40 to 50 km distance, and a limited rental housingmarket. As such, the vast majority of the economicallyactive population supplies labour exclusivelyto the local market.Average life expectancy is arguably influenced bymany factors – this indicator combines differencesin labour conditions, living conditions, general lifestyle,environmental situation and quality and availabilityof health care services. These differenceswithin Ukraine are so large that the data seem tocome from different countries rather than from differentregions of the same country. In particular, accordingto 2008 data, differences between regionsin terms of life expectancy were 7.25 years for menand 4.69 years for women.Budgetary capacity to finance health care is verylimited. Average health care expenditures represent2.5 percent of GDP on average in Organisationfor Economic Co-operation and Development(OECD) countries. In Ukraine, health carefinancing amounts to about 1.5 percent of GDP.Health care requires systemic reforms, taking intoaccount highly unequal access to quality healthcare services in the country, which leads to significantregional inequality in relation to health status,mortality and life expectancy. This extremelyhigh regional inequality of life expectancy shouldbe a major consideration in socio-economicpolicy development in the different regions ofUkraine.Efforts in multiple areas should be made to decreaseinequality in Ukraine: in particular, regulationof wages through the application of wellgroundedstate labour market guarantees anda clear social dialogue process; primary incomeredistribution through the introduction of a progressivepersonal income tax system; secondaryredistribution through the set up of a system oftargeted and universal assistance, benefits andsubsidies; and guaranteed standards of living forall groups of the population – including access toquality general and vocational education, qualityhealth care services and clean drinking water.To implement such changes effective publicprivatepartnerships are needed. Fostering socialdialogue, formulating a well-grounded system ofsocial standards and state minimum guarantees,transforming the system of inter-budgetary relations,and ensuring accelerated developmentof the road and transportation network wouldstimulate an increase in migration and enhanceaccess to employment. In particular, within sucha partnership, a corporate social responsibility focusshould promote greater availability of educationaland health care services, fair remunerationand adaptation of vocational training to labourmarket demands.The achievement of the MDGs will have an impactin terms of decreasing the level of inequality ofthe Ukrainian population and contribute towardsthe formation of social structures that accord withEuropean standards. 1 1 The data provided in this subsection are estimates from theInstitute for Demography and Social Studies of the NationalAcademy of Sciences (NAS) of Ukraine based on theHousehold Budget Survey of the State Statistics Committee.24MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Human DevelopmentHuman development is the major goal in the effortto achieve social progress. It has three keyobjectives: the ability to live a long and healthylife; the ability to access knowledge and obtain aneducation; and the ability to enjoy decent livingstandards. The human development concept emphasizes:(1) increased investment in education,health care, healthy lifestyle and proper vocationaltraining to ensure people’s active participationin production and the fair distribution of benefits;(2) fairer distribution of income and wealth toensure an economic foundation to develop thehuman potential of the less competitive groupsof the population; (3) balancing of social expendituresto strengthen the economic foundation ofthe social sphere; and (4) strengthening individuals’abilities to make their own choices in political,social and economic spheres.One of the main aspects of the human developmentconcept is the introduction of measuresto overcome poverty, unemployment, loss ofhealth, etc, by stimulating human development,strengthening individuals’ role in society and enhancingtheir capacity to make decisions on theirlives while increasing their responsibility for thesedecisions and for their implementation.UNDP’s organisational framework for the introductionof the concept of human developmentinto the public administration promoted socialprogress. UNDP Human Development Reportshave been published in various languages since1990 and have gone on to enhance and enrichour understanding of human development, makingit possible to formulate new and promisingapproaches to the design of socio-economicpolicies.In 1993, the Human Development Index (HDI) wasfirst calculated for Ukraine (in the UNDP HumanDevelopment Report). In the first years, whenUkraine was first included in HDI calculations, itranked 45th, and was placed in a group of countrieswith high human development. Over time,though, the country’s global ranking decreasedsignificantly and it ended up in the middle humandevelopment group. In the 2009 HumanDevelopment Report, Ukraine ranked 85th on theHDI, having gone down nine positions from 2005,when it ranked 76th out of 177 countries. Table 3. Human Development Index of Ukraine, 1993–2007, calculated by UNDPYear of datacalculationHDI of UkraineWorld HDIRanking ofUkraine on theHDINumber ofcountriesPublication yearof the UNDP HumanDevelopmentReport1990 0.809 – 45 173 19931995 0.756 0.772 102 174 19981997 0.721 0.706 91 174 19991998 0.744 0.712 78 174 20001999 0.742 0.716 74 162 20012000 0.754 0.722 80 173 20022001 0.766 0.722 75 175 20032002 0.777 0.729 70 177 20042003 0.766 0.741 78 177 20052004 0.774 0.741 77 177 20062005 0.783 0.743 76 177 2007/20082006 0.789 0.753 84 182 20092007 0.796 0.753 85 182 2009Source: UNDP. Human Development Reports,1993–2009.CHAPTER ONE. UKRAINE: DEVELOPMENT DIMENSIONS 25

Table 4. Human Development Index Rankings by Component, as of 2007HDI valueLife expectancy atbirth (years)Adult literacy rate (%)Combined grossenrolment ratio ineducation (%)GDP per capita(PPP US $)1. Norway (0.971) 1. Japan (82.7) 1. Georgia (100.0) 1. Australia (114.2) 1. Liechtenstein (85,382)83. Lebanon (0.803)84. Armenia (0.798)85. Ukraine (0.796)86. Azerbaijan (0.787)87.Thailand (0.783)108. Fiji (68.7)109. Moldova (68.3)110. Ukraine (68.2)111. Azerbaijan (68.2)112. Kyrgyzstan (67.6)182. Niger (0.340) 176. Afghanistan(43.6)4. Latvia (99.8)5. Estonia (99.8)6. Ukraine (99.7)7. Belarus (99.7)8. Lithuania (99.7)30. Hungary (90.2)31. Latvia (90.2)32. Ukraine (90.0)33. Israel (89.9)34. UK (89.2)92. Grenada (7,344)93. Albania (7,041)94. Ukraine (6,914)95. Cuba (6,876)96. Belize (6,734)151. Mali (26.2) 177. Djibouti (25.5) 181. DemocraticRepublic of the Congo(298)Source: UNDP. Human Development Report 2009: Overcoming Barriers: Human Mobility and Development. New York:UNDP, 2009. – 229 p.Development Trendsand Global Climate ChangeClimate change is a critical issue in the 21st Century.Global climate change as a result of economicactivities, according to scientific estimates,represents one of the most dangerous threatsto the planet. The Fourth Assessment Report ofthe Intergovernmental Panel on Climate Change(2007) states: ‘Warming of the climate system isunequivocal. Most of the observed increase inglobal average temperatures since the mid-20thCentury is very likely due to the observed increasein anthropogenic greenhouse gas concentrations.’A Survey on Climate Change Perceptions inUkraine was conducted under the aegis of theUnited Nations in 2009. The vast majority of expertsparticipating in the survey associated globalclimate change with serious risks for both humanityin general, and Ukraine in particular.Risks mentioned in the survey can be divided intonatural, economic and socio-political. The naturalrisks are: (1) shifts in climatic zones, weather instability(high temperature fluctuations in shortperiods of time) and general changes in the environmentalconditions of living organisms; (2)decreases in biodiversity; (3) deterioration in thehealth of living organisms, including humans(particularly increases in cancer); (4) mutagenesisof all living creatures, primarily bacteria, mushroomsand viruses; (5) flooding of large areas ofdry land and onset of dangerous geological processes,particularly abrasion, shifts and saturations;(6) desertification; (7) lack of drinking water(particularly in the eastern and southern regionsof Ukraine); and (8) increased number of naturaldisasters (including forest fires, floods and landslides)and negative weather phenomena (hurricanes,droughts, flooding, etc).Natural risks – if they materialize – can have thefollowing economic consequences: (1) irreversibleloss or considerable shortage of natural resources;(2) changes in the territorial structure ofthe economy, particularly because of flooding ordrinking water shortages, etc; and (3) increasedburden on the state budget (which has to mitigatethe consequences of natural disasters, copewith an increased number of people with disabilities,implement agricultural subsidies, etc). Theserisks particularly concern agriculture, construction,housing and utility services, tourism andinsurance (given the growing number of naturaldisasters and cataclysms and deteriorations in thepopulation’s health, for example).The social risks related to climate change include:(1) issues related to the increase in scope and intensityof migration; (2) lack of food and increasedfood prices, which will initially affect the poorest;(3) social consequences of natural disasters;and (4) reduction of territories suitable for living,which can lead to the emergence of new – andthe escalation of old – conflicts, including armedconflicts.The response to climate change includes bothmitigation of greenhouse gas emissions and adaptationto climate change. Mitigation promotes26MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

the development of renewable energy technologiesand increased energy efficiency. Adaptationconsists of identifying actions and seekinga system to ensure that we can adapt to climatechanges. This will require significant additional financialresources and strengthened institutionalcapacities.During the 20th Century, 43 years of droughtwere recorded in Ukraine, including seven duringthe last 15 years. At the beginning of the newmillennium, the occurrence of other natural phenomena,such as dry winds, floods, overflow andsaturations, etc, all of which are impacted by environmentaland climate changes, has becomemore frequent.Complex research devoted to identifying thepositive and negative consequences of globalwarming has been conducted in Ukraine, aimedat introducing measures to mitigate the consequencesof climate change. This research coversdifferent fields of economic activities and the environmentboth countrywide and in the differentregions. Furthermore, continuous hydro-meteorologicalsurveys are conducted and the informationgathered is provided to the World MeteorologicalOrganization.Although forecasting the possible effects of climatechange on Ukraine’s socio-economic developmentis complex, several examples can beprovided.Agriculture. According to the Ukrainian HydrometeorologicalCentre, the contribution of meteorologicalfactors to yield fluctuations in generalreaches 20 to 50 percent for winter cerealsand 35 to 75 percent for spring cereals. In someyears, yield losses caused by unfavourable conditionsand events can reach 45 to 50 percent. Duringthe past 20 years, there has been an increasein the frequency of certain meteorological events,which in some cases have become catastrophesand have led to losses in agricultural production(rains, lightning, storms, hailstorms, whirlwindsand windstorms). Changes in the amount of condensationand temperature changes will have asignificant influence on crop yields, increasingthe number of plant pests and triggering erosionprocesses.Box 2. Ukraine signed the United NationsFramework Convention on Climate Change(UNFCCC) in 1992. On 29 October 1996,the Parliament of Ukraine ratified it andon 11 August 1997 Ukraine became a Partyto it. Ukraine signed the Kyoto Protocolon 15 March 1999, which commits Ukraine as anAnnex I country to stabilizing greenhouse gasemissions during 2008–2012 at the 1990 level. TheParliament of Ukraine ratified the Kyoto Protocolon 4 February 2004. The National Action Planon the Implementation of the Kyoto ProtocolProvisions to the UNFCCC was approved by Orderof the Cabinet of Ministers of Ukraine No. 346-r on18 August 2005. The Cabinet of Ministersapproved amendments to the National ActionPlan at the beginning of 2009, taking into accountaspects of the international negotiation process.The National Action Plan envisages all conditionsnecessary for the fulfilment of obligations inaccordance with the UNFCCC and full participationof Ukraine in the Kyoto Protocol mechanisms.The main components of the National Action Planare:• Conducting a national greenhouse gasinventory on greenhouse gas emissions andabsorption, publicizing obtained results andworking towards improvements;• Development of infrastructure for jointimplementation projects;• Development of a national greenhouse gasemissions trading system;• Regular preparation of nationalcommunications on climate change issues;• Development of national and regional actionplans on the mitigation of climate changeconsequences;• Development of national, regional and sectoralaction plans on adaptation to climate change;• Creation of a database of environmentally safetechnologies and methods;• Preparation of scientific, technical andmanagerial personnel;• Public awareness raising on climate changeproblems.According to the Fourth Assessment Report ofthe Intergovernmental Panel on Climate Change,the average annual air temperature within thezone could increase by 2–3°С by 2025–2030. Withsuch warming rates, and with insignificant fluctuationsin the annual amount of atmospheric condensation,Ukraine may see an increase in farm-CHAPTER ONE. UKRAINE: DEVELOPMENT DIMENSIONS 27

ers’ yields in the immediate future, in both cropyields and gross harvests. (However, an increasein carbon dioxide volumes will cause a decreasein grain quality, in particular a decrease in nitriccontent, proteins and, as a result, nutritional value.)An acceleration in the photosynthesis processby 30–100 percent will be observed. Such anincrease will in turn accelerate growth and thepost-harvest of wheat, barley and sunflowers,and will increase harvest potential by 20–30 percent.In Polissia in particular, the winter wheatyield may increase by 20–40 percent; in the foreststeppe by 10 percent; and in the steppe by onaverage 20–30 percent. However, yields may alsodecrease owing to the shortening of the vegetationperiod.At the same time, negative climate change impactsmay cause a decrease in agricultural productionby 15–50 percent in Ukraine. Changes inthe temperature can influence the physical conditionof animals. Climate changes will influencethe conditions of forage production, which in turnwill determine the growth rate of the livestockpopulation. Production of forage crops under climatechange may decrease by 12–17 percent. Adecrease in production is possible, particularlyin milk production, by approximately 9 percent,and in beef production, by approximately 25 percent,compared with 1989. This is because, first,the term of the forage crop seeding and the seedingrate will change; second, the vegetation periodand the dates of the phonological phase offorage crop development will change; and third,the number and acreage of the leaf mass area willincrease. However, if acreage and the structureof farmers’ seeds change as a result of warming,then favourable conditions for cattle farming developmentwill be created in Ukraine.Forestry. An increase in the number of forest firesis forecast. Furthermore, it is probable that changeswill occur in forest types, forest floristic composition,productivity and stability. General reductionof forests as a result of droughts and changesin temperature could be compensated for by thecreation of new forest plantations.Water resources. Changes in water resource distributionas a result of climate change influencehow the water needs of the population and ofindustry are ensured. According to the statisticaldata, water-related emergencies rank the highestamong natural disasters in terms of frequency,territorial spread and gross average annual losses.It is anticipated that problems with the watersupply of the southern and south-eastern regionsof Ukraine will be aggravated – these regions alreadysuffer from droughts during the summerand the people already have less access to cleandrinking water. Overflowing and saturation processeswill intensify in Polissia, the Carpathianregion and the Transcarpathians where, in thepast 10 years, catastrophic floods and high watershave become the major reason for disruption ofthe normal living conditions of the population.In addition, some changes in the hydrologicalregime of rivers are expected as a consequenceof climate change, which may result in a lack offreshwater reserves.The negative consequences of expected climatechanges in the medium term may include: (1)increased health risks (morbidity and mortalityrates) of vulnerable groups of the population; (2)increased number of natural disasters (includinghigh waters and landslides) and negative weatherevents (hurricanes, droughts, abundant rains,etc); (3) increased number of fire hazards in forests;(4) disruption of the ecological equilibrium,with some biological species replaced by others;(5) increased desertification (in the steppe areas);and (6) intensified erosion processes. The followingexpected climate changes can be consideredpositive: (1) decreased energy consumption,especially during the heating season; and (2) increasedyield potential of certain types of agriculturalcrops.Climate changes at the global level can be differentfrom those at the regional (local) level. The developmentof different ecosystem types (swamps,forests and steppes) may vary, even within a particularregion. In particular, swamps, organic matterand peat will decompose faster and nitrogenwill mineralize faster in areas with higher temperatures.Swamps could be overgrown by forest andswamp species may disappear. The depauperizationof ecosystems and the spreading of droughtresistantspecies, which could replace commonplants, are forecast for Polissia in the case of achange in the hydrothermal regime (increases intemperature and humidity). An increase in forestfires is possible, as well as the transformation of28MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

forest types and the composition, productivityand stability of forest species. Deepening problemswith water supply of southern and southeasternregions are predicted.Changes in the hydrological regime of rivers areexpected in the long-term perspective, as a consequenceof anthropogenic climate change. As aresult, decreases in freshwater reserves and deteriorationin quality are possible. Climate changesmay lead to an increase in the scale and frequencyof dangerous natural events, such as floods,high waters, mudslides, avalanches, droughts andhurricanes. Climate change and increasing temperaturesmay lead to a rise in the water levels ofthe Black and Azov Seas. This will in turn increasebank abrasion, saturation, overflowing and soilsalinization in the Black Sea region and will causesignificant changes to the ecosystems of the riverdeltas of the Danube, the Dnieper and the Dniester.Erosion of the coastal lines of the Black andAzov Seas may cause house destruction and a decreasein the size of agricultural land and industrialzones.With regard to the impact of climate change onthe achievement of the MDGs in Ukraine, the followingshould be noted. The poor are undoubtedlythe most affected by climate change. Climatechange will deepen problems of extreme povertyrelated to inadequate nutrition and morbidity.Changes in infrastructure and labour productivitycaused by climate change will impact the economicgrowth rate. This will in turn increase therisk of urban populations ending up below thepoverty line as a result of loss of jobs or decreasesin income. Poverty and unemployment will reduceopportunities to receive a quality education.The direct effects of climate change include increasesin mortality and illnesses related to fluctuationsin temperature, especially among the elderlyand the urban poor. The number of fatalitiesin winter owing to cold weather is already increasingin some regions. Extreme weather events alsolead to an increase in accident rates. Meanwhile,the indirect influences of climate change onhealth are more significant. Climate change decreasesthe amount and quality of drinking water.This is a precondition for a high prevalence rateand spreading of infectious diseases, particularlythose related to drinking water.Issues of climate change prevention are reflectedin the Strategy of the National EnvironmentalPolicy of Ukraine by 2020, which is planned tobe approved in 2010. In particular, the amount ofgreenhouse gas emissions should be decreasedby 20 percent by 2020. CHAPTER ONE. UKRAINE: DEVELOPMENT DIMENSIONS 29

CHAPTER TWOMILLENNIUM DEVELOPMENTGOALS, ADAPTED FOR UKRAINE

This chapter provides information on theMDG framework in Ukraine. The subchapters coverthe main challenges in achieving each Goal andsuggest recommendations on ways to resolve these.This chapter also provides an analysis of progresson each MDG and an updated matrix of targets andindicators (see Annex 2). A matrix of each MDG’stargets and indicators is provided at the beginningof each subchapter, giving actual data and valuesof indicators, taking into account forecast developmenttrend and against a 2000 baseline. Thesefigures are the result of consensus achieved amongall stakeholders who participated in the Reportpreparation.The process of establishing an MDG frameworkin Ukraine started in 2000, when the President ofUkraine signed the United Nations MillenniumDeclaration. The global MDGs were adopted atnational level in 2003. The Ministry of Economy ofUkraine, with support from UNDP, conducted analytical,consolidating and organisational work onadapting adapted the global Goal to the nationalcontext. The National Report Millennium DevelopmentGoals – Ukraine was an outcome of thiswork, determining the country’s long-term Goals.This contained the main human and sustainableenvironment development indicators by 2015,which were aligned with forecast macroeconomicindicators.Originally, the national MDG framework consistedof 6 Goals, 13 targets and 33 indicators, to supportthe annual monitoring of progress on theMDGs. The following national Goals were definedfor Ukraine:Goal 1. Poverty Reduction(2 targets and 2 indicators);Goal 2. Quality Lifelong Education(2 targets and 8 indicators);Goal 4. Improved Maternal Health and ReducedChild Mortality (2 targets and 4 indicators);Goal 5. Reducing and Slowing Down the Spreadof HIV/AIDS and Tuberculosis(2 targets and 5 indicators);Goal 6. Gender Equality(2 targets and 10 indicators).In 2009, the Ministry of Economy of Ukraine initiateda review of the MDG targets and their respectiveindicators in accordance with currentdevelopments and projected trends in the postcrisisperiod. As the central executive authorityresponsible for development and implementationof economic policy and strategy, the Ministrycoordinated this effort. A Working Group was established,consisting of Government employees,scientists, civil society representatives, United Nationsagencies, UNDP experts and internationalorganisations. The Report preparation included:(1) formulation of a set of targets and indicators;(2) policy analysis (identification of issues andoptions to resolve them); (3) elaboration of recommendationsfor state policies; and (4) establishmentof a framework for monitoring by civilsociety of the implementation of governmentalpolicy aimed at achieving the determined Goals.Numerous roundtables were held to ensure expertassessment of achievements in relationto the MDGs as well as new challenges. This allowedfor an analysis of the progress (or regression)and for the proposal of an updated matrixof the MDG targets and indicators. The updatedmatrix (15 targets and 33 indicators) was developedthrough a transparent and open strategicplanning process and through forecasting of developmenttrends by 2015. The following Goalswere set:Goal 3. Sustainable Environmental Development(3 targets and 4 indicators);32MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Goal 1. Reduce Poverty(3 targets and 5 indicators);Goal 2. Ensure Quality LifelongEducation(2 targets and 6 indicators);Goal 3. Promote Gender Equality(2 targets and 4 indicators);Goal 4. Reduce Child Mortality(1 target and 2 indicators);Goal 5. Improve Maternal Health(1 target and 2 indicators);Goal 6. Reduce and Slow Downthe Spread of HIV/AIDS andTuberculosis and Initiatea Trend to Decrease theirScales(2 targets and 6 indicators);Goal 7. Ensure EnvironmentalSustainability(4 targets and 8 indicators).The updated MDG targets and indicators willbe used in the preparation of Government strategicand programme documents. Some of thekey tasks in achieving the MDGs lie in establishinga system for the integrated implementationof identified measures and the management ofchanges.Success in achieving the updated MDG targetsdepends significantly on the state’s ability toensure sustainable economic growth by: usinghighly developed human capital; applying informationaland resource, energy and nature conservationtechnologies; and ensuring a stable linkagebetween economic growth and the welfareof the population.Achieving the MDG targets will have an impact inrelation to:• Ensuring economic stability (creating an innovativeand environmentally efficient economy,raising the competitiveness of the nationaleconomy, etc);• Ensuring quality of life and raising the welfareof the population (increasing average life expectancyand quality of education, ensuringhuman rights, following principles of equalopportunities, etc);• Ensuring an environmental balance (preservingand renewing natural ecosystems,improving the environment for humans, stabilizingand improving the quality of the environment,etc);• Enhancing the quality of institutional changes.It is important for Ukraine to opt for economicdevelopment that takes environmental and socialcomponents into account in a single and integratedmodel. Harmonizing human, economicand environmental development can ensuresocial progress that fits the needs of each individual.Strategic development activities requireimprovements in the regulating mechanisms thatemerged during Ukraine’s transition period, aswell as efforts to ensure economic, political andcivil liberties. Achieving the country’s developmentGoals is possible only if efforts at central andregional levels are aligned, based on the furtherdevelopment of mechanisms of market liberalization,political democracy, national and culturalpluralism and other self-regulation tools that arecommon in a developed civil society.Making the best choice among various options forthe socio-political and economic development ofUkraine is extremely important. It is necessary toforesee and assess the impact of economic andsocial reforms, and their consequences for futuregenerations while planning and implementingthem. Updating the MDG targets must become adriver towards improving regulating mechanismsthat emerged during the country’s transformation,while ensuring economic, political and civilliberties. CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 33

GOAL 1:REDUCE POVERTYThis subchapter analyses progress towards thisGoal, the challenges in overcoming poverty andrecommendations on how to respond to these.The updated matrix of targets and indicatorswill be used for developing policy on povertyalleviation. The subchapter stresses that, despitea general context of positive changes, thepoverty situation is critical, particularly amongchildren and in rural areas. The trajectory of theUkrainian economy towards sustainable growthshould create the necessary preconditions forensuring significant changes in relation to satisfyingthe population’s essential needs. Theseconditions primarily concern economic equality,poverty reduction and ensuring equal accessof all groups of the population to quality socialservices.І. Targets and IndicatorsTargetTarget 1.A: Eradicate povertyaccording to the criterion ofUS $ 5 (PPP) per day by 2015Target 1.B: Decrease share ofpoor population (accordingto the national criterion ofpoverty 4 ) to 25% by reducingthe number of poor amongchildren and employedpeopleTarget 1.C: Decreaseby 10 times by 2015 thenumber of people whosedaily consumption is belowthe actual subsistenceminimum23Indicator1.1. Share of populationwhose daily consumption 3 isbelow US $ 5 (PPP), %1.2. Share of poor populationaccording to the nationalcriterion, %1.3. Share of poor amongchildren, %1.4. Share of poor amongemployed people, %1.5. Share of population withconsumption below the actualsubsistence minimum, %2 Consumption is the average per capita aggregatehousehold expenditure calculated per equivalent personaccording to the following scale: 1.0; 0.7; 0.7.3 The Poverty Reduction Strategy determines the criterionthat determines whether an individual is poor ornot – 75 percent median level of gross expenditurescalculated per adult.34MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

ІІ. Situation AnalysisSome positive changes in terms of reducing povertyhave been achieved in recent years. In particular,the scale of absolute poverty has beenreduced owing to an increase in wages, pensionsand the main types of social assistance for families.The economic crisis that broke out in 2008 allowedfor a further increase in state social guaranteesand increased social expenditure.Established trends of income differentiation andrelative poverty levels continued during the periodof economic growth. This led to an increasein income inequality and inequality in relation toliving conditions. Traditionally, the highest risks ofpoverty are observed among children and ruralinhabitants. The relative poverty among childrenremains steadily high during this period, and theindicator for the rural population increases annually.Generally, low wage standards remain aspecific problem for Ukraine, leading to povertyamong the employed population: 79 percent ofthe poor today are from households with at leastone employed person.Given the implementation of a well-groundedstate social policy, the economic crisis will at leastnot increase the differentiation in incomes. It isexpected that the share of the poor according tothe national (relative) poverty line will decrease inthe near future.It should be noted that a decrease in the povertylevel determined according to the national criterionrequires an improvement in the situation ofchildren and employed people. Previously, theshare of the poor population (determined accordingto the national poverty line) was to be decreasedto 18.4 percent by 2015. However, monitoringof the poverty situation for 1999–2008 hasshown that it is impossible to decrease the relativepoverty level without introducing changes to thebasic redistribution process. It became clear thatit is impossible to achieve the declared target indicatorby 2015. As such, it has been necessary toestablish a more realistic value – at 25 percent –considering the current socio-economic situationin the country and the likely development prospectsfor the next five years.2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2013 2015Indicator 1.1.Share of population whose daily consumption is below US $ 5 (4.30) (PPP), %11.9* 11.0* 3.0* 4.0* 2.0* 1.3*9.0 6.0 6.6 3.8 4.5 5.0 4.0 3.0

It is important to set a new target – ‘reducing theshare of the poor according to the subsistenceminimum’ – based on the need to decrease thescale of absolute poverty. In using the specifics ofthe subsistence minimum as the basis for identifyingstate social guarantees as dependent onthe state’s financial capacity, the actual subsistenceminimum calculated based on the prices ofthe corresponding period should be consideredthe poverty line. 6 The trend of the indicator during2000–2008 provides the basis for establishingthe target benchmark – i.e. reduce the shareof the population with a per capita consumptionlevel below the current subsistence minimum bytenfold by 2015 against the level in 2000.An analysis of the poverty situation in Ukraineduring 1999–2008 shows that positive results interms of economic growth allowed for a reductionin the absolute poverty level. However, theydid not influence the situation of relative poverty,since income differentiation was not halted. TheGini coefficient value 7 remained at around 30 percentduring the whole period, which shows thatinequality trends that emerged in the transitionprocesses of the 1990s have become stronger.A major feature of inequality in the country is ahigh concentration of the population close tothe poverty line. Thus, the share of the non-poorpopulation with an income slightly higher thanthe poverty line may, in an unfavourable economicsituation, end up below the poverty line.At the same time, income differentiation amongthe poor is insignificant, and the fluctuation in thedepth of poverty is around 23–25 percent.Poverty level indicators under the subsistenceminimum criterion demonstrate impressivelypositive dynamics (from 72.5 percentin 2002 to 12.6 percent in 2008). In addition, povertyand extreme poverty indicators according torelative criteria (75 percent and 60 percent of themedian level of aggregate equivalent expenditures,respectively) remain almost unchanged –6 The subsistence level is established annually based onbudget capacity. When the standard is established withoutfull incorporation of the previous year’s inflation and thecurrent year’s forecast inflation, the subsistence levelis artificially depreciated. This leads to a decline in themonitored absolute poverty which does not reflect the realsituation.7 Calculations are based on the Gini-Theil formula.at around 26–28 percent and 13–15 percent,respectively.The decrease in the poverty level, determinedbased on the subsistence minimum criterion, continuedat high rates in 2008. However, the statesocial standard (the subsistence minimum) wasrevised for 2008, and 2007–2008 inflation rateswere not adequately incorporated. This artificiallyreduced the absolute poverty line and influencedthe poverty level indicator. According to experts,the poverty level based on the subsistence minimumcriterion is estimated at 19.9 percent, andnot 16.1 percent. This does not change the positivedynamics overall, but rather decreases therate of reduction of the poverty level.Poverty alleviation policy, implemented throughthe Strategy to Alleviate Poverty from 2001,did not provide the expected results: two majorproblems, i.e. reducing poverty risks amongfamilies with children and among the rural population,were not resolved during the strategy’stimeframe.Based on the national criterion, from year toyear, the poverty level among households withchildren traditionally exceeds that among thehouseholds without children by 1.7-2.0: 33.1 percentagainst 19.7 percent in 2008. The situationfor families with children improves from year toyear based on the subsistence minimum criterionbut the poverty level steadily exceeds the correspondingvalue among households without children.In 2008, these two indicators drew closer toeach other. The poverty level among families withchildren reached 17.0 percent against 7.5 percentamong households without children. However,this owes mostly to a reduction in the overallgroup of the poor and not to a relative improvementin the situation for families with children(Figure 4).The direst situation among families withoutchildren is traditionally observed in householdswhere all members are older than 75. The highestpoverty level for the period from 2000 is registeredwithin these groups in 2008, at 29 percent.This shows a direct decrease in the purchasingpower of the minimum pension payment, sincepeople from the older age groups cannot earn anincome additional to their pension income.36MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Figure 60.04. Dynamics of the Poverty Level53.8across Households with and without Children,47.0According to Relative and Absolute National Criteria, 40.7 2000–2008, %poverty level, %poverty level, %90.0 76.280.077.670.890.030.060.00.030.00.061.7 61.7 61.959.040.135.4 35.3 33.9 33.176.280.077.628.131.9 33.4 34.4 33.1 35.423.732.919.770.818.661.717.861.717.817.061.919.3 19.416.918.4 59.0 18.0 17.753.87.447.040.140.735.4 35.3families with children according to the national relative criterion33.9 33.128.131.9 33.4 families 34.4without children 33.1 according 35.4to the national relative 23.7 criterion32.918.6 19.7families with children according to the subsistence level criterion17.0families without children according to the subsistence level 19.3 criterion 19.417.8 17.8 16.918.4 18.0 17.77.4families with children according to the national relative criterionfamilies without children according to the national relative criterionfamilies with children according to the subsistence level criterionfamilies without children according to the subsistence level criterionSource: Calculations of the Institute for Demography and Social Studies of the NAS of Ukraine based on the HouseholdBudget Survey of the State Statistics Committee of Ukraine.Figure 5. Dynamics of the Relative Poverty Level in Rural and Urban Areas, 1999–2008, %50.0poverty level, %poverty level, %38.4 37.940.036.734.435.0 35.232.329.2 28.730.050.0 27.125.420.024.7 23.621.523.5 23.2 23.022.138.4 37.940.036.734.435.0 35.210.032.329.2 28.730.027.1Urban areasRural areas25.420.024.7 23.621.523.5 23.2 23.022.138.221.538.2Source: Calculations of the Institute for Demography and Social Studies of the NAS of Ukraine based on the HouseholdBudget Survey 10.0 of the State Statistics Committee of Ukraine.21.5Rural poverty increases from year to year – bynow, a huge gap exists between Urban areas urban and ruralareas. Under stable conditions, some decreasein poverty indicators at the national level basedon the relative criterion is observed in citiescompared with in rural areas. The poverty levelin rural areas was almost twice that of urban areas(38.2 percent against 21.5 percent) accordingto 2008 data.Therefore, a deepening of the most severe problems,related to the poverty of children and tolarge-scale poverty in rural areas, has been observed,despite Rural areas a context of positive changes inthe poverty situation. An increase in poverty risksamong households with elderly members maybecome a new problem for Ukraine as a result ofthe crisis in the economy.An analysis of poverty dynamics based on the relativecriterion during 2000–2008 shows a generalstable situation and some problems within povertyprofiles, in particular extremely high povertyindicators among children and high indicator val-CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 37

Table 5. Relative Risks of Poverty, 2000–2008Relative risks of poverty of: 2000 2001 2002 2003 2004 2005 2006 2007 2008Children 1.25 1.28 1.34 1.31 1.36 1.35 1.33 1.33 1.30Employed people 0.84 0.83 0.83 0.79 0.83 0.82 0.79 0.79 0.78Pensioners 0.83 0.82 0.77 0.87 0.83 0.79 0.87 0.88 0.89Source: Calculations of the Institute for Demography and Social Studies of the NAS of Ukraine based on the HouseholdBudget Survey of the State Statistics Committee of Ukraine.ues for the employed. Such profiles may indicateinefficiency of state social policy related to childrenand problems in the labour market – whenemployment does not guarantee a sufficient incometo satisfy basic needs or to protect familiesfrom poverty.An analysis of relative poverty risks 8 in selectedgroups confirms an extremely unsatisfactorysituation for children compared with the generalsituation in Ukraine (Table 5). Moreover, in recentyears, poverty risks for the employed have fallensomewhat behind corresponding values for theretired. However, in 2000–2002 and 2005, povertyrisks for the employed exceeded those for the retired,which contradicts basic economic relations.Poverty in Ukraine does not show a clearlymarked gender aspect, but some differencesare observed. Women have significantly lesspersonal income than men (UAH 925.2 againstUAH 1,380.5 per person per month), and thepoverty level 9 for men (over 18 years of age)is 24.4 percent against 25.5 percent for women.The most significant differences in poverty levelrelated to gender are observed among youth(18–34 years of age) and among people over theretirement age. In particular, the poverty levelamong men in the younger age group is 24.9 percentagainst 28.7 percent for women. Amongpeople over 60 years of age, the poverty level formen is 4.4 percentage points lower than that ofwomen (at 22.3 percent against 26.7 percent).The high share of expenditure on foodstuffswithin the structure of household expenditures is8 Relative poverty risks are calculated as the ratio of thepoverty indicator for a particular population group tothe average value in the country. They provide moreinformation during poverty profile analysis.9 The poverty level is calculated exclusively for households;therefore, indicators based on gender are derived fromhousehold indicators.one of the basic features of the low level of livingstandards and the significant incidence of povertyamong the Ukrainian population. Accordingto analysis of decile distribution based on this indicator(Table 6), around one-third of the country’spopulation (according to 2008 data) spendsaround 60 percent of their budget on foodstuffs,whereas the share of expenditures on food ofthose from the second to fifth decile groups averages57.6 percent. The value of the indicator iswithin the limits of 47–49 percent even for theeighth to ninth decile groups. Representatives ofthe richest (tenth) decile spend 36.3 percent oftheir budget on food. Although a decrease in theshare of expenditure on foodstuffs is observed forthe entire 2000–2008 period, this has occurredtoo slowly. Accordingly, there is no reason to expectfast changes in the population’s consumption,especially during the crisis period, when purchasingpower of all incomes will have decreased.In addition to the monetary dimension of poverty,Ukraine is characterized by a significantdegree of deprivation, or poverty of living conditions.According to the survey conducted bythe State Statistics Committee of Ukraine in October2007, 28.6 percent of the population sufferdeprivations simultaneously in four or more dimensions,including: improper living conditions;limited availability of social services; lack of property;shortcomings in health care; impossibility tohave a proper rest; etc. Rural inhabitants experiencedeprivations related to poor infrastructuraldevelopment more strongly than urban inhabitants.Every second rural household suffers frominadequate access to emergency medical assistanceand other public services, and every thirdfrom the lack of a health care institution close totheir place of residence and regular transport.Households with children suffer more from a lackof money to travel and from lack of a separateplace of residence and insufficient living space.38MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Table 6. Share of Household Consumption Expenditures Spent on Food and Non-AlcoholicBeverages (including Foods from Outside the Home), 2000–2008, %Decilegroup2000 2001 2002 2003 2004 2005 2006 2007 20081 75.0 73.0 71.0 70.6 70.1 70.5 68.2 65.7 64.92 72.0 69.3 66.6 68.6 66.4 66.9 64.9 60.5 59.13 69.1 66.3 64.7 64.9 64.6 63.8 62.5 59.0 58.84 68.9 66.6 64.0 63.4 63.4 62.6 60.8 57.9 55.75 67.7 65.1 63.7 63.1 61.7 61.0 59.4 57.2 56.66 65.4 64.5 61.6 62.7 60.9 60.7 58.2 56.2 52.67 65.6 63.7 61.6 61.0 60.2 59.7 55.8 53.6 50.58 63.8 62.1 59.5 58.4 58.3 57.9 53.9 51.7 49.49 62.1 60.4 56.3 57.4 56.6 56.4 52.5 48.1 47.310 56.1 52.6 50.8 48.9 47.8 45.6 41.2 40.3 46.3Country average64.9 62.6 60.2 59.9 58.9 58.1 54.9 53.2 50.8Source: Data of the state Household Budget Survey of the State Statistics Committee of Ukraine.Households without children usually do not havethe financial capacity to pay for health care.The economic crisis significantly influenced theincomes of the employed. Despite nominal wagegrowth in 2008–2009, the real wage decreased.In particular, wages in 2009 (in comparable pricesof 2007) were significantly behind the correspondingmonth of 2008 (Figure 6). It was possibleto bring the average wage (in comparableprices) to the level of December 2008 only in December2009; during all other months of 2009,the average wage was less than that of the previousyear, by 9.97 percent.The past two years, 2008 and 2009, are characterizedby a sharp increase in wage arrears: at thebeginning of 2008, this was at UAH 668.7 million;as of 1 January 2010, it reached the level ofUAH 1,473.3 million, which is equal to 6.2 percentof the wages fund of December 2009. If the crisisdeepens or economic development stagnates,Figure 6. Average Monthly Wages, 2008–2009 (in December 2007 prices), UAHUAH.1700163116801631165116241636160015001478154515521403153414121548140914911514144914721448152214361626200820091400132313491300JanuaryFebruaryMarchAprilMayJuneSource: Calculations of the Institute for Demography and Social Studies of the NAS of Ukraine based on data of the StateStatistics Committee of Ukraine.JulyAugustSeptemberOctoberNovemberDecemberCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 39

there may be a heightened risk of a decrease inthe purchasing power of wage rates and an increasein wage arrears.The poorest groups of the population already feltthe influence of the economic crisis in 2009: accordingto the US $ 5 (PPP) poverty line, the povertylevel increased to 4.7 percent during the firsthalf of the year, compared with 4.0 percent duringthe corresponding period of 2008. The positivetrend in terms of the decrease of absolute povertycame to a halt in 2009, and the general povertysituation will not be able to change in 2010,even under conditions of favourable economicdevelopment.ІІІ. ChallengesPoverty is one of the uppermost social issues inUkraine. It determines limitations in access to developmentresources such as quality services ineducation, health care, culture and child development.Low income levels of a significant share offamilies, combined with considerable disparity inincomes, cause social tension, restrict the country’soverall development and lead to crises in thefamily and in society.Challenges to reducing poverty lie in the followingareas: (1) inefficient redistribution of incomes;(2) low level of remuneration; (3) poverty amongfamilies with children; (4) unfair distributionof state transfers directed towards social support;(5) impact of the global economic crisis;and (6) spread of a ‘welfare mentality’ and socialinactivity.Inefficient redistribution of incomes, concerningboth primary and secondary redistribution.Expenditures on social protection in Ukraine(including on state social insurance and healthcare) amount to approximately 26 percent ofGDP, which is similar to levels in highly developedcountries. However, these funds are spent inefficiently.The social protection system is poorlytargeted and excludes people who really need it.Most types of assistance, benefits and subsidiesdo not protect socially vulnerable populationsfrom poverty.High social polarization (extreme wealth and luxury,on the one hand, and subsistence at the povertyline, on the other hand) and lack of wealth redistributionbetween the rich and the poor causeoutrage and a sense of social unfairness among alarge share of the population. It also hinders povertyalleviation.Given financial constrains, state policies on povertyalleviation are directed primarily at minimizingthe worst forms of poverty, i.e. supportingthe poorest groups of the population and assistingthem to increase their income levels, whichare significantly lower than the poverty level.Meanwhile, there is disconnect between socialpolicy and poverty: the latter is determined accordingto one criterion (relative) and the formeris determined according to another (the subsistenceminimum and the level to ensure minimumsubsistence). Furthermore, an assessment of allexpenditures directly or indirectly earmarked tosupport the poor reveals that assistance is oftenreceived by people who are not the most in need.The problem of poor targeting has not yet beenfully addressed. The mechanism for assessingfamilies’ poverty level requires significant expendituresbut has not provided the necessaryresults. The low level of coverage of the poor bysocial assistance negates the state’s efforts toovercome extreme poverty. To ensure an effectivesocial assistance system capable of strengtheningthe impact on the poverty situation in the countrywill require large-scale changes.Low wages. Wages in Ukraine are among thelowest in Europe. Today, one employed personcannot ensure full subsistence for even one additionalunemployed family member. This situation,whereby poverty is spread even among highlyqualified workers with high educational levels,is unacceptable in relation to developed worldstandards.The high poverty level among the employedpopulation is caused by problems in the labourmarket, such as its inability to ensure decent workconditions and acceptable wages, and also bymaintenance of a large number of low-productivityand marginal working posts.40MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Poverty among rural inhabitants is especially severe.The poverty level of the rural population istwo times higher (38.2 percent) than that in bigcities (17.5 percent). Some of those in rural areassettle into stagnant poverty and later into inheritedpoverty.One of the specific features of poverty in Ukraineis a relatively small poverty gap and high concentrationsof people close to the poverty line. Therefore,there is a risk that unemployment causedby the general economic decline or by structuralreforms will cause a sharp increase in the numberof the poor, in particular poor families that do notreceive guaranteed state assistance in the form ofsocial transfers.Impact of the global economic crisis. Poverty alleviationand social policy in Ukraine have beencomplicated by systemic crisis and reduced statefinancial capacity caused by the global economiccrisis. The crisis made impossible to further increasestate social guarantees and public expenditureson social development.Development of a ‘welfare mentality’ and socialinactivity is reflected in the gap between thepopulation’s expectations of state support andthe state’s failure to fulfil them. The expectationof full care by the state is inherited from the Sovietperiod and rooted in the consciousness of asignificant part of the population (especially theelderly). The poor of today, who have been poorfor a long time, have marginal awareness, are economicallyand socially inactive, have norms andvalues justifying their continued condition anddo not feel able to pull themselves out of thissituation.Ensuring citizens’ constitutional rights to a decentstandard of living, addressing their dissatisfactionwith the economic situation and with their ownmaterial situation and changing the way of assessingpoverty under current conditions requireelaboration of new approaches towards povertyalleviation.IV. Moving ForwardUkraine’s recovery from the economic crisis andthe renewal of positive economic trends are preconditionsfor solving current issues related topoverty alleviation. Effective functioning of thedomestic economy and productive economicactivity are the key to success in achieving theMDGs.It is necessary to direct social policy towardsensuring high standards of living, enhancing therole of civil institutions and supporting civil initiativeson social protection.Modernization of the social assistance system isurgent. It will be impossible to solve critical problemsby carrying out a simple adjustment of thecurrent social protection system – it is necessaryto shift to a more efficient system of support ofpopulation groups in need while focusing on bettertargeting of social assistance.In order to resolve particular issues of poverty alleviation,certain meaningful measures are necessary.Radical reforms of the primary income redistributionsystem must be conducted to avoidexcessive income differentiation and to achievefairer redistribution, in particular tax exemptionson incomes below the subsistence minimum, introductionof taxes on wealth, excessive real estateand heritage, etc.Amendments to secondary income redistributionpolicy are needed to ensure effective andefficient protection from poverty. To do so, it isnecessary to: transform social assistance institutions;improve targeting of social assistancethrough a gradual changeover to an integral programmeof social protection based on the principlesof assessing family income; and improve thestate social standards and guarantees system asthe basis for determining structural relationshipswithin income policy and the social protectionsystem. Also, monitoring and evaluation of thesocial protection system should be introduced,particularly of financial flows, in order to facilitatethe increased efficiency of social protection andthe rationalization of amounts and directions ofstate expenditures.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 41

A system of standards for providing social servicesto the population should be established inorder to unify the consumption standards of socialbenefits and services across regions and toensure optimization of allocated expenditures inthe social sector by local self-governing authorities.The system must become a basis for a formulato equalize inter-budgetary transfers.To prevent the spread of poverty among employedpeople, changes should be introducedinto wage remuneration policy, labour remunerationand employment should be consistentlyguaranteed and state control over employers’observance of labour legislation needs to bestrengthened, including the rights and guaranteesof employees while decreasing the numberof employed and introducing part-time work..To resolve issues related to poverty alleviation, itis necessary to consolidate and promote the effortsof all civil society representatives, implementprinciples of gender equality, strengthen socialdialogue and improve the legal base through theparticipation of civil society institutions in socialpolicy implementation. 42MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

GOAL 2.ENSURE QUALITYLIFELONG EDUCATIONThis subchapter discusses obstacles in ensuringequal access to quality education and analysesthe situation in education, by level (preschool,general secondary, out-of-school, vocational,higher and postgraduate). Ukraine maintainshigh indicators in education (coverage by compulsorysecondary education, public expenditureson education, etc). A new legislative andregulatory framework for education has beenestablished and institutional barriers for its implementationhave been removed. At the sametime, access to quality education at all levels forUkrainian citizens remains critical. The subchapteremphasizes that education remains a priorityarea in relation to society’s socio-economic,spiritual and cultural development.І. Targets and IndicatorsTargetsTarget 2.A: Increase enrolmentrates in educationTarget 2.B: Raise the qualityof educationIndicators2.1. Net enrolment rate in preschooleducational institutionsfor children aged 3–5 in urbanareas, %2.2. Net enrolment rate in preschooleducational institutionsfor children aged 3–5 in ruralareas, %2.3. Net enrolment rate forchildren in secondary education,%2.4. Net enrolment rate inpost-secondary institutions forthose aged 17–22, %2.5. Cumulative gross rate ofpersons undergoing retrainingor professional development,thousand people2.6. Number of general educationalinstitutions with internetaccess, %CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 43

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2011 2013 2015Indicator 2.1.Net enrolment rate in preschool educational institutions for children aged 3–5 in urban areas, %– – 79.5 82.6 85.8 86.9 87.2 87.3 88.0 89 91 93 95Indicator 2.2.Net enrolment rate in preschool educational institutions for children aged 3–5 in rural areas, %– – 27.5 29.9 33.2 38.0 41.7 44.9 47.6 50 52 55 60Indicator 2.3.Net enrolment rate for children in secondary education, % 11– 98.1 – 97.8 99.1 99.3 99.4 99.5 99.7 99.7 99.8 99.8 99.9Indicator 2.4.Net enrolment rate in post-secondary institutions for those aged 17–22, %– 32.5 – 35.0 32.7 41.8 44.1 45.4 46.3 48.0 52.0 54.0 56.0Indicator 2.5.Cumulative gross rate of persons undergoing retraining or professional development, thousand people– 158 – 167 188 193 193 197 292 294 297 310 320Indicator 2.6.Number of general educational institutions with internet access, %– – – – – – – – 42 43 55 75 90The table presents actual data by 2009, expected data for 2009 and forecast calculated values of indicators for 2010–2015.The targets aimed at achieving this Goal are interlinked.Indicators for monitoring progress onthe Goal’s achievement, set up in 2003, inadequatelyreflect the situation in the education sector.Therefore, the matrix of indicators needs tobe updated to take into account recent reformsin education. In particular, the net enrolment rateof children aged three to four in preschool educationalinstitutions (PEIs) and that of those agedfive in PEIs should be combined. The value of theenrolment rate for children aged six to nine hasbeen stable for the past 10 years (99.2–99.3 percent).The value of the indicator ‘proportion of currentstate education standards that comply withthose in the EU (%) (within joining the Bolognaprocess)’ cannot be monitored owing to a lack ofstate standards for higher education, which aredetermined and approved at the legislative level.Also, approaches to statistical surveys on educationhave recently been changed.1010 Share of graduates of 9th grade continuing their educationto complete general secondary education (students of 10thgrade in secondary schools, first-year students of vocationaleducational institutions (VEIs), first-year students of highereducational institutions (HEIs)).II. Situation AnalysisThe main priorities of development in this sectorinclude improving the quality of education,ensuring equal access to quality education at alllevels and enhancing the competitiveness of thenational educational system and its integrationinto the European education environment.The main indicators of competitiveness of nationaleducational systems, according to WorldEconomic Forum assessments, are: quality of theeducational system; quality of maths and scienceseducation; quality of the management ofschools; capacity of scientific research institutionsfor innovative changes; extent of staff training;availability of professional managers; qualityof scientific and research institutions; and capacityof scientists and engineers for innovation. Ananalysis of Ukraine’s position with respect to itseducational system meeting the requirements ofinnovation shows that the country is significantlybehind developed countries on this indicator. Inparticular, Ukraine is lagging behind in relationto the capacity of its scientists and engineers forinnovation (it is at 4.6 points compared with 6.0for Finland, 5.8 for the United States and 6.1 forSingapore). With respect to developing personnelretraining systems, which is the basis for the edu-44MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

cation system, Ukraine scored almost two timeslower than the leading countries in the ranking(Finland, the United States, Sweden, Singaporeand Germany).The Law of Ukraine on Education has a range ofshortcomings. The legislative basis for regulatingthe educational market and the public administrationsystem of education both requiremodernization. The Constitution of Ukraine (Article53) determines that the state needs to ensurethat preschool, complete general secondary, vocational,higher, out-of-school and postgraduateeducation are available and free of charge. However,this list is not exhaustive. Important levelssuch as continued education, adult education(which is not always exclusively vocational), distancelearning, inclusive education, etc, are notincluded.Preschool education. The individual personalityis formed during the early years. Knowledge andskills achieved in childhood influence a person’slife journey and his/her harmonious development.Decreased enrolment rates in preschoolprogrammes in Ukraine are mainly related tothe consequences of the socio-economic crisisin the 1990s, lower birth rates and, as a result,a sharp decline in the network of PEIs. In earlieryears, a significant number of the state-ownedPEIs were closed, reoriented and transferredto other ownership forms. The PEI network decreasedby 39.2 percent during 1990–2004. Overall,there were 15,400 PEIs (1,200 of which werenot operational) in 2008 as against 24,500 in 1990.The lowest value of this indicator was observedin 2004, at 14,900. During 2000–2004, therewere less than 1 million children in these institutions(the lowest value was 968,000 in 2001).In 2008, the number of children in PEIs hadreached 1,195,000 (57 percent of all children ofthe corresponding age).General secondary education. An overall decreasein the number of school-age children inUkraine has negatively affected the network ofgeneral educational institutions (GEIs). This hasresulted in lower average school occupancy levelsand a greater number of GEIs with a smallnumber of pupils, which in turn has led to highercosts per pupil and a lower pedagogical load onteachers. The most affected have been schools inrural areas. Owing to shortcomings in the currentsituation of financial, economic, material, humanresources and scientific methodological support,implementation of a full-fledged curriculum inmany educational institutions, primarily in ruralareas, remains problematic. The situation ofrural schools in remote areas remains difficult.In the 2009/10 academic year, rural schools wereattended by only 83.9 percent of those pupilswho were in need (329,500).In 2009, 391,257 children obtained a certificateof completed general secondary education(against 505,477 in 2001). Specialized educationis being introduced in senior school (10th–12thgrades). As of September 2008, specialized educationcovered 1.35 million pupils of GEIs, or 28 percent.11 The Model Regulation on the EducationalDistrict was approved in 2006 to ensure that pupilsliving in remote areas would obtain a specializededucation. The primary education standardsapproved in 2005 require revision. The new statestandards for general secondary education are beingdeveloped. Gradual computerization of generalsecondary education is taking place: 93 percentof the schools in the country have computerclasses. 12 The School Bus Programme works in allregions of Ukraine; however, limited fuel supply,funded by local budgets, as well as ageing busparks and lack of sufficient financing for their renovation,remain critical issues.Since 2008, Ukraine has been carrying out a generalexternal evaluation of graduates of secondaryschools, which is mandatory for applicants tonational higher educational institutions.It is important for Ukraine to ensure integrationinto the system of comparative internationalstudies. The Trends in International Mathematicsand Science Study (TIMMS) was conductedfor the first time in Ukraine in 2007. According toits results, particularly those of international performancetests for the 4th and 8th grades, Ukraineranked below the Russian Federation, Kazakhstan,Armenia and the Baltic countries. Agreementshave been reached to include Ukraine in the Pro-11 Academy of Pedagogical Sciences of Ukraine. White Book ofthe National Education. Part І. Kyiv: Academy of PedagogicalSciences of Ukraine, 2009. – 185 p.12 Cabinet of Ministers of Ukraine. Report on Situationand Development of Informatization in Ukraine in 2009,8 November 2009.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 45

gramme for International Student Assessment(PISA) and TIMSS in 2011. As a result, Ukraine willapproach international standards of quality assessmentof general secondary education.Box 3. One of the priorities of state policy is toensure the rights of orphans and children withoutparental care. The number of deprived children inUkraine has increased during the past five years.There were 103,500 orphans and children withoutparental care in the country as of the beginningof 2009, 568 more than in 2008. An insignificantdecrease in the number of educational institutionsfor orphans and children without parentalcare (in 2009 there were 203 institutions, asagainst 206 institutions in 2008) has beenobserved in the general secondary and preschooleducation system, resulting from the developmentof family education. The number of orphansand children without parental care in socialrehabilitation institutions is not decreasing,however. The network of such institutionscontains 11 general education schools and threevocational schools. Around 600 children are raisedin the social rehabilitation institutions, in whichthe overall share of orphans and children withoutparental care is around 3 percent.Out-of-school education. Out-of-school educationis part of the continued education system.However, modernization and increased state supportare necessary in order to be able to securefurther development of out-of-school educationalinstitutions and to provide additional opportunitiesfor the spiritual, intellectual and physicaldevelopment of children and youth, who wishto acquire out-of-school education in various areas(arts and aesthetics, tourism and local studies,ecology and nature, science and technology,research and experimentation, physical trainingand sports, military patriotic education, etc).In 2009, there were 625,700 children in children’sand youths’ sports schools; this is 98,000 fewerthan in the previous year and 12.6 percent of thetotal number of pupils aged 6–18 (in 2008, thiswas 723,800, or 13.6 percent). In Ukraine, owingto the lack of sufficient financing for study, training,necessary equipment and proper sports facilities,sports schools for children and youth are notable to prepare a reserve for the national teamsand do not create the necessary competition forthese. Funds earmarked for children’s and youths’sports schools cover 76 percent of the wages oftrainers and personnel; 5.4 percent of the total financingcovers study and training work. It shouldbe noted that a similar situation can be observedin all educational institutions of the country, sincekey budget expenditure items are directed topay wages and utility payments. Hence, out-ofschooleducational institutions have insufficientfunding to ensure the educational and developmentprocess or to buy necessary accessories andequipment.Vocational education. The number of graduatesof VEIs was 239,355 in 2009 (against 266,757 in 2000). The vocational and educational orientationof Ukrainian youth has been affected by factorssuch as the declining prestige of occupations as aresult of the recession in the 1990s, the increasingsocial significance of higher education in societyand expanding public and commercial educationsectors. These have increased demand for highereducation among young people. For example, inthe 2008/09 academic year, the ratio between thenumber of students at HEIs and the number of studentsat VEIs was 6.3 per 10,000 population, comparedwith 3.7 in 2000/01. Although the currentlist of occupations contains more than 7,000 positions,vocational education fails to respond toactual demand in the labour market. The currentdynamics of industry development common to amarket economy requires professional educationof a certain quality and efficiency, which can beintegrated smoothly into the economy and whichis flexible enough to respond to constant changesin the demand and supply of personnel.Higher education. Significant reforms have beenimplemented within the national higher educationsystem during the years since independence.These reforms correspond to the tenets of theBologna Declaration: (1) Bachelor’s and Master’sdegrees were introduced (the diploma certificatewas introduced much earlier); (2) a system ofhigher education cycles was introduced, with acompleted higher education (a specialist’s or Master’sdegree qualification) impossible to achievewithout completion of the first cycle (Bachelor’sdegree); (3) the ‘credit’ dimension of the labourintensiveness of education disciplines was introducedin 1994; (4) nowadays, more students andscientists study or work abroad compared within 1991; and (5) cooperation has been enhancedwith foreign educational institutions in educationand research.46MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Box 4. The number of students at HEIs ofI-IV accreditation levels has increased during theyears since independence, reaching the maximumlevel at the beginning of the 2007/08 academicyear – 2,813,800 – and gradually decreasing lateron: in the 2008/09 academic year – 2,763,900 – andin the 2009/10 academic year – 2,599,400 (i.e. thequantitative indicator in 2009 is at the 2004 level).This occurred because of: (1) a significantdecrease in the admission rate, the maximumbeing at the beginning of the 2005/06 academicyear – 672,300 – and the minimum at thebeginning of the 2009/10 academic year – 463,900;(2) an increase in the number of graduates(in 2009 there were 642,100); (3) a loss ofpopularity of HEIs of the I-II level accreditationlevels (at the beginning of the 2009/10 academicyear, there were 354,200 students, whereasin 1995/96, there were 617,7000; 93,400 wereadmitted into HEIs at the beginning ofthe 2009/10 academic year, comparedwith 188,800 during the 1995/96 academicyear); (4) a significant decrease in the admissionrate to private HEIs (46,100 students in 2009,compared with 103,000 in 2005); and (5)the expulsion of students whose studies arefunded by individuals (mostly because of thedeterioration of households’ financial situation).In 2009, in full-time education at the expenseof the state budget, 58,100 students outof 122,300 were admitted to Master’s degreecourses and 109,900 students out of 215,700 to theBachelor’s degree courses.A set of legislative documents to improve thehigher education system has been developed inUkraine aimed at enabling the country to join theBologna Process, in particular introducing a list ofspecialist qualification levels.The Compass Programme, which created theHEI ranking among employers, was introducedin Ukraine in 2008. It should be noted that thenumber of applicants choosing prestigious specializationsowing to the increased range of educationalinstitutions – not just state- but also nonstate-owned– is growing. Non-state institutions,which try to obtain licences to provide educationalservices and issue educational certificates,specialize mostly in educating students majoringin specializations required by business (management,marketing, banking, economics and law).The long-term trends of demand and supply in thelabour market are not always taken into account,which may lead to an increase in tensions in thelabour market in the future. The share of specialistsin disciplines such as economics, commerceand entrepreneurship out of the overall numberof graduates of HEIs increased from 28.3 percentin 2000 to 33.3 percent in 2006.Multiple attempts to reform the higher educationsystem have not been integrated or systemic. Sectorsproducing public wealth, goods and servicesand sectors preparing respective specialists andconducting scientific research should be consideredin an integrated manner. Furthermore, whilemaking forecasts of socio-economic developmentfor the medium term, expected labour marketneeds, in line the scope of the Government’sneed for specialists, must be taken into account.Box 5. A de-stabilization of the higher educationalservices market is related to a significant forecastshortage in the number of graduates of VEIs andHEIs in upcoming years. There is a risk that thesetrends will aggravate the following: (1) a largescaledecrease in the number of scientific andteaching employees in HEIs, worsening of theirfinancial situation and destabilization of generalactivities of HEIs; (2) a significant decrease in thesupply of qualified workers and specialists withhigher education in the national and regionallabour markets.Postgraduate education. Postgraduate educationis an ongoing component of the nationaleducational system, to ensure expansion andupdating of professional knowledge and skills.In 2008, the total number of workers who hadbeen retrained and raised their qualificationswas 292,000, which significantly exceeded thelevel of previous years (2007–197,000 people).However, when comparing this with the numberof registered enterprises and organisations, accordingto the National State Registry of UkrainianEnterprises and Organisations (1,228,900 asof 1 January 2009), on average only one workerper four enterprises increased his/her skills level.The current level of development of the moderneconomy and science and information technologiesrequires new approaches to retraining andupgrading qualifications, and additional professionaleducation of students, from secondaryeducation up to postgraduate and doctoral levels.There is a need to ensure the development ofCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 47

continuous professional education (from secondaryschool to university) following the multiversitymodel and applying innovative educationaltechnologies based on the promotion of self-educationof pupils and students. Previous qualificationsmust correspond with updated qualificationrequirements or be brought up to the levelneeded for work in new professions or new typesof labour activities. Retraining teaching and managerialstaff in the educational sector is equallyimportant. The Law on Post-Graduate Educationhas still not been adopted in Ukraine.Lifelong education (adult education). Rapidlychanging demands in technology require continuousskills enhancement and retraining ofworkers to allow them to enter into new professions.Widespread economic changes and the increasedflexibility of the labour market also meanthat people need to change jobs and even professions,meaning an ever greater shift from traditionalforms of employment towards more flexibleones and the use of innovative technologiesin professional training. This especially concernsthe organisation of professional training for theunemployed, aiming at enhancing their competitivenessin the labour market.Box 6. According to a sociological survey inUkraine in 2007, 12.1 percent of respondentsreplied ‘yes’ to the question ‘Have you participatedin any courses, lectures, training or lessons duringthe last 12 months prior to the survey that aimedto improve knowledge or skills needed for yourjob?’ (For comparison: Norway – 49.8 percent,Finland – 49.6 percent, Denmark – 47.2 percent,Sweden – 49.0 percent, Switzerland – 44.6 percentand Iceland – 51.8 percent). Ukraine’s rankingbased on the indicator of positive replies is 23 rdout of 25 countries (Source: Institute of Sociology ofNAS of Ukraine).Lifelong education must be available to all. Thisrequires a change in approach in the comingyears, towards reforming the educational system,stepping up the motivation to continuously improveeducation levels and creating efficient adulteducation establishments to satisfy the needs ofthe labour market. Implementing the continuouseducation concept envisages the removal of allrestrictions to lifelong education.ІІІ. ChallengesChallenges to achieving this Goal are cross-cutting.The main issues that prevent adaptation ofthe educational system to the current situation include:(1) decrease in access to and lack of qualityof education to meet current needs; (2) non-complianceof the education system with the needs ofthe labour market and discrepancy between thetraining of specialists and employers’ demands;(3) inefficient state financing mechanisms, whilebudget expenditures on education are constantlygrowing; and (4) overly centralized administration.It is necessary to improve the efficiency offunds, which are currently spent mostly on themaintenance of educational institutions and noton improving educational outcomes.Preschool and general secondary education.The lack of available places in PEIs and an absenceof PEIs altogether in some settlements are mostserious problems. In response, a range of alternativeinstitutions specializing in early childhooddevelopment have emerged. In several regionsof Ukraine, social and pedagogical patronagehas been established. The number of childrenaged three to five increased in preschool institutionsin urban areas by 17.6 percent and in ruralareas by 23.4 percent compared with 2005. However,the introduction of various forms of enrolmentfor children in preschool education (shortstay groups for children, weekend groups, familygroups, child development centres, etc) remainsa critical issue.School buildings are outdated and uncomfortablefor children and teachers. In particular, accordingto data of the basic survey of 2005–2008 (conducted by the Institute of SociologicalTechnologies in 187 schools in six pilot districtsof Ukraine within the framework of the Equal Accessto Quality Education in Ukraine Project ofthe Ministry of Education and Science, supportedby the World Bank), the average age of schoolsis 37 years. School buildings need urgent repairs,both structural and operational. Just 27.8 percentof general educational institutions have operationalmedical aid units. Educational resourcesare insufficient: only 68.6 percent of pupils areprovided with textbooks for all subjects. There isa significant number of unused buildings: there48MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

are over 100 GEI buildings, with only 70 percentoperational.Vocational education. Growing negative trendsare observed in the national professional educationsystem, including: (1) weak adaptation of theeducational services market to the needs of thelabour market and the lack of systemic monitoringand forecasting of changes in the educationalmarket that consider the labour market environment;(2) slow rate of employment restructuringand inadequate changes in qualified personneltraining; (3) deterioration of the quality of educationalservices in VEIs and lack of a state systemfor ensuring the quality of vocational education;(4) insufficient financing of the development ofvocational education and underdevelopment ofits infrastructure; (5) disconnect between educationalinstitutions and employers; and (6) lack ofincentives among teachers to introduce innovativeeducational technologies.Inefficiency in relation to the choice of professionsis caused by a lack of strategic analysis on labourmarket development, by the application of traditionaleducational systems that are not adapted tochanges in the requirements of youth and labourmarkets and by underdevelopment of a system ofstep-by-step professional training and continuededucation. Overcoming these obstacles will allowfor an increase in youth’s adaptation potential,helping them to learn socially active behaviourand to become socialized professionally.Higher education. The inadequacy of the administrationsystem of HEIs is characterized by itsfragmented structure. In particular, at the beginningof the 2009/10 academic year, 293 HEIs ofI-IV levels of accreditation were under the administrationof the Ministry of Education and Scienceof Ukraine; 56 were under the Ministry of Healthof Ukraine; 47 the Ministry of Agricultural Policyof Ukraine; 35 the Ministry of Culture and Tourismof Ukraine; 20 the Ministry of Transport and Communicationof Ukraine; 13 the Ministry of InternalAffairs of Ukraine; 10 the Ministry of Ukraine forFamily, Youth, and Sports; and 8 the State Committeeof Forestry of Ukraine. In addition, fiveHEIs of I-IV level of accreditation are under the administrationof the Ministry of Defence of Ukraineand the Ministry of Labour and Social Policy ofUkraine, with 169 HEIs of I-IV levels of accreditationunder the administration of other ministries.There is a lack of cooperation between employersand HEIs, which limits employment opportunitiesfor HEI graduates. Only a few Ukrainian employersare ready to invest in education, as shown bythe low level of tuition paid for students by thelegal entities (enterprises). In particular, 52 juniorspecialists (out of 145,100), 923 Bachelor’s degreestudents (out of 315,600), 686 specialists (outof 277,000) and 94 Master’s degree students (outof 98,200) were admitted to HEIs paid by legal entitiesin 2009.A competency-based curriculum for HEIs needsto be developed, which would allow knowledgeobtained to be applied in the labour market.In addition, there is inadequate development ofqualification frameworks for specialists, who mustbe trained by educational institutions of differenttypes, and an insufficient level of assessment ofthe regional labour market’s needs for qualifiedstaff. Particularly important issues are educationalplans, especially the ratio of basic and variablecomponents within them. Work to improve listsof courses and qualifications for training specialistswith higher education is inadequate: the developmentof ’third generation’ higher educationstandards has slowed down.Box 7. Problems in training and skills improvementof experts in the education area include: (1)insufficient provision of VEIs with highly qualifiedteaching staff: only 85 percent of the need issatisfied. Currently, 10,800 (21.9 percent) ofteaching employees of pre-retirement andretirement age still work and 39 percent ofteaching employees have not completed highereducation; (2) insufficient professional trainingof teaching staff and limited institutionalopportunities to enhance their qualifications:only 63.4 percent of managers of GEIs haveobtained specialized education or havecompleted special courses to assume their postsand 84.1 percent of teachers consider masteringmodern and interactive educational technologiesduring the teaching process as a part of skillsimprovement; (3) incomplete numbers of teachingstaff in GEIs and VEIs, which impacts the quality ofservice provision; and (4) the current staff trainingprogrammes, forms and methods need significantimprovement.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 49

Owing to the imbalance between the labourmarket and the educational system, a reorientationof higher education towards a multilevel systemof personnel training is needed. An HEI canstrengthen its position within the ‘institute – student– employer’ system simply by identifying potentialconsumers’/employers’ demands for competitivespecialists in the labour market. Ukraine’scurrent educational system does not ensure therapid development of professionally orientedhigher education.Weak competency in specialization. Inconsistencyof educational content with the demandsof the labour market. Educational programmesare overloaded with factual information. Selectionof programmes is not allowed, textbooksare of poor quality, educational innovations takeplace ineffectively and teaching methods needimprovement.Standards in both general secondary and highereducation are in the process of continuous transformationand modernization. The major criteriain evaluating the educational system are the demandin the labour market for graduates and theirhigh competitiveness during assessment of theirqualification level by employers. Experts considerthat efficiency, i.e. students’ ability to use the acquiredknowledge and skills in practice, is one ofthe most problematic aspects of the higher educationsystem.Given the current lack of a coordinated and consistentpolicy in developing the ‘triangle of knowledge’of education, science and innovation, thesefields function independently, without coordinationand joint objectives. Higher educationalinstitutions play a secondary role in conductingadvanced scientific research, which is the basis forelite university training. In this context, a systemof state priorities was built and university educationtook on an enlightening, supporting role butnot a productive and innovative one.Access to quality education. As mentioned, problemsof equal opportunities for all to access qualityeducation, starting from preschool education,remain. Quality education is limited by problemsof staff, retraining and teachers’ skills, as well as bymaterial, technical, scientific and methodologicalissues in terms of providing education. Accessto preschool education is problematic in big citiesand in rural areas, whereas access to qualitysecondary education causes problems primarilyin remote rural areas. Education of children withspecial needs remains critical too. For example,there is a lack of textbooks and specialized literaturefor children with visual and hearing impairments.There are difficulties in access to qualityeducation for children who live in boardingschools under the social protection system, whichdo not conduct any educational activities and donot have appropriate specialists and teachers.There are cases of child refugees not attendingschool. 13Box 8. According to the data of the annual reportsof Ukrainian Helsinki Human Rights Union,almost 20,000 children of school age did notattend schools in 2005 (the 2007 report suggeststhat the situation had not changed) (Source:Y. Zakharova, I. Rapp, V. Yavorsky / UkrainianHelsinki Human Rights Union. Human Rights inUkraine – 2007. Kharkiv: Prava Ludyny, 2008.).The excessive number of disciplines in the studyplan and the burden on teachers decrease thequality of education. The issue of access to qualityeducation must be resolved, especially higher education,which becomes more paid, i.e. which isinaccessible for families with low income levels. Afinancial support programme for youth from lowincomefamilies has been established, entailingprovision of educational credits (the programmebudget amounted to UAH 15 million in 2008/09).Lack of demand for qualifications among graduates,insufficient work experience and not beingpsychologically ready to make their own decisionsare among the causes of youth unemployment.An effective system of lifelong educationand enhancing qualifications in modern professionswould help to facilitate economic recovery.13 United Nations Children’s Fund (UNICEF). AlternativeReport on Ukraine’s Implementation of the United NationsConvention on the Rights of the Child 2002–2008. Kyiv:UNICEF, 2009. – 90 p.50MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

IV. Moving ForwardTo further develop the preschool education systemit is important to ensure that the network ofPEIs is optimal and balanced enough to respondto the population’s needs and demographic situation.In this direction, it is necessary to: (1) increasethe number of places within the PEIs of communalproperty according to need and transferministerial PEIs and those financed by collectiveagricultural enterprises to communal property;(2) develop the network of PEIs of compensatingand combined types owing to an increase in childmorbidity and continue the development of childdevelopment centres; (3) strengthen scientificand methodological support to preschool education,update its standards and introduce on widescale a new generation of preschool educationprogrammes; (4) enhance functions of preschoolinstitutions by introducing socio-pedagogicalpatronage by families who raise children of preschoolage, including those with psychologicalimpairments who, for different reasons, do notattend preschool institutions; and (5) support theestablishment of educational associations of ‘preschoolinstitutions – schools.’In order to enhance the population’s access togeneral secondary education and raise its quality,it is necessary to: (1) create an optimal networkof GEIs by enlarging specialized senior schoolsand enhance the network of educational institutionsbased on the ‘schools – families,’ principallyby taking into account the specifics of the localand demographic situation; (2) provide transportationservices (including the state Programmeon School Bus) for all pupils in rural areas wholive at a distance of more than 3 km from schoolsand arrange transportation to school; (3) fully implementcomputerization of VEIs, HEIs and interschoolvocational training and production plants(including equipping schools with modern computers,licensed software and telecommunications,as well access to the internet); and (4) implementthe Action Plan for the Development ofNatural Sciences and Mathematical Education aswell as the State Programme on Work with GiftedYouth for 2007–2010 and expand the State Programmeon the School of the Future to all regionsof the country.In order to ensure monitoring and quality controlof secondary education, it is necessary to:(1) create a system of monitoring studies on thequality of education of pupils of GEIs; (2) ensureparticipation in comparative studies (TIMMS andProgress in International Reading Literacy Study(PIRLS)); and (3) introduce a ranking system forGEIs by taking into account results of an externalindependent evaluation on knowledge and publicationsof relevant information.In order to enhance access to education, it is importantto: (1) introduce a strategy of inclusive educationand integration of children with specialneeds; (2) create a sufficient number and qualityof educational materials and train personnel toteach children of national minorities; and (3) promotethe education of children from marginalizedfamilies in GEIs.In order to facilitate the education of children withspecial needs and enable inclusive education, it isnecessary to: (1) adopt strategies of inclusive educationat the state level and bring Ukraine in linewith European standards; (2) ensure special trainingand enhance qualifications in psychophysicaldevelopment of teaching staff working withchildren with special needs, within the frameworkof inclusive education in preschool, generaleducation and out-of-school- educational institutions;(3) widely disseminate forms of integrated(inclusive) education of children with specialneeds; (4) identify an employment mechanism forgraduates with special needs; (5) provide specialGEIs with equipment for individual and collectiveuse under the Programme on Correctional Education;and (6) create the conditions for unhinderedaccess by individuals with special needs to socialinfrastructure of educational institutions.In order to promote the education of children ofnational minorities, it is recommended to: (1) implementsectoral programmes for improving thestudy of the Ukrainian language in educationalinstitutions as well as national minority languages;(2) provide GEIs that teach national minoritylanguages with up-to-date textbooks and educationaland methodological materials; (3) facilitatethe operations of weekend schools, in whichlanguages of national minorities are studied,and provide these schools with educational andmethodological literature and appropriate edu-CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 51

cational means; and create proper conditions forenhancing teachers’ qualifications.In order to increase the level of coverage of childrenof out-of-school education and to improveits quality, it is necessary to: (1) elaborate theConcept of the Out-of-school Education Developmentfor 2010–2014; (2) implement the State Programmeon the Youth of Ukraine for 2009–2015;(3) provide out-of-school educational institutionswith technical education equipment and educationaland methodological materials; etc.In order to increase the quality of vocationaleducation, it is important to: (1) develop the Conceptof the Vocational Education Development inUkraine for 2010–2020; (2) facilitate the introductionof flexible module technologies for professionaltraining of personnel at work; (3) create asystem of independent qualification attestation;(4) ensure that the computerization of vocationaleducation responds to the informational andcommunicational needs of the participants of thestudy process; (5) develop minimum standards inproviding training workshops, stations, laboratoriesand grounds in state VEIs with new equipment,machines, etc.In addition, measures need to be taken on: (1) optimizationof the network of VEIs in line with theprospective needs of the economy, taking intoaccount the demographic situation and labourmarket needs; and (2) creation of an experimentalteaching network based on VEIs by respectivesectors aimed at the development and introductionof state standards for blue-collar jobs.In order to overcome complications in the transitionperiod towards harmonization of higher educationdevelopment with European trends, thefollowing must be ensured: (1) expansion of educationalinstitutions’ autonomy; (2) reform of theHEI network by expanding and creating regionaluniversities and strengthening cooperation ofemployers with HEIs; (3) decrease fragmentationof HEIs’ subordination in order to eliminate duplicationin training of specialists and more rationalutilization of funds earmarked for higher education;(4) promotion of integration processes in theeducational system by creating an educationaland an educational-scientific-manufacturing interface;and (5) development and provision ofcomputer equipment, licensed software productsand telecommunication equipment in distancelearning centre networks.Procedures for admission tests must be improvedby balancing the results of external independentevaluations of educational achievements ofgraduates of secondary educational institutions,results of entrance exams and average marks onthe school certificate, aiming at ensuring equalconstitutional rights in youth’s access to highereducation.In order to implement the Bologna Declarationprovisions, a range of measures must be systemized,particularly to: (1) develop and ensure theadoption of certain governmental documents onthe restructuring of professions of training specialistswith Master’s degrees and junior specialisteducational qualifications; (2) introduce a systemof academic educational and professional qualifications,grades and appendices to diplomas inline with European requirements; (3) create conditionsfor the mobility of students and teachersof HEIs, aiming at ensuring their competitivenessin the European labour market; and (4) facilitateUkraine’s participation in international educationaland scientific projects. It is also necessaryto develop the National Qualifications Frameworkin line with the general qualification framework inEuropean higher education and to follow a strategyof joining the European Quality AssuranceRegister for Higher Education.Expedient measures include: (1) enhancing socialpartnerships among HEIs and employers, thepopulation and their associations, and invitingthem to take part in working out and adoptingdecisions on higher education issues; (2) optimizingvolumes of training and retraining for staffwith higher education in the context of innovativedevelopment of the national economy; and(3) providing state support to training specialistsdealing with high priority industries of the economyin the form of ‘science-education-technology’through integration with scientific institutionsand manufacturing.The following are needed in terms of quality enhancement:(1) establishing a system of qualitymonitoring and ranking of education of studentsand activities of HEIs; and (2) creating and intro-52MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

ducing employment monitoring of graduates ofHEIs at regional and state levels by involving centraland local authorities and employers.To enhance the functioning of the higher educationsystem, the following needs to be undertaken:(1) improving the state order system forthe training of specialists; (2) ensuring developmentof distance learning as a form of trainingand retraining and increasing qualifications; (3)implementing the State Programme on Informationand Communicational Technologies in Educationand Science for 2006–2010; (4) ensuring anincrease in the quality of professional and practicaltraining of educational stakeholders; and (5)developing standards in relation to the burden ofacademic responsibilities on teachers and the financialresources per student in HEIs, etc.In order to develop a modern system of continuedprofessional education, it is necessary to:(1) increase the number of institutions that provideservices in professional education and stafftraining (inter alia, by attracting civil society organisations);(2) create conditions for enhancingcivil and professional mechanisms of attestationand accreditation of educational programmes; (3)enhance the role of civil society organisations ineducational management; (4) design a generalnational system to assess education quality andimplement educational programmes; and (5) createconditions to ensure the educational mobilityof students.Development of education content should ensure:formation of competences for personal development;participation in the democratic proceduresof civil society; adaptation to the labourmarket; and lifelong education. The following isnecessary in this direction: (1) coordinating educationalstandards with best international practicesand standards; (2) creating a free marketfor textbooks and independent commissions forcompetition among authors; and (3) creating regionaldistance learning centres. CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 53

GOAL 3:PROMOTEGENDER EQUALITYThis subchapter analyses the current situationwith respect to ensuring gender equality.The basic gender development principles inUkraine are determined by the Constitution ofUkraine. This provides that all citizens, regardlessof their gender, have equal constitutionalrights and liberties. This is ensured by providingwomen with equal rights and opportunitiesfor self-affirmation in all spheres of life.However, the constitutional provisions can beimplemented only when they are embeddedwithin the legislation system in general andare being enforced by means of proper institutionalmechanisms.І. Targets and IndicatorsTargetsTarget 3.A: Ensure genderrepresentativeness at thelevel of no less than 30–70%in representative bodiesand high-level executiveauthoritiesTarget 3.B: Halve the gap inincomes between womenand menIndicators3.1. Gender ratio among themembers of the Parliament ofUkraine, number of women/number of men3.2. Gender ratio among themembers of local authorities,number of women/numberof men3.3. Gender ratio among thehigher-level civil servants(1–2 categories), number ofwomen/number of men3.4. Ratio of average wagesbetween women and men, %54MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2011 2013 2015Indicator 3.1.Gender ratio among the members of the Parliament of Ukraine, number of women/number of men8/92 8/92 5/95 5/95 5/95 5/95 9/91 8/92 8/92 8/92 20/80 25/75 30/70Indicator 3.2.Gender ratio among the members of local authorities, number of women/number of men42/58 42/58 42/58 42/58 42/58 42/58 35/65 35/65 37/63 37/63 44/56 47/53 50/50Indicator 3.3.Gender ratio among the higher-level civil servants (1–2 categories), number of women/number of men15/85 15/85 14/86 16/84 13/87 19/81 19/81 17/83 18/82 19/81 25/75 27/73 30/70Indicator 3.4.Ratio of average wages between women and men, %70.9 69.7 69.3 68.6 68.6 70.9 72.8 72.9 75.2 77.2 80 83 86The table presents actual data by 2009, expected data for 2009 and forecast calculated values of indicatorsfor 2010–2015.The development targets at the internationallevel related to ensuring gender equality wereadapted significantly to fit Ukrainian conditions.In particular, issues of gender inequality in accessto education and wage employment, which stillremain important for most developing regionsof the world, are not relevant to the specificsof gender development of Ukraine. At present,no gender restrictions in access to any level ofeducation are observed in Ukraine. Moreover,among the population covered by higher education,there is a notable gender imbalance infavour of women. No significant gender differencesare observed with respect to access to thelabour market – the levels of economic activityand employment of Ukrainian women remainamong the highest in the world. Problems ofgender inequality in Ukrainian society are fundamentallyof another kind: high levels of employmentand educational and professional trainingof women are accompanied by insignificant representationof women in decision making. Womenare underrepresented in political life, higherlevels of public administration and managementof economic organisations. There are high levelsof professional gender segregation, i.e. concentrationof women and men in positions of differentlevels and in different spheres of economicactivity. And there is a significant gender gap inthe population’s income level, as well as feminizationof poverty.These issues concentrate gender developmenttargets in Ukraine on ensuring equal opportunitiesin socio-political life and public administrationand on reducing the income gap betweenwomen and men. The gender indicators includeindicators on the participation of women andmen in high-level public administration (amongcivil servants of the 1–2 categories) and in representativebodies of different levels – Parliamentand local self-governing bodies, as well as thegender wage ratio in the economy.Taking into consideration the experiences ofdeveloped countries, indicators of the genderratio among the Members of Parliament andhigh-level executives/civil servants are set at noless than 30 : 70 and among local public administrationbodies at no less than 50 : 50. On average,women’s wages should be at least 86 percentthose of men’s. Although the initial systemof indicators to monitor progress proposed abroader system of gender indicators, relating toparticipation in the different levels of local authorities(including the oblast, rayon, town andvillage councils, as well as the Cabinet of Ministersof Ukraine), it was decided to exclude thesefrom the system. The situation of gender paritywithin local self-governing bodies at the lowerterritorial level was more favourable, and targetsset for some indicators were achieved beforethe deadline (for example, the ratio of womento men among members of village councils exceededthe corresponding target values duringthe whole period).CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 55

II. Situation AnalysisThe low level of gender development in societyhas led to a deepening of gender-based socioeconomicdifferentiation. It has also led to limitedrealization of gender equality as declared in theConstitution of Ukraine as well as in the principlesof democratic society. Moreover, the existence ofgender inequality slows down opportunities foreconomic development, weakens the public administrationsystem and reduces the efficiency ofhuman development strategies.Equal participation of women and men in politicallife and in higher levels of the public administrationis a requirement not just for fairness anddemocracy but also for obtaining equality in societyand promoting gender-sensitive policy inother spheres of life. Interregional comparisonsalso prove that higher indicators of women’sparticipation in governmental structures in eachcountry are accompanied by lower levels of corruption,and help strengthen the social orientationof state policy.Ukraine’s unfavourable position on this indicatoris determined by representation of womenin the Parliament: during the entire period sinceindependence, their share among Members hasnot exceeded 8 percent and, during 2002–2006,it even decreased to 5 percent. At the same time,women occupy on average around 30 percent ofparliamentary seats in the EU and even higher innorthern European countries that have been successfulin attaining higher levels of progress ongender equality (for example, in Sweden, the shareof seats in the Parliament occupied by women isequal to 47 percent, in Netherlands 42 percent, inFinland 40 percent and in Norway 39 percent). 14At present, Ukraine not only is behind the bestEuropean examples, but also comes in below theaverage indicator of women’s participation inother national parliaments (18.7 percent).The current exclusion of Ukrainian women fromdecision making at the highest political levels is inconsistentwith high indicators on their participationin the lower levels of the public services sector.In general, there are fewer women than mencivil servants – at both managerial and specialist14 Data of the Inter-Parliamentary Union as of 31 December2009: www.ipu.org/wmn-e/regions.htm.levels (64.8 percent and 79.5 percent, respectively,as of the beginning of 2009). However, womenconstitute the absolute majority of civil servantsin lower-level positions – this requires lower qualificationsand does not entail significant responsibility(Figure 7). As we go higher up, their sharedecreases, reaching only 13.3 percent in the firstposition category of managers who participatein decision making at the state level. Although atthe beginning of the decade an increase was observedin the share of women among higher-levelcivil servants in 1–2 categories (from 15 percentin 2001 to 19 percent in 2005), this trend was unstable:according to 2008 data, women in Ukrainecomprise 18 percent of higher-level civil servants.Women are much better represented at thelocal level of administrative bodies throughoutthe world, including in Ukraine. Accordingto 2008 data, the share of women’s representationwithin local administrative authorities was 37 percent;among the members of oblast-level authorities12 percent; rayon authorities 23 percent;town authorities 28 percent; and small and bigvillage councils 51 and 46 percent, respectively.Less power to access economic resources andtheir distribution, as well as in decision making atthe local level, remain the determining factors inensuring a higher level of women’s activity withinlocal administrative authorities.Some concern is raised by the decrease in women’srepresentation within administrative authoritiescompared with 2001 data, when womenaccounted for 40 percent of members of localcouncils. However, owing to a higher level of genderparity at the local level, one can observe acadre of quality personnel among women whohave the same educational and professional levelas men as well as the necessary working experience,and who are able to work in the higher levelsof public administration at the national level.With appropriate career development supportfor competent female personnel at the local level,such as leadership skills training, promotion ofrole models and the provision of family care support,these women may be mobilized to highermanagement positions at the national level.The possibility of accessing economic resourcesremains an important component of the genderequality concept. The gender gap in the in-56MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Figure 7. Gender Structure of Civil Servants in Ukraine by Position Categories,at the Beginning of 20100% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%managers by positioncategoriesthe firstthe secondthe thirdthe fourththe fifth13.325.641.548.769.186.774.458.551.3Women, %Men, %30.9the sixth70.030.0the second46.253.8specialists by positioncategoriesthe thirdthe fourththe fifththe sixththe seventh64.162.371.179.183.835.937.728.920.916.2Source: Data of the State Statistics Committee of Ukraine.come level in Ukraine is very large. According tothe Household Budget Survey conducted by theState Statistics Committee of Ukraine in 2008,women’s average income is only 65.2 percent ofthe average income of men, i.e. UAH 8,018 againstUAH 12,305 per year, respectively. Obviously, suchsignificant differences in income level are unjustified,considering the equal educational and qualificationpotential of women and men, women’shigh level of economic activity and employmentand the lack of significant gender differences inunemployment indicators.Gender disproportions in the material welfareof the population are reflected not just in women’slower incomes but also in differences in thesources of incomes. In comparing income sourcestructures between men and women, genderinequality in the labour market is evident, sincewomen’s incomes, to a great extent, are from nonlaboursources (pensions, stipends and benefits),whereas the share of men’s employment income,including both remuneration and income fromentrepreneurial and self-employed activities, issignificantly higher. Moreover, the latter sourcesof income contribute the most to the gender gap:i.e. women’s average income from entrepreneurialactivities is only 34.3 percent of that of men,and women’s average income from self-employmentis 39.5 percent of that of men.The gender gap in the income level increases ifwe consider the uncalculated share of income relatedto unpaid work within the household andcare for family members, i.e. activities conductedmostly by women. In particular, according to datafrom sociological studies, 15 the vast majority ofmen (60 percent of interviewees) are engagedin 1–15 hours of housework per week (34 percentdo 5–15 hours a week); the vast majority of women(60 percent of respondents) do 5–30 hours aweek (30 percent do 15–30 hours a week). Thereis a significantly lower share of men engaged inhousework for 30–60 hours a week (13 percentagainst 25 percent for women). In sum, women’sroles are significantly broader than thoseof men and cover household activities and raisingchildren as well as professional activities. Formen, employment in the labour market remainsthe major activity. This leads to women’s doubleworkload, limiting their opportunities for person-15 Y. Saienko. Gender Stereotypes and Society’s Attitude towardsGender Problems in the Ukrainian Society. Кyiv: UNDP, Centerfor Social Expertise of the Institute of Sociology of NAS ofUkraine, 2007. – 70 p.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 57

al growth, professional development, leisure andself-fulfilment.Official statistics on the domestic labour marketshow less significant differences in remunerationthan are seen in the data of the Household BudgetSurvey: the gender gap in the average wagefluctuated at 30 percent during 2000–2009. However,a positive trend of reducing differences inthis field started from 2004 (Figure 8). As a result,women’s average wage increased to 77.2 percentthat of men’s average wage (UAH 1,677 againstUAH 2,173 a month, respectively, in 2009). Thegender gap in the wage level is caused by a rangeof objective reasons, including: inter-industry differencesand differences between wages; specificitiesof educational and qualification levels;working conditions; overall input into labourresults; duration of labour period; and workschedule. In particular, women more often workpart-time; are employed more than men in lower-payingindustries (particularly, in the publicsphere – education, health care and social services);have a shorter length of service; and, to alower extent, are employed under harmful workingconditions and do not receive the appropriatecompensations.At the same time, ‘vertical’ professional segregationremains the major manifestation of genderdiscrimination in remuneration in Ukraine, whichresults in women being concentrated mostly inpositions with lower wages: the steady relationshipbetween the gender gap in income levelsand socio-economic status of the population isproof of this. According to data from the HouseholdBudget Survey in Ukraine, a larger gendergap in remuneration is observed among employers(women’s average income is 50.7 percent ofmen’s income), whereas among employees theratio increases to 79.3 percent and among theself-employed to 97.5 percent.Since wages are the major source of income forthe population, the gender gap in this field leadsto an excessive risk of the feminization of poverty,since women dominate in the vulnerablecategories of the Ukrainian population (one-parentfamilies with children and the elderly livingalone). Although data on the intra-family distributionof incomes disaggregated by gender arealmost inaccessible, since the household is thefocus of research in the national statistics system,analysis of family incomes depending on genderof the household head identifies some genderdifferences, which grow in single-person house-Figure 8. Ratio of Average Wages of Women and Men in Ukraine, 2000–2009250080.0UAH per month2000150075.070.065.0%100060.050055.002000 2001 2002 2003 2004 2005 2006 2007 2008 2009Average wage of women, UAH per monthAverage wage of men, UAH per monthRatio of the average wage of women and men, %50.0Source: State Statistics Committee of Ukraine.58MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Table 7. Gender Indicators of Poverty of Ukrainian Population, 2008Types of households Poverty level, % Extreme poverty level, %Households headed by men, out of which 26.3 13.2- households consisting of one person 17.8 8.1- households of retirees living alone 17.5 6.6Households headed by women, out of which 27.8 14.2- households consisting of one person 19.1 7.8- households of retirees living alone 21.3 8.6Source: Calculated based on the data of the Household Budget Survey of the State Statistics Committee of Ukraine.holds. In particular, from a gender point of view,women of retirement age living alone experiencethe highest risk of poverty in Ukraine (Table 7).Obviously, problems of poverty feminizationhave deepened as a result of the economic crisis,whose consequences are fully visible in Ukraine.A decrease in the already low wage level and anaccumulation of arrears in wage payments haveinfluenced women’s situation as representativesof the less-protected groups of population.It is also recognized at the international level thatthe global economic crisis may lead to a deteriorationof the situation of women in the labourmarket owing to accelerated unemployment. 16However, the situation is less straightforward inUkraine. Although the number of unemployedwomen registered in the State Employment Serviceof Ukraine exceeds the number of men (Figure9), such gender-related unemployment is traditionalin Ukraine. On the other hand, an analysisof data on the real labour force supply in the labourmarket shows that, during the past decade,the unemployment level among economically activemen of 15–70 years of age has insignificantlyexceeded that of women in the same category(6.6 percent against 6.1 percent in 2008; 10.3 percentagainst 7.3 percent in 2009), owing to economicrestructuring and closure of large industrialenterprises in traditionally male spheres ofactivity.Considering the immediate negative impact ofthe current economic crisis on the heavy industryof Ukraine, where men prevail among the16 United Nations (UN). The Millennium Development GoalsReport 2009. New York: UN, 2009. – 56 p.employed, the trend is preserved. The constructionindustry, in which women represent fewerthan 20 percent of the average number of workers,has also experienced losses. On the otherhand, women constitute the majority of workerswithin the public sector (particularly, education,health care, social services provision, public administrationsystem, etc), thus are more protectedwith respect to employment guarantees.Problems of unequal opportunities for womenand men in Ukraine are not limited to socio-politicallife, the labour market and income levels.Numerous gender inconsistencies are presentwithin the socio-demographic sphere and arerelated to the health and life expectancy of thepopulation, family legal relationships and issuesof family violence, labour migration, including illegalmigration, and also human trafficking. Thereis a large gender gap of 12 years in terms of averagelife expectancy of the population (averagelife expectancy at birth is 74 years for womenagainst 62 years for men), which remains a significantindication of inequality. The major componentof this gap is made up of losses of men at themost productive age, that is, the extremely highmortality rate among men of working age. In particular,according to demographic calculations, asof 2008, the probability of not living until 60 yearsof age was 39 percent for boys of 16 years of ageagainst 14.5 percent for girls of the same age. Externalreasons play a significant role in this ‘male’mortality, which may be eliminated with an improvementin lifestyle.A well-defined ‘gender character’ is also commonto the structure of population morbidity – especiallyfor socially determined diseases, whoseCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 59

Figure 9. Trend in Registered UnemployedWomen and Men in Ukraine,September 2008–February 2010, End of MonthFebruaryspread represents a kind of indicator of society’ssocial development and reflects the population’slifestyle. In particular, more men than women sufferfrom tuberculosis, sexually transmitted diseases,HIV infection and AIDS. There is a higherlevel of suicides among people, generally men,with psychic and behavioural disorders. Further,there has been an increase in the spread of riskyforms of behaviour and ‘bad habits’ (in particular,men dominate among alcohol and drug addictsregistered in health care institutions), which is evidenceof the ‘male crisis’ in Ukraine. This results inthe need for the introduction of integrated genderapproaches to the implementation of statepolicy. This policy must take into account differentmanifestations of gender inequality in society,and not concentrate exclusively on improvingwomen’s position.JanuaryDecemberNovemberOctoberSeptemberAugustJulyJuneMayAprilMarchFebruaryJanuaryDecemberNovemberOctoberWomenMenІІІ. ChallengesIncompleteness of the gender transformation remainsthe major barrier to the achievement of thisGoal. The slow introduction of legislative changesaimed at strengthening parity representation ofwomen and men in representative administrativeauthorities at national and local levels hascomplicated opportunities to develop gendersensitivepolicy and promote gender equality inother spheres of public life. Resolving personnelissues in central and local executive authorities isfor the most part based not on applying a genderapproach to personnel recruitment but onthe principle of political expediency. The nationalmechanism for ensuring gender equality doesnot have a sufficient level of authority, personneland financing to implement its assigned duties.Coordination of actions among different authorizedinstitutions, related to gender equality promotionat the national, regional and local level,remain insufficient. In addition, civil society representativesare not encouraged to participate ingender policy development and implementation.September0100 200 300 400 500 600thousand peopleSource: data of the State Employment Centre of Ukraine.There is a need for further development of genderstatistics that will fully and in an integratedmanner cover the problems of gender developmentin different spheres of civil life. Althoughthe current national statistical system makes itpossible to conduct gender analysis of data onpolitical representation, economic activity andthe employment and income capacity of population,obtaining reliable data on cases of indirectdiscrimination in the labour market, intra-familydistribution of power and resources, family violenceand illegal labour migration require specialstudies. The lack of such information complicatesopportunities for the regular monitoring of thegender indicators, for the assessment of progressin the field of gender development, for analysingcrucial problems in this sphere and for draftingstate gender policy.60MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

There is an insufficient level of awareness of thelegal aspects of ensuring the equal rights and opportunitiesfor women and men, of methods ofprevention and of instruments to counter genderdiscrimination, and a low level of usage bythe population of existing mechanisms to redressrights violations. The mass media’s insufficientlyactive position concerning covering current genderissues, ways to solve them and examples ofbest practices, as well as use of social advertising,also do not attract enough public attention tothese issues. Moreover, the dominance of sexistadvertisements renders ineffective any solitaryattempts of the mass media to provide gendersensitiveinformation, and also deepen the genderimbalance.Established gender stereotypes in society. Viewson the traditional distribution of gender roles incivil and private life, employment in the labourmarket and within the household, ‘male’ and ‘female’professions and types of activities remainwidespread in Ukrainian society. Insufficient engagementof men in fulfilling family and paternalduties makes it difficult for women to combineprofessional activities and housework, opportunitiesfor career promotion, participation in politicallife and important decision making for thecommunity. Men are expected to be the breadwinners,and social reluctance to accept men whohave fallen out of this role has also contributedtowards driving them into high-risk behaviour.Traditional gender distribution of social roles isstill consolidated by school textbooks and educationalprogrammes, and strengthened by the waywomen are represented in the mass media andadvertisement campaigns.Insufficient level of social infrastructure development.Lack of quality assistance in childbearingand housework remains the major factor hinderingthe professional activities of women. Thelack of easy-to-access infrastructure to providehousing services, the reduced number of preschoolinstitutions and the low quality of their educationalservices and insufficient considerationby employers of women’s family obligations putwomen under a double workload – in the labourmarket and in the household.IV. Moving ForwardAchieving gender parity within representativeauthorities and at higher levels of the public administrationis possible by taking decisive measureson the further adaptation of national legislationto meet European standards. With regard towomen’s limited access to the public administrationsystem, it is necessary to introduce legislativechanges in order to establish gender quotaswithin representative authorities and in higherlevels of the public administration, in lists of candidatesof political parties and blocs (particularlywith respect to the composition of party management).Quotas should be considered a temporaryprotectionist measure of the state with respect togender and must compensate for persistent neglectof the gender equality principle in Ukrainiansociety. Of paramount importance in achievingthe Goal is: eliminating the principle of politicalexpediency in recruitment and promotion decisionsin central and local executive authorities;providing gender expertise during the adoptionof legislation and other state decisions thatare important for the community; and introducinggender approaches into the development ofstate strategies. By focusing on gender issues inbudget policy and appropriating the necessaryfinancial resources for implementing gender policy,the state’s compliance with its obligations topromote gender equality will be ensured.Ensuring gender equality in access to decentlabour will be promoted by measures of thestate employment policy, which must be implementedsimultaneously in several directions:prevention of direct discrimination in the labourmarket; overcoming stereotypes of female andmale professions, which are strengthened by lowprofessional status and low remuneration levelsin female-dominant industries; and enhancingopportunities to attract women to obtain lifelongeducation. There is a particular need to introducegender approaches to social partnershipsin Ukraine’s development through the obligatoryinclusion in collective agreements of issuessuch as: the prohibition of gender discrimination;equal remuneration; equal opportunities for professionaland career growth; favourable employmentconditions for workers with family obligations;and work schedules.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 61

Decreasing the gender gap in income levels requiresthe implementation of policy measureson remuneration, aiming at decreasing inter-industryand inter-regional wage variations, to approachremuneration levels in budget and nonbudgetspheres that would allow for a decreaseof the gender gap in remuneration that resultsfrom professional segregation and also a generalincrease in the minimum wage, to bring it closerto the economically justified cost of labour. A decreasein gender differences in income will alsoensure the promotion of women’s entrepreneurshipand employment, while improved the targetingof social assistance. The introduction ofgender approaches into strategies of poverty alleviationwill promote more efficient protectionof vulnerable population categories, in whichwomen dominate. Taking into account the gendercomponent in forming the state budget canbe an efficient tool for decreasing the gender gapin income levels and improving performance onother corresponding indicators.Ensuring opportunities for balanced employmentin the labour market and in the householdplays a decisive role in promoting women’s professionalactivities, raising their professional statusand, accordingly, equalizing the income ofwomen and men. In this context, the followingactions are essential: developing easy-to-accessinfrastructure of housing services; enhancing thesystem of child preschool institutions that providequality educational services; and creating preconditionsfor men’s broader involvement in fulfillingfamily and parental duties, in particular encouragingfathers to take parental leave for three years inaccordance with current legislation. Positive lessonslearned from developed countries includerecognizing non-paid housework, assessing itscontribution to the GDP of the country, justifyingthe amount of direct payment for housework andits reflection in the national accounts system.Transforming established stereotypes on thetraditional distribution of gender roles in societyis a precondition to achieving the objectivesof gender development in Ukraine. Achieving thistarget requires coordinated activities by all civilsociety members and governmental institutionsduring the implementation of an information andeducational campaign on creating an egalitarianperception of Ukrainian society. There should bebroader inclusion of the mass media in genderawareness campaigns in Ukraine, enhanced developmentof ethics codes that will not toleratethe spreading of sexism through the mass mediaand the promotion of civil society activities aimedat preventing gender discrimination. The formationof a general gender culture will be facilitatedby introducing gender approaches to designingeducational programmes in educational institutionsof different levels; implementing gendereducation programmes for civil servants, educationalworkers and representatives of the massmedia; and using the resources of libraries andother cultural institutions for gender awarenesscampaigns. As a result of improving the nationalstatistics system by expanding the list of gendersensitiveindicators, the base of scientific and expertresearch in the field of ensuring equal rightsand opportunities for women and men will bestrengthened. It will also lead to more efficientmonitoring and assessment of progress on genderdevelopment. 62MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

GOAL 4:REDUCECHILD MORTALITYThis subchapter provides an analysis of challengesand tasks of the national health caresystem in the attempt to reduce child mortality.Protection of child health is an integral part ofthe health care system, whose achievementsgreatly influence the prospects of the furtherdevelopment of society. Indicators of child andmaternal mortality have socio-political importanceand reflect not only the quality and levelof health care for children and mothers but alsothe development of the health care system andsociety in general.І. Targets and IndicatorsTargetsTarget 4. A: Decrease themortality rate among childrenup to 5 years of age byone-fourthIndicators4.1. Mortality rate amongchildren of up to 5 years ofage, number of children ofcorresponding age who diedper 1,000 live births4.2. Infant mortality rate,number of infants up toone year of age who diedper 1,000 live birthsCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 63

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2011 2013 2015Indicator 4.1.Mortality rate among children up to 5 years of age, number of children of corresponding age who died per 1,000 live births16.0 14.4 13.6 12.9 12.4 12.9 12.4 13.6 12.2 11.3 11.2 11.1 11.0Indicator 4.2.Infant mortality rate, number of infants up to one year of age who died per 1,000 live births11.9 11.3 10.3 9.6 9.5 10.0 9.8 11.0 10.0 9.4 9.5 9.4 9.3The table presents actual data by 2009 inclusive and forecast calculated values of indicators for 2010–2015.Several changes were introduced into the valuesof the expected indicators, to represent progress interms of their achievement observed through monitoring.More ambitious benchmarks for 2015 weresuggested, based on analysis of the positive changesthat occurred during 2001–2009 and taking intoaccount available capacity. Monitoring data fromother global indicators of progress towards theachievement of the MDGs in Ukraine shows that, today,the situation in this area can be deemed satisfactory.For example, measles vaccination coverageof children of up to one year of age during recentyears has remained at over 90 percent (in 2008 itwas 94.3 percent). The vast majority (99 percent) ofdeliveries take place in health care institutions withqualified staff (over 90 percent of which are with theassistance of a doctor).The mortality indicator of children up to one yearof age is an indicator of the quality of life of thepopulation, reflecting welfare level and distributionof social and material benefits in society, en-Figure 10. Infant Mortality in Ukraine,Indicator per 1,000 of Life Births, 1990–2008II. Situation AnalysisAccording to the Laws of Ukraine on FundamentalPrinciples of Legislation on Health Care andon Protection of Childhood, the state guaranteeseach child the right to health care, through free ofcharge qualified medical assistance in state andcommunal health care institutions. Under theselaws, the state should also ensure living conditionssuitable for each child’s healthy developmentand adequate nutrition as well as the formationof a healthy lifestyle.A decrease in infant mortality was observedin 1995–2009 (except for in 2005 and 2007):from 14.7 per 1,000 live births in 1995 to 9.4 per1,000 live births in 2009 (Figure 10). The increasein the indicator value to 11 percent for 2007 wasexpected, since Ukraine started to apply newstandards for assessing the criteria for the perinatalperiod and live and stillbirths on 1 January2007. The infant mortality indicator decreasedin 2008, and in 2009 it amounted to 9.4 percent.0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0Source: State Statistics Committee of Ukraine.64MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

vironmental situation, level of education and culture,effectiveness of prevention measures, levelof availability and quality of health care, etc. Infantmortality is a key indicator not just of the healthand survival of children but also of efficiency andfairness in state service provision.Today, more than half of infant deaths are causedby specific conditions emerging during perinatallife. When adding these causes of death to overallcongenital development defects, the sharebecomes three-fourths of the overall number ofdeaths of children of up to one year of age.In 2007, Ukraine established an international-levelsystem of accounting and statistics for the identificationof criteria on perinatal life, live births andstillbirths, as well as procedures for the registrationof live births and stillbirths. 17 Taking into accountthis reform, aimed at improving health careprovision to pre-term children with extremelylow body mass at birth, the Ministry of Health ofUkraine developed and approved the appropriatemedical examination protocol.Box 9. Two-thirds of deaths from trauma (and mostnon-fatal trauma) in the European region couldbe prevented. It has been assessed that €1 spenton prevention ensures savings, particularly on:smoke-sensitive alarms – €69, child safety seats –€32, patronage visits and education of parentson child abuse – €19 (Source: Sethi D. Injuries andViolence in Europe. Why They Matter and What CanBe Done? Copenhagen: WHO, 2006. – 23 p).At the global level, reasons such as drowning,car accidents and burns occupy 8th, 9thand 11th places, respectively, and are amongthe major causes of death of children agedone to five; 95 percent of child deaths fromnon-deliberate trauma occur in low- andmiddle-income countries (Source: World HealthOrganization. World Report on Child InjuryPrevention. Geneva: WHO, 2008. – 39 p.)Infant mortality is a determining factor in Ukrainein the death rate of children of up to five years ofage. The probability of dying decreases sharplywhen a child reaches one year of age. The majorreason for differences between Ukraine and de-17 Adoption of Amendments to Article 281 of the Civil Codeof Ukraine and to the respective Decree of the Cabinet ofMinisters of Ukraine No. 144 of 15 February 2006 on itsimplementation.veloped European countries with respect to mortalityof children of up to five years of age owes toexternal reasons, i.e. those that can be prevented.According to State Statistics Committee data, almostevery third child out of overall child deathsin 2009 died as a result of trauma, poisoning orother external factors (270 out of 888 deaths ofchildren of up to five years of age). The absolutemajority of these deaths could be avoided withthe appropriate childcare.Breastfeeding helps decrease child morbidity andchild mortality and improves the mother’s health.In addition to positive results in terms of preventingpost-delivery complications, breastfeedingdecreases the risk of a woman getting breast cancerand positively influences the normal physical,intellectual, emotional and social development ofa child. The policy of promoting and supportingbreastfeeding is implemented consistently, bothby enhancing the awareness of the populationon the advantages of breastfeeding an infant andby managing respective health care institutions.Today, 245 health care institutions in all oblasts ofUkraine have the status of ‘Child-Friendly Clinic,’whereas in 2001 there were only four such clinics.Almost every second child was born in these clinicsin 2008. The National Action Plan on the Implementationof the United Nations Conventionon the Rights of the Child 18 envisages that no lessthan 90 percent of children will be born in institutionsthat meet the requirements of the status ofChild-Friendly Clinic by 2010.Another intervention that has helped decreasethe number of deaths of children of up to fiveyears of age is improving the efficiency of diagnosticsand treatment of neoformations. An increasein the number of lives saved of childrenwith cancer pathologies is expected as a result ofintroducing modern methods of diagnostics andtreatment, as well as improving the provision ofcancer (haematology) departments with equipmentduring implementation of the State Programmeon Child Oncology. 1918 Parliament of Ukraine. Law on the State Programme onNational Action Plan on Realization of the United NationsConvention of Rights of the Child by 2016, 5 March 2009.No. 1065-VI.19 Cabinet of Ministers of Ukraine. Resolution on Approvalof the State Programme on Child Oncology for 2006–2010, 19 July 2006. No. 983.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 65

A positive shift towards an decrease in child mortalitybecame possible as a result of measuresin the field of mother and child health care, particularly:introduction of contemporary perinataltechnologies; implementation of a clinical protocolof health care provision to mothers and children,developed on the basis of evidence-basedmedicine; opening of the Academic and ResearchMedical Centre of Child Cardiology and Cardiosurgery;etc. Approval of the State Programme onthe National Action Plan on the Implementationof the United Nations Convention on the Rights ofthe Child by 2016 was another step forward.Solving problems related to children’s health conditionsand prevention of diseases remains oneof the priorities for Ukraine. In order to improvehealth care services in GEIs and to engage parentsin the process of ensuring children’s health,the Ministry of Health of Ukraine developed anOrder on the Improvement of Health Servicesfor Students at General Educational Institutions.The main distinctive feature of the new proceduresfor the provision of health care services isthe need to carry out annual preventive examinationsof school-age children at a health care facilityat their place of residence, with the mandatorypresence of their parents. The examinations areheld at a time convenient for both parents andchildren, throughout the calendar year. In 2009,mandatory medical preventive examinations ofstudents at GEIs were conducted in accordancewith the Comprehensive Plan of Action for theDevelopment of Education in Ukraine for the Perioduntil 2011. Based on the results of the mandatorypreventive examination, students weredivided into groups for physical education classes:62.2 percent were included in the main physicaleducation group; 25.9 percent the basic group;and 11.5 percent in the special group; 0.4 percentof children were exempt from physical exertion inphysical education classes.The share of adolescents (15–17 years of age) inthe child population amounts to 20.8 percent.Health status, development and comprehensiveupbringing of adolescents are top priorities. Medicaland pharmaceutical HEIs of the I–IV accreditationlevels, postgraduate educational facilities,research institutions and health care facilities implementthe Action Plan for Implementation ofthe Educational Work Programme for 2008–2010.An important component in this plan is the creationof conditions to develop a sense of responsibilityfor one’s own health and an awareness ofthe need to choose a healthy lifestyle. In manyoblasts, ‘Youth-Friendly Clinics’ (centres, departments,consulting offices for health care and socialsupport to children and youth) operate, providinghealth care services to children and youngpeople using the friendly approach principles, asrecommended by the World Health Organization(WHO). A total of 73 of these clinics have beenestablished in Ukraine. The work in such institutionsis conducted by medical specialists in activesocial partnership with workers of social servicescentres for families, children and youth, and incollaboration with teachers at GEIs. Clinic activitiesare aimed at: preservation of mental health,specifically in difficult life circumstances; preventionof risky behaviour and mitigation of its negativeeffects; prevention of sexually transmitteddiseases, including HIV/AIDS; preservation of reproductivehealth and preparation for informedparenthood; and development of responsiblebehaviour in children with respect to gender andinterpersonal relationships and healthy behaviouralpatterns, among others.ІІІ. ChallengesChallenges to achieving Goal 4 include generalones related to the crisis in the health care systemin Ukraine and the complicated socio-economicsituation, which influence public health and functioningof this sphere, and within this mother andchild health care. This concerns, above all, lack ofstate social standards in health care, focus of thehealth care system on illness and not on healthand slow development of a healthy lifestylefoundation within society, etc. There is a lack ofparental awareness of the need to build healthylifestyle skills and self-preserving behaviour withtheir children, as well as to organize adequate nutritionand care for them.Specific challenges related to maternity andchildhood care services should be noted, particularly:insufficient number of primary care doctors;disproportion between primary, secondary andtertiary health care to mothers and children; irrationaluse of the hospital bed fund; and lack of pri-66MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

oritization of financing for all levels of the nationalmaternity and childhood care programmes. Mostof these challenges are more critical in rural areas.The lower availability of primary health care andsanitary and specialized medical assistance forchildren living in rural areas should be noted.Problems include lack of timely transportation ofpatients to health care institutions and difficultyfor patients in reaching emergency medical care,as well as a lack of the necessary specialists.Social influences, such as family instability andhaving one or both parents addicted to alcoholor drugs, lead to inappropriate childcare and increasednumbers of orphans and children withoutparental care. All of these issues raise the riskof child deaths caused by external reasons, includingviolent death, the spread of early, unsafesexual relations and sexually transmitted diseases,above all HIV/AIDS.IV. Moving ForwardHealthy lifestyles should be promoted in Ukrainiansociety by informing and educating thepopulation on mother and child health care. Informationshould relate to responsible sexualbehaviour, prevention of unwanted pregnancy,childcare issues and prevention of trauma, andgenerally should deal with ensuring responsibleparenthood. A real (not just declared) commitmentto prioritizing prevention within the nationalhealth care system will serve this purpose.Improvements in mother and child health carewill require increasing the quality of this care; furtherdissemination of contemporary perinatal andreproductive technologies; and the practice ofscientifically grounded standards and protocolsof treatment aimed at preventing losses of childlives that could be avoided or prevented throughthe development of medical science and practice.The system of obligatory medical examinations ofchildren requires significant improvement.It is essential to ensure the application of a single,unified technology of health care provisionto pre-term babies with extremely low weight atbirth, aiming at decreasing perinatal losses.A decrease in the number of children’s lives lostas a result of unnatural causes will facilitate thespread of knowledge among the population,above all parents of minors, on first aid healthcare provision in the case of trauma and accidents.It will also strengthen state control of livingconditions and childcare in the family.Achievements have been made in terms of preventionof mother-to-child HIV transmission, bymaintaining and increasing levels of coverage ofvoluntary HIV testing among pregnant womenand coverage of preventive antiretroviral treatmentto HIV-infected women.A change in approach is necessary: traditionalways of developing a healthy lifestyle should berevised and authorities and society should join effortsto promote this. The development of responsiblebehaviour among children and youth needsaddressing, particularly in terms of personal securityand health, including issues of sexual andinterpersonal relationships. In addition, healthylifestyle models should be created, which coverthe physical, psychological, social and spiritual dimensionsof life (prevention or cessation of badhabits, increased physical activity, consumptionof quality food and drinking water, etc). Specialattention should be paid to recognize the harmfrom smoking tobacco and alcohol and drugabuse, among others, to ensure that more healthychildren are born in the future.The network of Youth-Friendly Clinics, which providehealth care and social assistance to childrenand youth based on a friendly approach, shouldbe expanded. The principles of an inter-sectoralapproach to solving child health care problemsshould be followed. CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 67

GOAL 5:IMPROVEMATERNAL HEALTHThis subchapter covers issues related to improvementsin maternal health, which is an importanttask not only for today but also for thefuture development of Ukraine in general. Maternalhealth is one of the highest values in a society,as it lays the foundations for the economicand spiritual development of the country andimprovements in the demographic situation.Maternal health is one of the decisive factors indetermining the health of new generations, andthe health of children determines future labourand the intellectual potential of the country.І. Targets and IndicatorsTargetsTarget 5.A: Halve the maternalmortality rateIndicators5.1. Maternal mortality rate,number of maternal deathsper 100,000 live births5.2. Abortion level, number ofabortions per 1,000 womenof fertile age68MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2011 2013 2015Indicator 5.1.Maternal mortality rate, number of maternal deaths per 100,000 live births24.7 23.9 21.7 17.4 13.1*17.6 15.2 20.7 15.5 25.8 14.5 14.0 13.0Indicator 5.2.Abortion level, number of abortions per 1,000 women of fertile age32.1 29.4 25.8 25.3 23.2 21.3 18.7 18.5 17.95 17.9 17.5 16.4 15.1*Ukraine transferred to mortality coding according to the International Statistical Classification of Diseases, TenthRevision, in 2005. The indicators calculated before and after this transfer are not comparable, and therefore Indicator 5.1.is presented by two dynamic series.The table presents actual data by 2009 inclusive and forecast calculated values of indicators for 2010–2015.Considering positive trends during 2001–2008 towards achieving this Goal, and taking intoaccount forecast socio-economic developmenttrends, it was suggested to generate more ambitiousresults for 2015 than were put in place at thebeginning of the millennium.Trends on other global indicators in relation toachieving this Goal in Ukraine are fully satisfactory.Almost all deliveries in the country (99 percent)occur in health care institutions withqualified staff. Contraception has also spread:according to data from the Medical and DemographicSurvey of the Ukrainian Populationof 2007, two thirds (67 percent) of married womenuse contraception. Compared with the samesurvey in 1999, the level of coverage of contraceptionhas remained almost unchanged, but apositive trend has occurred – there is increasedusage of contemporary methods rather than traditionalones. A relatively low birth rate amongteenagers is observed, at around two casesper 10,000 girls of up to 14 years of age inclusively,and slightly more than 13 cases per 1,000 ofgirls of 15–17 years of age inclusively. Almost allmothers are provided with pre-delivery care byqualified medical workers, with an insignificantdifference observed between urban and ruralareas.II. Situation AnalysisA decrease in the maternal mortality level has beenobserved in Ukraine, from 24.7 per 100,000 livebirths in 2000 to 15.5 per 100,000 live births in 2008.However, a comparison of values on the indicatorthroughout 2000–2008 is impossible, sincefrom 2005 Ukraine has been coding mortality dataaccording to the International Statistical Classificationof Diseases, Tenth Revision. Indicators calculatedbefore and after this are not comparable. In general,by assessing monitoring data, conclusions canbe made on progress towards this Goal.Box 10. In the past, programmes and actionson reproductive health care and familyplanning focused mainly on the woman andher childbearing functions. Modern Ukrainianpolicy in this area focuses efforts on all familymembers (including children and men). The StateProgramme on Reproductive Health of the Nationby 2015 covers issues of promoting and protectingreproductive health during the entire lifetime.Improvement of the family planning system, andas a result, preservation of the reproductive healthof the whole population, is equally important. Theprogramme is targeted at improving reproductivehealth as a result of improvements in the qualityand availability of medical assistance and thepromotion of healthy lifestyles, responsiblepaternity and safe maternity. The introduction ofscientifically grounded standards and protocolsof treatment and contemporary perinataltechnologies into activities of health careinstitutions continues.Among all deaths of women during pregnancy,delivery or the post-natal period in 2005–2008,an average of two thirds were related to obstetricreasons (Table 8).Each maternal death is carefully studied and analysed.Continuous monitoring of death cases ofwomen during pregnancy, delivery or the post-natalCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 69

Table 8. Maternity Mortality in Ukraine, 2005–2009Maternity mortalityDeaths resulting from directobstetric causesDeaths resulting from indirectobstetric causesper 100,000 live births2005 17.6 12.2 5.42006 15.2 9.6 5.62007 20.7 11.4 9.32008 15.5 9.6 5.92009 25.8 9.4 16.4Source: State Statistics Committee of Ukraine.period and review of the data are regulated at stateand regional levels. 20 The main task of the ExpertCommissions of the Ministry of Health of Ukraineand regional health care authorities is not only to reviewthe reasons underlying maternal mortality butalso, above all, to professionally assess the quality oforganisational and treatment measures of the relevanthealth care authorities to improve future workand prevent further maternal losses.As a result of the implementation of family planningand reproductive healthcare programmes,the number of cases of maternal deaths relatedto abortions has decreased. In 2000, 17 womendied after abortion, whereas only seven diedin 2008 (all abortions were done outside of healthcare institutions or were unspecified).Almost all women are registered in a dispensaryfrom the first trimester (up to 12 weeks). In 2008,the level of coverage was 90 percent of pregnantwomen. However, the unsatisfactory health conditionof pregnant women in Ukraine is cause forconcern. For every 100 women under observationin women’s counselling centres of the Ministry ofHealth of Ukraine during their pregnancy, anaemiais recorded for 27 women, illnesses of the urogenitalsystem for 15 women, problems of bloodcirculation for 6 women and dysfunctions of thyroidgland for 10 women. 21 Anaemia is common –20 Ministry of Health of Ukraine. Order on Approval ofMethodological Guidelines on Encoding of Morbidity andMortality according to the International StatisticalClassification of Diseases and Related Health Problems, TenthRevision. Kyiv: Ministry of Health of Ukraine, 29 August 2008.No. 503.21 .Ministry of Health of Ukraine. Obstetric and GynecologicalAssistance in Ukraine: Statistical and Analytical Handbookin 2006–2008. Kyiv: Ministry of Health of Ukraine,Centre for Medical Statistics of the Ministry of Health ofUkraine, 2009. – 238 p.present in every third pregnant woman – since itsignificantly depends on quality and adequacyof nutrition (which depends, above all, on families’socio-economic situation and on nutritionawareness both in general and during pregnancy).Compared with in 2001, presence of anaemiadecreased by almost one third and of urogenitalillnesses by 10 percent. Problems with women’shealth (somatic and reproductive) hinder reproductivefamily planning. In particular, during nationalsocio-demographic studies, 16.9 percent ofwomen interviewed listed problems with healthas the main barrier to bearing the desired numberof children. 22Box 11. According to interviews with pregnantwomen in Ukraine, 40 percent smoked prior topregnancy, almost 5 percent continued smokingduring their pregnancy, 57 percent of respondentsconfirmed that the future father of their childsmoked and 23 percent confirmed that otherfamily members smoked. (Source: T. Andreeva,E. Gilpin, T. Salyuk, K. Krasovsky and A. Dovbakh.Smoking and Its Consequences for Pregnant Womenin Ukraine. Washington: World Bank, 2005).Further improvements in maternal health are impossiblewithout a responsible attitude towardsmaternity. Since a number of problems for bothwomen and their children are caused by behaviouralfactors, this refers above all to futuremothers. Today, consumption of alcoholic drinks,especially beer and low-alcohol beverages, iswidespread in Ukraine. Tobacco smoking is alsothe most widespread among women of activechild-bearing age. In particular, according to datafrom household interviews conducted by the22 Institute for Demography and Social Studies, UkrainianCentre of Social Reforms. Marriage, Family, and Child BearingAttitudes in Ukraine. Kyiv: ADEF, 2008. – 256 p.70MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

State Statistics Committee, every ninth womanaged 18–29 stated that she smoked.In general, the awareness level on smoking-relatedhealth problems, including reproductivehealth, is extremely low in Ukraine.Figure 11. Number of Abortions per 100 LiveBirths in Ukraine, 1997–2008yearsBox 12. Approximately one third (28 percent)of Ukrainians aged 15–29 interviewed knewthat smoking was harmful to the unbornchild and were aware of the dangers of passivesmoking (Source: T. Andreeva. Tobacco in Ukraine:National Survey of Knowledge, Attitude, andBehaviour. Kyiv: International Centre for PerspectiveResearch, 2005).The decrease in the number of complicated deliveries(from 68 percent in 2000 to 40 percentin 2008) is positive, as is the increase in the shareof normal deliveries, during which the risk tothe mother’s and the newborn’s life and healthis the lowest. The share of normal deliveriesreached 60 percent in 2008. This is also promotedby the practice of deliveries by partners, whichtoday is at almost 50 percent. The National ActionPlan on Implementation of the United NationsConvention on the Rights of the Child 23 setsa goal to increase the share of normal deliveriesto 70 percent by 2010 by establishing contemporaryperinatal technologies. Decrease in use ofmedication in deliveries, encouragement of familymembers and partners to participate, thermalshields for newborns, post-natal breastfeedingand promotion of breastfeeding in general have apositive influence in relation to the prevention ofdeaths of mothers and newborns.The abortion level decreased from 32.1 per1,000 women of fertile age in 2000 to 18.1 in 2008.A favourable trend has been observed in terms ofboth the number of abortions and the ratio of deliveriesto abortions (Figure 11).From 2001, the number of deliveries has exceededthat of abortions. This has been promoted byan improvement in reproductive health care servicesand in educational and preventive work withfuture parents, as well as awareness raising oncontraception measures and their availability.23 Parliament of Ukraine. Law on the State Programme onNational Action Plan on Realization of the United NationsConvention of Rights of the Child by 2016, 5 March 2009.No. 1065-VI.Source: Centre of Medical Statistics of the Ministry of Healthof Ukraine.Nevertheless, the level of abortions is higher thanin developed countries and abortion’s economicand social burden remains significant, and thereforeit represents an extremely important healthcare and social problem in the country. Indeed,abortion is the main reason for problems in reproductivehealth. Artificial termination of pregnancyis a family planning method for a significant shareof Ukrainian women. The first pregnancy oftenends with abortion (12.7 percent, or 27,600 pregnancycases in 2008). Still, society does not fullyrealize that abortion of the first abortion pregnancysignificantly decreases a woman’s chancesof becoming a mother in the future, as well as increasingthe probability of her suffering differenthealth problems throughout her life, includingpsychological problems.Prevention of unwanted pregnancies remains themost important objective of the state strategy topreserve women’s health. One of its methods is todisseminate contemporary contraceptive meth-CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 71

ods. In particular, in 2008, the level of contraceptionas an alternative to unwanted pregnancy increasedand reached 308.4 per 1,000 women offertile age.Reasons for the high numbers of abortions havebeen the subject of thorough study by expertsand civil society, assessing: community knowledge;behaviour and attitude of specialists, patientsand society towards the issues; and qualityof the main service provision in this field. 24It should be stressed that, although a significantshare of the population can afford oral contraceptivesat the middle price range, there is a sharethat needs free procurement.It is important that the development of jointmeasures to overcome high level of abortion bebroadly discussed, and not limited to medical aspects.The position of the Government is for thepromotion of wide cooperation among representativesof health care, education, different religionsand civil society organisations in the fieldof abortion, but not its prohibition. Responsiblebehaviour, which is the most effective method ofpreventing abortion and sexually transmitted diseases,is supported through promoting: a healthylifestyle; spiritual, ethical and cultural values; andforegoing an early sex life and pre- and extramaritalsexual relations. Despite the current diversityof ideas and positions concerning the artificialtermination of pregnancy, there is an unanimousvision in the country as to the value of new humanlife and perceptions of civil and personal responsibilityto preserve this.Positive changes in terms of preserving the healthof mothers and decreasing infant mortality becamepossible as a result of measures in motherand child health care, in particular: the introductionof contemporary perinatal technologies; clinicalprotocols of health care provision to mothersand children, developed on the basis of evidencebasedmedicine; the introduction of measures ofthe State Programme on Reproductive Health ofNation by 2015 and the sectoral Programme onSupport of Breast Feeding in Ukraine for 2006–2010; and the opening of the Academic and Re-24 Ministry of Health of Ukraine. Abortions and Contraceptionin Ukraine. Strategic Assessment of Policy, Programmes, andStudies. Kyiv: Ministry of Health of Ukraine, 2008. – 88 p.search Medical Centre of Child Cardiology andCardiosurgery.Schools of Responsible Parenthood operate efficientlyin Ukraine. Future mothers and fathersare being prepared to deliver healthy childrenand to nurse newborns. More and more futuremothers and fathers are becoming students ofthese schools, which have led to an increase inthe number of normal deliveries and deliveriesby partners and improvements on indicators relatedto breastfeeding and child development inthe first year of life. Special attention is given tothe father’s assistance during childbearing anddelivery.In Ukraine, inequality of access to quality, timelyhealth care for mothers and children is relatednot only to income level, place of residence orshortcomings in the organisation and provisionof medical assistance, but also to behaviouralfactors. Even though there are some problemsin rural areas related to the remoteness of healthcare institutions, lack of specialists or an inabilityof poor citizens to pay for necessary medicineor services, maternity and childhood protectionservices, including reproductive health care andfamily planning, are generally far-reaching andprovide citizens with a sufficient level of access.The biggest problems and threats to the lives andhealth of mothers and children appear among socialrisk groups, especially when there are precipitatingcauses: risky sexual behaviour; numerousabortions; women not breastfeeding; irresponsibleattitude towards timely monitoring and treatmentof reproductive illnesses; spread of substanceabuse; and inappropriate child nursing.The socio-economic situation in the country isan important determinant of public health, includingreproductive health. The most importantway the global economic crisis has affected theachievement of this Goal is through the budgetdeficit. The state’s decreased ability to ensure financingof social programmes and actions suchas those on maternity and childhood protection,despite their prioritization, can negatively influencethe implementation of the planned measures.The depreciation of the hryvnia and a decreasein the real value of allocated funds haveled to a situation whereby certain purchasedmedicines, equipment and services will gradually72MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

decrease as their price increases. Increases in thenumber of the unemployed or partially employedfacilitate the spread of poverty, declines in nutrition(which can influence the health of pregnantwomen and those practising breastfeeding), anincrease in the number of risk groups and thepromotion of less-than-healthy lifestyles or riskyforms of behaviour. Furthermore, a worsening ofthe sanitary and epidemiologic situation is possible.In particular, heating problems or electricshutdowns in health care facilities may representa hazard to life and health, particularly of mothersand children. Overall, all of this is related to a lackof correspondence of state financing with socialneeds and decreases the access of the populationto prevention services and treatment.ІІІ. ChallengesA range of problems related to the crisis of healthcare system operations and to the economic crisis,which coincided with complex transformationprocesses in modern Ukraine, impede theachievement of Goal 5. All of these problems directlyinfluence community health in general andmaternal health in particular. Lack of integratedapproaches to reforming the health care system,slow introduction of healthy lifestyle principles insociety, insufficient impacts of information andeducational programmes, popularity of tobaccosmoking, consumption of alcohol and drugs andthe spread of risky sexual behaviour, especiallyamong youth, exacerbate the situation.Issues include the spread of sexually transmitteddiseases related to the sexual revolution, adecrease in the living standards of some groupsof the population, unemployment, increases inpopulation mobility and intense migration withinthe country and abroad. The morbidity level andthe contribution of infections to the deteriorationof mothers’ reproductive health are much higherin Ukraine than in developed European countries.There are some specific problems related to theorganisation of maternity and childhood protectionservices: an insufficient number of doctorsfor primary health care, especially in rural areas;inefficient and disproportionately higher financingof higher levels of health care provision formothers and children; non-adherence to the principleof prioritizing the implementation of the nationalmaternity and childhood protection programmes;contraception services and abortionsin Ukraine that are not in line with WHO standards;inadequate quality control of health care(in both state and private institutions); and lowawareness levels (of both patients and medics) oncontemporary contraception methods. As withGoal 4, the acuteness of the listed problems ismuch higher in rural areas.Furthermore, other social problems include: insufficientpreparation of youth for responsibleparenthood; lack of an adequate number of specialiststrained to work with children and youthon the issues of responsible parenting as a methodof early prevention of social orphanhood; significantnumbers of marginalized families; andinadequacy of the interdepartmental approachto health care and social support to vulnerablefamilies.ІV. Moving ForwardThe basis for healthy lifestyle behaviour in societyin general should be established through informationaland educational campaigns among the population.This should focus on problems and ways topreserve the health of mothers and children. Necessaryconditions for success here include the activeinter-sectoral cooperation of medical and educationalworkers and representatives of the massmedia and civil society organisations.Introduction of the ‘ABC strategy’ (‘abstinence,’i.e. beginning sexual life at an older age, ‘be faithful’– loyalty in relationships – and ‘condom use’),which is now quite popular among youth, couldbecome an effective measure.Improvement of mother and child protection requiresenhancement of the quality of their medicalassistance, further promotion of contemporaryperinatal and reproductive technologies andimplementation of scientifically grounded treatmentstandards and protocols. Significant effortsare needed to counteract the high level of abortions,including dissemination of contemporarymethods of preventing unwanted pregnancy. Asingle unified technology for providing healthCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 73

care to pre-term children with extremely lowweight at birth should be ensured, aiming at decreasingperinatal losses.Special attention should be paid to issues of reproductivehealth among children and youth,preparing future parents for pregnancy and childbirth.In particular, this concerns the fostering ofresponsible paternity foundations, avoiding badhabits in the period before and during pregnancy,improving future mothers’ health, understandingthe need for medical examination before planningon pregnancy and medical observationduring pregnancy. Special attention is needed toensure adequate, complete and balanced nutrition,by providing adequate energy and nutrientintake and composition of micro-elements andvitamins during pregnancy and breastfeeding.It is important to improve access to reproductivehealth care and family planning services and tocontemporary contraception methods, to ensurewomen’s equal and sustainable access (independentlyof their place of residence and social status)to quality medical assistance during pregnancyand delivery and to create the conditions for safematernity.The awareness level of the population (bothwomen and men) needs to be raised concerningsafe and efficient methods and means of familyplanning and the potential consequences of sexuallytransmitted diseases and ways to preventinfection.To reduce the negative impact of social factors,a primary focus should be on: issues of mothersand children from vulnerable families; continuedenhancement of the network of mother andchild social centres; provision of social support toyoung families; and improvements in the familyplanning system and specialists’ training on responsibleparenthood. The mass media and civilsociety must be involved in preventing social orphanhood,which contributes towards worseninga child’s health and also generating future problemsfor the child as an adult.Application of these measures will make it possibleto address issues of reproductive health,strengthen health care of mothers and childrenand, in general, improve the demographic situationin Ukraine. 74MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

GOAL 6:REDUCE AND SLOW DOWNTHE SPREAD OF HIV/AIDSAND TUBERCULOSISAND INITIATE a TRENDto DECREASETHEIR SCALESThis subchapter covers issues concerning thespread of HIV infection/AIDS and tuberculosis.The HIV/AIDS epidemic in Ukraine remainscritical. Lessons learned in other countries showthat the spread of HIV/AIDS and tuberculosiscauses a decrease in the average life expectancy,an increase in the need for health care anda deepening of poverty, social inequality andorphanhood.І. Targets and IndicatorsTargetsTarget 6.A: DecreaseHIV prevalence rates by 13%Target 6.B: Decrease tuberculosismorbidity level by 20%(compared with 2005)Indicators6.1. Number of peoplenewly diagnosed withHIV per 100,000 population6.2. HIV prevalence rate, %6.3. Number of peoplewho died fromAIDS, per 100,000 population6.4. Level of mother-to-childtransmission of HIV, %6.5. Number of peoplediagnosed with tuberculosisfor the first time (includingtuberculosis of respiratory organs)per 100,000 population6.6. Number of tuberculosisdeathsper 100,000 populationCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 75

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2011 2013 2015Indicator 6.1.Number of people newly diagnosed with HIV per 100,000 population12.9 14.4 18.2 21.0 25.7 29.3 34.5 38.1 41.2 43.2 45.2 47.2 49.1Indicator 6.2.HIV prevalence rate, %- +11.6 +26.4 +15.4 +22.4 +14.0 +17.7 +10.4 +8.1 +4.9 +4.7 +4.5 +4.0Indicator 6.3.Number of people who have died from AIDS per 100,000 population1.0 1.5 2.3 3.8 5.5 7.7 8.8 9.8 11.2 11.7 9.0 8.5 8.0Indicator 6.4.Level of mother-to-child transmission of HIV, %- 27.8 10.0 10.0 8.2 7.7 7.1 6.2 5.4 4.6 3.0 2.0 2.0Indicator 6.5.Number of people diagnosed with tuberculosis for the first time (including tuberculosis of respiratory organs)per 100,000 population60.4 69.5 76.0 77.8 81.2 84.4 83.4 80.1 78.0 72.7 70.7 68.5 67.5Indicator 6.6.Number of tuberculosis deaths per 100,000 population22.3 22.7 20.5 21.8 22.7 25.3 22.3 22.6 22.4 18.2 18.0 17.0 15.0The table presents actual data as of 1 January 2009, preliminary data for 2009 (except for Indicator 6.4,for which the expected data are presented for 2008–2009) and forecast calculated values of indicators for 2010–2015.The indicators for Goal 6 together with the NationalIndicators for Monitoring and Evaluation ofthe Efficiency of Measures to Ensure HIV/AIDS EpidemicControl (Box 18) are the key indicators fordefining trends and developing the national responseto the epidemic. To estimate HIV and AIDSindicators, the methodology of the new HIV/AIDSepidemic modelling for countries with a concentratedepidemic was used. This methodologyconsists of the Estimation and Projection Package,Beta version U and the updated version ofSpectrum software (version 3.40) to perform accurateestimations of the HIV/AIDS epidemic andthe need for antiretroviral therapy. The UkrainianCentre for AIDS Prevention conducted a new seriesof sentinel epidemiological and behaviouralstudies among injecting drug users (IDUs), menwho have sex with men (MSM) and commercialsex workers (CSW) in cooperation with the InternationalHIV/AIDS Alliance in Ukraine in 2008. Theresults of these studies, together with data fromsimilar studies on HIV prevalence obtained in previousyears, were used to develop new estimatesof the number of people living with HIV and alsothe number of people who need antiretroviraltreatment.A series of stakeholder meetings was organizedin 2009, in which the new national estimates ofHIV in Ukraine as of the end of 2008 were presentedand discussed. In particular, these data werediscussed during workshops with chief doctors ofthe Oblast Centres for AIDS Prevention and meetingsof the Working Groups of the Ministry ofHealth of Ukraine on issues of HIV/AIDS treatmentand monitoring and evaluation, of the United NationsHIV/AIDS Thematic Group and of the NationalCouncil on Tuberculosis and HIV/AIDS. Theresults were provided to the United Nations JointProgramme on HIV/AIDS (UNAIDS) Secretariat, theWHO and the UNAIDS/WHO Working Group onGlobal HIV/AIDS and Sexually Transmitted Infec-Box 13. Indicator 6.3. The number of HIV-relateddeaths per 100,000 populationThe HIV-related mortality indicator (the numberof HIV-related deaths per 100,000 population) isone of the major indicators depicting both theepidemiology of the HIV infection and the effectsof introducing large-scale antiretroviral therapyin Ukraine. Deaths in Ukraine are registered bythe entities of civil status registration (CSR). Deathis registered on the basis of a medical deathcertificate (form # 106/o), a medical assistant’scertificate of death (form # 106–1/0), a medicalperinatal death certificate (form # 106–2/0) or acourt ruling, etc. One copy of a death statement,together with a medical death certificate (or otherdocument), is sent by the CSR body to the officethat carries out statistical processing.76MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Since 2005, processing of causes of death hasbeen carried out according to the InternationalStatistical Classification of Diseases and RelatedHealth Problems, Tenth Revision. Statisticsreporting on AIDS-caused deaths prepared by theUkrainian Centre for AIDS Prevention is based ondata on fatalities of those who were in dispensarycare at Regional Centres for AIDS Prevention.Statistical data of the State Statistics Committeeexceed data on similar AIDS mortalityindicators prepared by the Ukrainian Centrefor AIDS Prevention by almost two times. Thisdifference in reporting is explained by theincomplete registration of HIV-infected individualsat Regional Centres for AIDS Prevention, i.e. someHIV-positive persons are under the care of medicalstaff of other services (tuberculosis, narcological,infections, etc). Deaths of such patients are notregistered by Regional Centres for AIDS Prevention.To rectify the situation, it would be reasonablefor Regional Centres for AIDS Prevention toregularly review, together with oblast statisticaldepartments, each AIDS-related death.tions (STI) Surveillance for their review and consideration,and were positively received. Evaluationspresented concerning HIV/AIDS in Ukrainewere used during the preparation of the regularNational Report on the Execution of Decisions ofthe Declaration of Commitment of HIV/AIDS.been diagnosed with HIV. A significantly greaternumber of Ukrainians may be infected but unawareof their status. This stresses the need forgeneralized estimated data.Figure 12. Trends in New OfficiallyRegistered HIV Cases among the UkrainianPopulation, 1987–2009years5822696562999992121658497II. Situation AnalysisHIV /AIDS and tuberculosis are among the mostcomplex socio-political and medical problemsglobally.The HIV epidemic. The scale of the HIV epidemiccontinues to grow in Ukraine. From 1987 to 1 January2010, 161,000 cases of HIV infection were registered.The highest number of new HIV infectioncases for the entire period was recorded in 2009–19,840; 31,241 people have been diagnosedwith AIDS since the beginning of the epidemicand 17,791 individuals have died. According tothe State Statistics Committee, 22,824 peopledied in 2005–2009 from diseases caused by HIV.It is widely known that official data do not reflectthe real situation of the HIV epidemic, particularlythe current number of people living with HIV. Thedata provide information only on the number ofpeople who, according to their test results, havenumber on HIV-infected personsAt present, prevention of mother-to-childHIV transmission is one of the most successfulprevention measures in the country. Beginningin 2003, the level of coverage of voluntaryHIV testing among pregnant women has continuouslyexceeded 95 percent. The level of coverageof preventive antiretroviral treatment of womendiagnosed with HIV during their pregnancy increasedfrom 9 percent in 1999 to 92.5 percentin 2007 and 94.9 percent in 2009. This resultedin a significant decrease in the level of motherto-childHIV transmission from 27.8 percentCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 77

Box 14. The estimated prevalence of HIV infectionamong the adult population of Ukraine is one ofthe highest in Europe, at 1.33 percent in 2010,or 360,000 adults aged 15–49. According toUNAIDS and WHO criteria, Ukraine’s HIV epidemicis classified as a concentrated epidemic. Theuse of injection drugs remains one of the maintransmissions channels.Evaluation of the HIV/AIDS Situation inUkraine as of the End of 2008 and ForecastIndicators for 20152010 2013 2015Total number of people 360000 376000 377000living with HIV (adultsfrom 15 years of age)HIV infection prevalence 1,33 1,41 1,43(adults aged 15–49, %)Estimated number of 32000 27000 23000new HIV infectionsEstimated number ofdeaths owing to AIDS21000 22000 22000The HIV prevalence rate is growing among thegeneral population. The number of new HIV infectionsregistered during a calendar year continuesto increase. To successfully respond to HIV andAIDS, in recent years a complex system of healthand social care has been created for those in need.In particular, measures are directed at the sustainableimplementation of antiretroviral and substitutiontherapy, the treatment of tuberculosis and viralhepatitis and care and support for HIV-infectedpatients. An increase in antiretroviral coverage forpeople with HIV and AIDS will lead to increasedprevalence of HIV, since the mortality of people livingwith HIV and receiving treatment will decrease.In 2009, for the first time during epidemiologicalobservations of HIV infection, a decrease was observedin the number of people dying from AIDSrelatedillnesses (among people under dispensaryobservation). However, the expected significant increasein the number of people living with HIV andin need of treatment and support will necessitatean improvement in the strategy to provide treatmentservices, such as decentralized provision ofantiretroviral treatment, rapid scale-up of substitutiontherapy for IDUs as well as effective prevention,diagnostics and treatment of tuberculosis inpeople living with HIV.Figure 13. Dynamics of Mother-to-ChildTransmission of HIV, 2001–2007yearsSource: Developed with the participation of the UkrainianCentre for AIDS Prevention of the Ministry of Health ofUkraine, WHO in Ukraine, International HIV/AIDS Alliancein Ukraine and UNAIDS in Ukraine, 2009.Scaling up antiretroviral therapy will lead toan increase in the survival rate resulting from adecrease in AIDS morbidity and mortality levelsin the future and, accordingly, to an increasein the number of people living with HIV/AIDS. HIV prevalence among adults of 15 years ofage and older will continue to grow, with a forecastdecrease in the number of new HIV infections anda stabilization in the number of people dying as aresult of AIDS.in 2001 (data from baseline study) to 6.2 percentin 2007. However, more efforts are required forlevels to reach the level of the target indicator forEuropean countries: 2 percent.percentage of HIV-infected childrenThe epidemiological dynamics indicate continuousgrowth in the number of HIV-infected womenof reproductive age in Ukraine. This in turn leadsto an increase in the number of children deliveredby mothers living with HIV.In 2008, the share of different transmission channelschanged for the first time since 1995: sexualtransmission exceeded parenteral (or vertical)transmission. The share of people infectedthrough sexual contact increased to 44 percentin 2009. An increase in heterosexual transmissionand in the number of HIV-infected womenof reproductive age caused a gradual increase inthe number of children delivered by HIV-infectedmothers. Prevalence among pregnant women78MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

and blood donors reflects prevalence among thegeneral population in the country. Prevalenceamong pregnant women was 0.33–0.34 percentin the past three years, and among blood donors0.13–0.14 percent. At the same time, on average,HIV prevalence among pregnant womenwas 0.55 percent in the country. An analysis ofthe regional data shows that this indicator fluctuatedgreatly by region in 2009–0.04 percent inZakarpaska, 1.59 percent in Kyivska oblast andover 1 percent in Mykolayivska, Dnipropetrovskaand Kirovogradska oblasts. Such data may indicatea possible generalization of the HIV epidemicin some regions of Ukraine.Figure 14. Number of Registered HIV-InfectedWomen of 15–49 Years of Age and theChildren Born to Them, 1995–2009YearsHIV-infected women of 15-49 years of ageChildren delivered by HIV-infected womenGender aspects. Although insignificant attentionis often paid to gender issues, they play a decisiverole by determining both the biological susceptibilityof a woman to HIV infection and vulnerabilityto its consequences. Since HIV infection is affectinga growing number of women in Ukraine, politicalmeasures and prevention programmes havebecome increasingly focused on eliminating thebasis of gender inequality and enhancing women’sopportunities to improve their health, education,legal protection and economic independence.Other important gender-specific measures includeincreasing understanding and resolving problemsof HIV transmission among sexual minorities, includingMSM. Studies and in-depth interviewswith HIV-positive women suggest the followingthree factors of women’s enhanced vulnerability toHIV: discrimination in the labour market; non-uniformdistribution of family obligations; and violationof their reproductive and sexual rights.With regard to the tuberculosis epidemic inUkraine, considering the social basis of the disease,the country cannot expect its mitigation. The currenttarget ensures the appropriate control of theinfection’s spread, which particularly includes increasedefficiency of tuberculosis treatment and adecrease in the resulting mortality rate.A deterioration of the tuberculosis epidemiologicalsituation began in 1990; 1995 was consideredthe beginning of the full-fledged tuberculosisepidemic. Tuberculosis incidence grewcontinuously from 1995–2005 and increasedfrom 41.8 to 84.4 cases per 100,000 population.At the same time, significant political support forthe control of tuberculosis, and improved efficiencyof resource use, including a significant increasein financing, led to some positive results. In recentyears, a decreasing trend has been observed inrelation to indicators of morbidity and mortalityfrom tuberculosis. Today, however, the tuberculosissituation remains critical in Ukraine: morethan 30,000 new cases are recorded each year. Asignificant portion of the impact is on poor andsocially marginalized populations, whose numbersincreased in Ukraine during the economiccrisis. Unemployed individuals of working agerepresented 53.1 percent of those who becameill with tuberculosis for the first time. 25 The tuber-25 Data of the Centre for Medical Statistics of the MoHfor 2009;Ministry of Health of Ukraine. Tuberculosis inUkraine: Analytical and Statistical Handbook, 1998 – 2008.Kyiv: Ministry of Health of Ukraine, Centre for MedicalStatistics of the Ministry of Health of Ukraine, 2009. – 90 p.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 79

culosis incidence rate increases in penitentiaryinstitutions, which is facilitated by the high concentrationof prisoners in cells and by unsatisfactorynutrition. The highest levels of incidence ofall forms of tuberculosis are in the south-easternregions of Ukraine: Khersonska, Dnipropetrovska,Mykolaivska, Luganska, Donetska oblast and theAutonomous Republic of Crimea.Although some decline in tuberculosis incidencehas been observed in Ukraine during the past fouryears, WHO and the national strategy for overcomingthe tuberculosis epidemic have establishedthat its prevalence and mortality rate mustbe reduced by 50 percent compared with 1990.Box 15. The following forecast indicators of allforms of tuberculosis morbidity and mortalityin Ukraine were obtained through the statisticalextrapolation method:Level of morbidity for alltuberculosis forms(per 100,000population )Number of deaths fromtuberculosis(per 100,000 population)2011 2013 201570,7 68,5 67,518,0 17,0 15,0The mortality rate is one of the major indicatorscharacterizing the epidemiologic situation of tuberculosisduring recent years. Over 10,000 peopledie each year from tuberculosis in Ukraine.This high mortality level is caused by the economicdecline in recent years, which has affectedthe HIV epidemic, and the insufficient availabilityof health care services.Tuberculosis remains the primary cause of deathamong adults from infectious diseases in Ukraine.Tuberculosis strikes above all those who suffermost from poverty and undernutrition and fromgenerally unsatisfactory sanitary conditions. It isalso the main cause of death among people livingwith HIV, owing to their weakened immune systems– a quarter of a million cases of death fromtuberculosis worldwide are related to HIV. The tuberculosisepidemic exacerbates the HIV epidemicand vice versa.III. ChallengesThe worsening situation with respect to HIV andtuberculosis infections has been caused by lowawareness in society and a range of socio-economiccauses: the rate of development of medicaland social care infrastructure has not correspondedto rates of epidemic prevalence, exacerbatedby insufficient financing of measures on preventionand treatment.Some of the changes taking place in the transitionto a market economy have been accompanied bydestructive processes, resulting in a favourableenvironment for the spread of infectious diseasessuch as HIV and tuberculosis.There have been regional disparities in the economicdownturn period and an increase instructural unemployment (explicit and hidden)in Ukraine. The employment crisis has been feltstrongly in oblasts with developed heavy industry.There is a relationship between the morbidityrate and infectious diseases, unemployment levelsand the number of IDUs, as well as betweenenhanced migration, frequent change of sex partnersand the number of sex workers temporarilyor permanently involved in the sex industry. Thisrelationship leads to prevalence in communitiesand regions that are especially vulnerable tothese diseases.With stable trends of new HIV and tuberculosisinfections and low efficiency of countermeasures,the consequences may significantly deepen thealready complex demographic crisis in the nearfuture, leading to a decline in the quality of theproductive forces of society and of other componentsof socio-economic development.HIV epidemic-related challenges. Currently,Ukraine remains in the category of countriesthat have an HIV epidemic concentrated amongsome groups that are at the highest risk of infection(IDUs, CSWs, MSM). According to the sentinelepidemiological survey, HIV prevalence variesamong these population groups but is alarminglyhigh. Data show that the new wave of HIV infectionthrough sexual contact is closely related torisky sexual behaviour of IDUs and their partners.80MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Other population groups that are increasinglyaffected by the epidemic are prisoners and individualsunder investigation. Although prisonersare not isolated as a risk group, there are datashowing high levels of risky behaviour amongthem. Epidemiological monitoring shows theneed to categorize prisoners within the groups atincreased risk of HIV infection, which require additionalattention, resources and support.Prevention among most-at-risk populations.The scale and quality of preventive measuresamong most-at-risk populations and their sexualpartners play a decisive role in identifying the furtherdevelopment of the HIV infection epidemicin Ukraine. Global experience shows that IDUs arethe most vulnerable to HIV, and the spread of theinfection among them is the fastest.According to sociological studies in 2009, thelevel of coverage of prevention programmes ofIDUs (the most at-risk group in the country) wasjust 32 percent. Prisoners are the only risk groupsthat can easily be covered with complex preventionprogrammes. However, according to this2009 data, just 15 percent of prisoners were receivingsome kind of prevention service. To date,most prevention measures among most-at-riskgroups are supported by contributions from externaldonor organisations and implemented bynon-governmental and some religious organisations,with almost no support from the state. Atthe same time, in the past four years, the qualityand intensity of these priority interventions haveimproved, leading to the stabilization of the epidemicamong IDUs and, consequently, a decreasein intensity of new HIV infections in the country.This is shown by a decrease in the growth rateof new HIV infections, by three and a half timesin 2006 compared with 2005 (+16. percent) andin 2009 compared with 2008 (+4.6 percent). Atpresent, a decrease in the rates of HIV infection isbeing observed in Ukraine.However, the scale, quality and intensity of thesemeasures are insufficient to stop the spread ofHIV within these groups and to limit the potentialof HIV spreading to the general population.It should be noted that the current State Programmeon HIV/AIDS does not set any clear prioritiescorresponding to the concentrated epidemicstage in Ukraine, which is moving threateninglyclose to the generalized stage of the epidemic.Prevention among the general population. Althoughawareness of HIV and HIV preventionmeasures among the general population has improvedto some extent during the past severalyears, most of the key general population groups(youth, students) are still not supported by effectivemeasures. The spread of the HIV epidemic inmost countries is mainly through the sexual transmissionof the virus by new generations of youngpeople. Availability of correct knowledge aboutHIV is an important component to decrease riskybehaviours with respect to HIV transmission.At present, students of higher and secondaryvocational educational institutions, the mostsexually active age group, are not covered by anyconsistent HIV prevention measures at the nationallevel. According to data from sociologicalinterviews in 2007 and 2009, 40 percent of youngpeople in Ukraine correctly identified ways of preventingthe sexual transmission of HIV. Because ofa lack of trained teachers, though, there has beenlimited introduction of consistent and comprehensiveHIV awareness programmes in Ukrainianschools. In 2006, only 57 percent of GEIs hadteachers trained to ensure the education of pupilsin accordance with programmes of healthy lifeskills development regarding HIV prevention; thisfigure increased in 2009 to 58.7 percent. Developinghealthy life skills is an important componentof educational activities, helping young peopledeal with the problems and demands of everydaylife. Innovative means of promoting HIV awarenessamong the general population, such as advertisementson the radio and television or integrationof HIV awareness-raising campaigns intohigh-level sports or cultural events, have not yetbeen introduced in the country.Voluntary counselling and testing. Coverageof HIV counselling and testing among grouprepresentatives (IDUs, patients with tuberculosisand STIs and prisoners) is low and inconsistent.There are huge differences in the coverageof HIV counselling and testing services betweenregions, caused on the one hand by deficits in localbudgets and on the other hand by a lack ofunderstanding of the role of these groups’ representativesin addressing HIV. These differencesCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 81

can mean that the real scale of HIV prevalenceis hidden in oblasts where inadequate resourcesare allocated for purchasing testing systems andwhere people from risk groups do not have easyaccess to counselling and testing services.Laboratory diagnostics. The quality of laboratorydiagnostic services is a determining factorin ensuring the accuracy of epidemiologicaldata and making decisions on the treatment ofHIV patients. If laboratory services at the nationallevel are not expanded and their potential is notstrengthened, it will be impossible to reach theobjectives of increasing HIV counselling and testingof people from risk groups as well as providingantiretroviral treatment for all who will need suchtreatment. Contemporary accreditation of laboratories;assuring the quality of laboratory studies,including external quality control; and a procurementand supply system for laboratory equipmentand materials have not been introduced inthe country. There are also serious shortcomingsin registration, procurement and the supply ofHIV diagnostic testing systems. Most HIV studiesin Ukraine are conducted through the applicationof testing systems from one Ukrainian producer.Although these testing systems are consideredreliable, a regular independent assessment (in accordancewith international standards) has neverbeen conducted in Ukraine.Medical care and treatment. In 2008 and2009, 41 percent of adults and 48 percent ofchildren with progressive HIV infection receivedantiretroviral therapy. However, coverage is insufficientto satisfy the needs of a growing numberof patients. The expected increase in the numberof people living with HIV who will need treatmentis a serious problem for the health care system.Non-medical care and support. There is still verylow coverage of care and support services, whichdo not correspond to the scale and complexityof current and future needs. Only a small groupof clients receive integrated care and supportservices, while a large and growing group of peopleliving with HIV lack access to them. Further,medical and social expert commissions are insufficientlyefficient, since people living with HIV areprovided with limited assistance for short periodsof time only.Planning, budgeting and financing. Procurementand supply management. State planning,budgeting and monitoring of the financing ofmeasures to respond to and prevent AIDS are extremelycomplicated. They do not fully reflect thecontributions of all partners. The lack of financingfor the scale-up of prevention programmesis one of the key problems hindering an effectivenational response to the HIV epidemic in Ukraine.HIV/AIDS expenditure assessments show thatmore than half of the expenditures in the countryare covered by contributions from externaldonors and individual citizens. A significant increasein financing by the State Programme toCombat HIV Infection/AIDS has been observedin recent years. However, its underfundingin 2009 amounted to 47 percent, and it is expectedthat underfunding will reach 48 percent in 2010.State financing is not earmarked for purchasingmedicine for the treatment of STIs, opportunisticinfections or viral hepatitis. The country does nothave a clear national policy for the procurementand supply management of goods, equipmentand services related to HIV and AIDS. This leadsto inadequate coordination between key nationalpartners.Box 16. The resources of the state are beingsupplemented by a significant contribution fromthe Global Fund to Fight AIDS, Tuberculosis andMalaria, and also by contributions from otherinternational and bilateral donors. Epidemiologicaltrends of HIV infection in Ukraine demand moreattention and support from the country’s bilateraland multilateral partners. Considering significantand growing needs in prevention, treatmentand care, it is expected that Ukraine will needfurther external support for these activities,which correspond to national interests, aboveall to the State Programme to Ensure Preventionof HIV Infection, Treatment and Support of HIV-Infected and AIDS Patients for 2009–2013.Human rights. Despite numerous regulations inUkrainian legislation guaranteeing the protectionof human rights, such practices are not alwaysfollowed. People who live with HIV or who areaffected by the epidemic suffer from stigma anddiscrimination. This is a serious hindrance to accessto efficient services.As a result of its negative influence on the demographicsituation, tuberculosis in Ukraine hasbecome a threatening health and social problem.82MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

The main reasons for the problem include: thecontinued socio-economic crisis in the country, adecrease in living standards, a decrease in communityimmunity, insufficient preventive orientationof the health care system and insufficienthealth care financing.Lack of diagnostic and treatment of tuberculosisamong some marginalized groups of the population(homeless, street children, migrants, refugees,some ethnic minorities, residents of remotevillages, etc) prevents an adequately assessmentof the level of the epidemic within these groups.There are discrepancies among some legislativedocuments in relation to implementation ofthe Global Stop TB Strategy. Implementation ofthe Directly Observed Treatment Short Course(DOTS) strategy is efficient in oblasts where thereare external sources of financing. State budgetfunds are limited and are not fully or adequatelyutilized for the introduction of economicallyefficient, international standards to overcometuberculosis.Insufficient coordination and lack of governance.The State Programme to Combat Tuberculosisfor 2007–2011 was developed and adoptedby the Law of Ukraine in 2007, with the aim of reducingthe burden of tuberculosis in the country.In accordance with this Programme, anti-tuberculosisinstitutions should be provided with equipment,medicine and medical supplies throughcentralized procurement. However, at present,state financing of activities conducted accordingto the Programme does not satisfy 100 percentof the need both for anti-tuberculosis medicineof the II level and for laboratory and X-rayequipment.There is an excessive number of laboratories.In addition, the role of the National ReferenceLaboratory, which should coordinate the work oflaboratories of all levels, including work on issuesof ensuring quality of studies, is insufficient.There is an insufficient level of cooperation andcoordination on treatment between specializedanti-tuberculosis and HIV infection treatment institutions,particularly with regard to treatmentof patients with co-infection. The network of primaryhealth care institutions is not inadequatelyinvolved to provide services to people withtuberculosis.There is a high and constantly growing numberof multidrug-resistant cases of tuberculosis (i.e.resistant to the therapeutic effect of standard anti-tuberculosismedications). The situation is complicatedby the fact that the number of cases ofmultiple and extreme drug-resistant tuberculosisis rapidly growing in Ukraine. This raises the costof treatment by almost 100 times. For example, inrecent years, it was revealed that patients’ primarychemo-resistance of the tuberculosis causativeagent to key anti-tuberculosis medicines was 25–30 percent, and secondary was 70 percent. Thehigh level of chemo-resistance indicators is a resultof inadequate implementation of the mainapproaches to overcoming tuberculosis, particularlyinfection control and the DOTS.Box 17. Globally, 425,000 cases of multidrugresistantillness occur each year; the highestindicators are observed in the former Soviet Unionand in China. Furthermore, recent cases have beenreported of almost incurable forms of tuberculosis.The large number of acute forms of tuberculosislinked to HIV infection reveals the peculiarities ofmodern tuberculosis. This leads to a decrease inthe efficiency of treatment and, consequently, toan increase in indicators of tuberculosis morbidityand mortality.Overcoming tuberculosis requires comprehensivedecisions at the state level, since tuberculosisis not only a health care issue but also a socioeconomicone.IV. Moving ForwardThe experiences of European countries show thateliminating problems related to HIV and tuberculosisrequires that these issues become top healthcare and social priorities. The implementation ofstate policy on prevention, treatment, care andsupport of people living with HIV and tuberculosismust be ensured by the joint efforts of thestate authorities, society, churches, private sectorand international organisations.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 83

Prevention among most-at-risk population.There is an urgent need to increase the effectivenessof the prevention of further spreading of theepidemics. In order to stop the spread of HIV, thefollowing are urgently needed: intensification ofthe coverage of most-at-risk groups by revisingthe implementation mechanisms of preventivemeasures and enhancing them through the integrationof the state social protection system,health care and other sectors in rural settings;and ensuring their long-term stability through efficientpublic administration at all levels.Prevention among the general population. PrimaryHIV prevention and awareness raising playimportant roles in the complex measures againstthe epidemic. Political commitment is needed, aswell as an enhanced use of resources through theintroduction of economic approaches, increasedstate resources and appropriate programmes formaintaining the current low rates of HIV infectionprevalence among the general population,above all among youth. The epidemic raises theneed for initiatives aimed at improving reproductivehealth and creating the conditions for ensuringgender equality. At present, global actionsare being implemented for women, which aim todevelop new HIV prevention methods. Enhancingprevention programmes, which can have a significanteffect on further decreasing mother-to-childtransmission, is a key component of the set of actionsdeveloped as a response to HIV. Preventionmeasures and awareness raising of the generalpopulation, including through sexual and reproductivehealth programmes as well as eliminationof stigma and discrimination, are importantcomponents in mitigating the impact of the HIV/AIDS epidemic.Voluntary counselling and testing. Consideringthat two thirds of people living with HIV donot know their status, it is necessary to enhancethe level of coverage and quality of counsellingand testing services for representatives of groupsat the greatest risk of HIV infection. This is veryimportant for both the prevention of new infectioncases and for decreasing mortality, which requiresgreater efficiency in the policy and strategyof testing.Laboratory diagnostics. A complex system oflaboratory accreditation; ensuring the quality ofstudies, including external quality control; andprocurement management systems must be establishedimmediately. These would aim at ensuringa regular and timely supply of laboratoryequipment and materials, including blood banks.Medical care and treatment. It is necessary torevise and improve strategies for providing treatmentservices and to analyse the availability ofadequate infrastructure and other resourcesaimed at moving services closer to patients’ placeof residence. It is also necessary to decentralizethe provision of antiretroviral therapy, increasethe level of coverage of substitution therapy andincrease the efficiency of prevention, diagnosticsand treatment of tuberculosis among people livingwith HIV.Non-medical care and support. Plans for careand support services should be revised to ensurethat social services supporting people living withHIV are integrated into the state social protectionsystem, aiming at more uniform coverage andsustainability of the most important of them. It isnecessary to review the state system of disabilityprivileges provided to people living with AIDS.Planning, budgeting and financing. Procurementand supply management. In order to fulfilthe guarantees and obligations of universalaccess to prevention, treatment, care and support,as set out in the Law of Ukraine on Preventionof Acquired Immune Deficiency Syndrome(AIDS) and Social Protection of the Population aswell as the State Programme to Ensure Preventionof HIV Infection, Treatment and Support ofHIV-Infected and AIDS Patients for 2009–2013, itis necessary to use resources efficiently, and notjust significantly increase their amount. The StateProgramme to Ensure Prevention of HIV Infection,Treatment and Support of HIV-Infected andAIDS Patients for 2009–2013 was approved underthe Law of Ukraine in 2009 for the first time.Enhancing the legal status of a new programmeshould ensure the prioritization of its budget financingat all levels (national, oblast and rayon).In addition, the programme envisages unprecedentedresources for non-health ministries. It isnecessary to approve a strategic approach to procurementmanagement, which would take intoaccount the acute needs of this programme, includingthe optimization of expenditures based84MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

on the principles of timeliness and economicefficiency.Human rights. It is necessary to develop andimplement national policy on the protectionof most-at-risk groups and people living withHIV from rights violations, stigmatization anddiscrimination during service provision and tostrengthen mechanisms to enforce these norms.The annual number of lives lost to tuberculosishas reached more than 10,000. Under the currentsocio-economic conditions and given the insufficientfinancing of tuberculosis services, the followingmeasures for overcoming tuberculosis areprioritized.Improvement of access to treatment of vulnerablepopulation groups through: (1) implementationof the DOTS in regions that currently haveinsufficient infrastructure; (2) increased numbersof patients with multidrug-resistant tuberculosisreceiving treatment; (3) introduction of anefficient system for overcoming tuberculosis inthe penitentiary system; (4) improvement of themultidisciplinary approach for patients with tuberculosisand tuberculosis/HIV co-infection: decentralizationand the guarantee of quality medicalservices at primary health care level; and (5)establishment of an economically efficient strategyof overcoming tuberculosis, primarily amongvulnerable populations, and enhancement ofstrategic planning and management.Improvement of diagnostics in civil and penitentiaryhealth care systems should lead to improvementsin the situation through: (1) applicationof contemporary tuberculosis diagnosticmethods, i.e. microscopic examination of sputumswabs and the creation of proper conditions inhealth care institutions to detect the disease; (2)conducting of tuberculinodiagnostics amongcontacted individuals and those belonging totuberculosis risk groups; (3) training provided tomedical workers of health care institutions oncontemporary technologies for conducting examinationsand consulting patients with tuberculosissymptoms; and (4) development of nationalstandards for laboratory diagnostics of tuberculosisand establishment of a quality control systemfor laboratory studies.Strengthening of material support and staffingof the tuberculosis service, including that of specializeddepartments of academic and researchinstitutions, through: (1) provision of tuberculosisinstitutions with anti-microbacterial medicinesand other necessary supplies; and (2) improvementof the pre-degree and postgraduatetraining system of psychiatrists and staffing oftuberculosis institutions with highly professionalpersonnel.Integration of activities of anti-tuberculosisservices into the general network of clinics,sanitary and epidemiological services and otherrespective executive authorities (services of internalaffairs, execution of sentences, migration, etc)through: (1) coordination of the anti-tuberculosisinstitutions under a single state administrationauthority on combating HIV and other sociallydangerous diseases; (2) coordination of the activitiesof ministries, other executive authoritiesand local self-governing bodies and communityorganisations in tuberculosis prevention; and (3)encouragement of health care institutions of allforms of ownership to conduct timely laboratorydiagnostics of tuberculosis by applying the methodof sputum swab microscopic evaluation.Development and implementation of a systemfor monitoring tuberculosis countermeasuresthrough: (1) introduction of monitoring of thetreatment process and observation of the applicationof the standardized treatment of patients;(2) improvement of the registration and reportingsystem, taking into account WHO recommendations;and (3) creation of national and regionaltuberculosis registries.Social mobilization for reducing stigma anddiscrimination related to tuberculosis and enhancingawareness of overcoming tuberculosisthrough: (1) systematic awareness raising of thepopulation on issues of tuberculosis preventionand treatment, as well as information campaignson healthy lifestyles; and (2) the provision of socialservices to people living with tuberculosiswith the involvement of civil society. CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 85

Box 18.National Indicators for Monitoring and Evaluationof the Efficiency of Measures to Ensure HIV/AIDS Epidemic ControlNo. National indicators Indicator ValueNational Commitment and Actions1 Domestic and international AIDS spending by categories andfinancing sources2007:Total: US $ 79.3 million(UAH 400.7 million),includingUS $ 16.7 million(UAH 84.2 million) from thestate budget2008:Total: US $ 102.4 million(UAH 539.8 million),includingUS $ 30.7 million(UAH 162 million) from thestate budget2 National Composite Policy Index 2009: -National Programmes (blood safety, antiretroviral therapy coverage, prevention of mother-to-childtransmission, co-management of TB and HIV treatment, HIV testing, prevention programmes, services fororphans and vulnerable children, and education)3 Percentage of donated blood units screened for HIV in a qualityassuredmanner4 Percentage of adults and children with advanced HIV infectionreceiving antiretroviral therapy5 Percentage of HIV-infected pregnant women who receivedantiretrovirals to reduce the risk of mother-to-child transmission6 Percentage of estimated HIV-positive incident TB cases thatreceived treatment for TB and HIV7 Percentage of women and men aged 15–49 who received anHIV test in the last 12 months and who know their results8 Percentage of most-at-risk populations who received an HIV testin the last 12 months and who know their results:– Injecting drug users– Commercial sex workers– Men who have sex with men– Prisoners2009: 0%2008: 40%Children: 90%2009: 48%Children: 100%2008: 95.5%2009: 94.9%2008: 21%2009: 13%2009:IDUs – 26%CSWs – 59%MSM – 43%Prisoners – 12%86MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

9 Percentage of most-at-risk populations reached withHIV prevention programmes:– Injecting drug users;– Commercial sex workers;– Men who have sex with men;– Prisoners10 Percentage of orphaned and vulnerable childrenaged 0–17 whose households received free basic external supportin caring for the child11 Percentage of schools that provided life skills-based HIV educationin the last academic year2009:IDUs – 32%CSWs – 59%MSM – 63%Prisoners – 15%Does not correspond tothe epidemic recorded inUkraine2009: 58.7%Knowledge and Behaviour12 Current school attendance by child orphans and children withparents who are 10–14 years old13 Percentage of young people 15–24 years of age who correctlyidentify ways of preventing HIV infection sexual transmission andknow how the infection can be transmitted14 Percentage of most-at-risk populations who both correctlyidentify ways of preventing the sexual transmission of HIV andreject major misconceptions about HIV transmission:– Injecting drug users;– Commercial sex workers;– Men who have sex with men– Prisoners15 Percentage of young women and men aged 15–24 who have hadsexual intercourse before the age of 1516 Percentage of women and men aged 15–49 who had sexualintercourse with more than one partner in the last 12 months17 Percentage of women and men aged 15–49 who had more thanone partner in the past 12 months who used a condom duringtheir last sexual intercourse18 Percentage of female and male sex workers reporting the use of acondom with their most recent client19 Percentage of men reporting the use of a condom during the lasttime they had anal sex with a male partner20 Percentage of IDUs reporting the use of a condom during the lasttime they had sexual intercourse21 Percentage of IDUs reporting the use of sterile injectingequipment during the last time they injectedDoes not correspond tothe epidemic recorded inUkraine2009: 40%2009:IDUs – 55%CSWs – 51%MSMs – 71%Prisoners – 41%2009: 2.4%2009: 15%2009: 61%2009: 88%2009: 64%2009: 48%2009: 87%CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 87

Impact22 Percentage of young women and men aged 15–24 who areHIV- infected23 Percentage of most-at-risk populations who are HIV-infected:– Injecting drug users;– Commercial sex workers;– Men who have sex with men– Prisoners24 Percentage of adults and children with HIV known to be ontreatment 12 months after initiation of antiretroviral therapy25 Percentage of infants born to HIV-infected mothers who areinfectedDoes not correspond tothe epidemic recorded inUkraine2009:IDUs– 22.9%CSWs – 13.2%MSM – 8.6%Prisoners – 15.0%2009: 85%2007: 6.2%88MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

GOAL 7:ENSURE ENVIRONMENTALSUSTAINAbILITYThis subchapter presents an analysis of sustainableenvironmental development. The impactof human activities on biological resources remainshigh in Ukraine. The environmental issuesthat require urgent attention include, interalia, conserving and improving land and waterresources, protecting the atmosphere and conservingbiodiversity and increasing the efficiencyof energy use, among others. A priority taskfor Ukraine is to resolve those issues that havea negative impact on health and living conditions,especially of the poorest groups of thepopulation. These issues include primarily airpollution and the availability of drinking water.І. Targets and IndicatorsTargetsTarget 7.A: Increaseby 2015 share of thepopulation with access tocentralized water supply,inter alia 90% of the urbanpopulation and 30% of therural populationTarget 7.B: Stabilizeby 2020 greenhousegas emissions at 20%below 1990 levelsTarget 7.C: Stabilize pollutionof water reservoirsby 2015. Stabilize at thelevel of 8,500 million tonnesper year the volume ofsewage disposal to surfacewater reservoirs, millioncubic metres per yearTarget 7.D: Increase forestcover of the territory ofUkraine to 16.1% and areaof nature reserve territoryby 2015Enhance the network ofnature reserves, biospherereserves and national naturalparks to 3.5% of the overallterritory of Ukraine andto 9.0% of the overall area ofterritories and objects of thenatural reserve fundIndicators7.1. Share of urban populationwith access to centralized watersupply, % of overall urbanpopulation7.2. Share of rural populationwith access to centralizedwater supply, % of overall ruralpopulation7.3. Volume of emissions ofpollutants into atmospherefrom stationary sources, milliontonnes per year7.4. Volume of emissions ofpollutants into atmospherefrom mobile sources, milliontonnes per year7.5. Volume of reused waterdisposals, million cubic metresper year7.6. Forest cover and ratio oflands covered with forests, %of overall area of the territoryof Ukraine7.7. Share of area of naturalreserves, biosphere reservesand national natural parks, %of overall area of the territoryof Ukraine7.8. Share of area of territoriesand objects of the naturalreserve fund, % of overall areaof the territory of UkraineCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 89

2001 2002 2003 2004 2005 2006 2007 2008 2009 2011 2013 2015Indicator 7.1.Share of urban population with access to centralized water supply, % of overall urban population86 - - 87 86 86 86 88 - 89 89.5 90Indicator 7.2.Share of rural population with access to centralized water supply, % of overall rural population- - - - - - - 28 - 29 29.5 30Indicator 7.3.Volume of emissions of pollutants into atmosphere from stationary sources, million tonnes per year4.05 4.07 4.09 4.15 4.46 4.82 4.81 4.52 3.93 4.6 4.7 4.7Indicator 7.4.Volume of emissions of pollutants into atmosphere from mobile sources, million tonnes per year1.99 2.03 2.01 2.17 2.15 2.21 2.57 2.69 2.51 2.92 3.2 3.2Indicator 7.5.Volume of reused water disposals, million cubic metres per year10,136 9,613 9,098 8,697 8,553 8,484 8,579 8,342 7,381 8,340 8,500 8,500Indicator 7.6.Forest cover and ratio of lands covered with forests, % of overall area of the territory of Ukraine- 15.6 - - 15.6 - - 15.6 - 15.8 16 16.1Indicator 7.7.Share of area of natural reserves, biosphere reserves and national natural parks, % of overall area of the territory ofUkraine1.6 1.7 1.7 1.7 1.8 1.8 1.8 1.9 2.0 2.9 3.2 3.5Indicator 7.8.Share of area of territories and objects of the natural reserve fund, % of overall area of the territory of Ukraine4.2 4.5 4.5 4.57 4.65 4.73 4.95 5.04 5.4 7.0 8.0 9.0The table presents actual data by 2009, expected data for 2009 and forecast calculated values of indicatorsfor 2010–2015.The targets for economic, social and environmentaldevelopment must be coordinated and determinedtogether, by taking into account the basicprinciples of sustainable development. In Ukraine,the practice of making economic, social, technologicaland environmental decisions continuesto proceed without necessarily integrating theminto a single complex system based on a balancedstrategy of state development in the 21st Century.At present, there is a need to develop andapprove at the state level a long-term strategy ofsustainable development with defined priorities,objectives and tasks.Intensive development of production causesdisturbances in the equilibrium of the environment,which intensify socio-economic problems.Increased consumption of non-renewable energyresources contributes to the pollution of the environment,especially of water resources and theatmosphere, the shrinking of forested areas andfertile soils and the disappearance of individualspecies of plants and animals. This has negativeimpacts on the state’s natural resource potentialand the population’s health. Problems with thecollection, use, disposal and removal of waste ofall types of hazard have increased. Furthermore,the network of natural reserve territories and objectsis expanding at a slow pace.Low-waste resources and energy-saving technologieshave not been introduced sufficiently inUkraine. The quality of drinking water is decreasingas a result of the gradual pollution of freshwater sources, the deterioration of water outflowsand water supply and the use of outdated watertreatment technologies and other unsatisfactorytechnical conditions.The ecological situation in Ukraine is characterizedby significant regional discrepancies in the levelof human-induced burdens on the environment.Relative stabilization of the human-induced loadhas been observed during recent years, caused90MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

y structural changes in the economy and a declinein production related to the consequencesof the financial and economic crisis. These issuesrequired adjustments of the major target and indicatorsfor 2015.ІІ. Situation AnalysisAccess to drinking water (centralized water supply).The population of Ukraine has in general adequateaccess to drinking water which complieswith national quality standards. At the same time,there are significant inequalities in the provisionof drinking water between urban and rural areas.These inequalities include different water levelsof provision to the centralized water supply,which is tested regularly for quality. In particular,today, 88 percent of the urban population ofUkraine (100 percent of the population of largecities) is provided with water from the centralizedsupply compared with only 28 percent of the ruralpopulation (excluding well water).In 2008, 66 percent of centralized water supplyenterprises in urban areas in Ukraine provideddrinking water that did not comply with nationalquality standards for water. Almost half of centralizedwater supply systems in rural areas operatewith defects. Imperfect exploitation and ageingequipment means that the water supply cannotbe guaranteed as being of a standard quality.Decentralized water supply objects in rural areas,which include pit wells (over 2.1 million),catchments (around 1,000) and deep waterwells (around 90,000) and wells with small pipes(over 350,000) are mostly in unsatisfactory atechnical and sanitary condition. Almost onethird of the infrastructure for underground andgroundwater intake does not have appropriatelyequipped sanitary control areas.As a result of a significant financing deficit of theComplex Programme on the Provision of CentralizedWater Supply Systems to Rural Areas thatUtilize Imported Water during the 2001–2005 Periodand Forecast by 2010 and of the State TargetSocial Programme on Primary Provision withCentralized Water Supply of Rural Areas that UseImported Water by 2010, which were developedto improve the unsatisfactory provision of waterto areas that lack their own sources of qualitydrinking water, Ukraine has been unable toachieve its goals. In particular, measures of theComplex Programme envisaged drinking waterprovision for 362 rural areas and an allocation ofUAH 302.4 million from the state budget for thesepurposes. During this period, UAH 23.4 million, orjust 7.7 percent, of these measures were financed.The financing situation of these programmesdid not change during 2006–2008. In particular,UAH 50 million should have been allocatedto finance the State Programme in 2008, but infact only UAH 39.45 was allocated (underfundingof the programme’s measures at 21.1 percentin 2008). Therefore, there is a need to revise theindicators of achievement.Greenhouse gas emissions. Greenhouse gasemissions in Ukraine declined dramatically byover 50 percent over the period after 1990, followingthe collapse of the former Soviet Union. Thisowed to the collapse in economic activity over thisperiod. However, since then, greenhouse gas emissionshave continued to rise, and Ukraine continuesto be one of the least energy-efficient countries inthe world, with one of the highest greenhouse gasemissions level per unit of GDP among all Commonwealthof Independent States (CIS) countries.The UNFCCC national greenhouse gas inventoryestimates that total emissions from Ukrainein 2007 were 436.0 million tonnes of CO 2equivalent(the corresponding figure for 2006 was 436.8 milliontonnes). This is 53 percent less than the KyotoProtocol baseline for 1990 (926.0 million tonnes),but it has been growing steadily together with theincrease in economic activity since 2000, addingan average of 6.6 million tonnes of greenhousegas emissions a year. This results in a per capitaemission of 9.45 tonnes of CO 2equivalent peryear (for comparison, annual per capita greenhousegas emissions is 19.78 tonnes for the UnitedStates, 10.40 tonnes for Germany and 12.00 tonnesfor the Russian Federation). Consequently, Ukraineis ranked 19th among the world’s largest emittersof greenhouse gases. The largest sector for emissionsis the energy sector, with the largest sourcesof greenhouse gas emissions from the oil and gassectors. Combined, the energy sector alone accountsfor approximately 70 percent of Ukraine’stotal greenhouse gas emissions.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 91

High energy consumption compared with GDP isa result of a lack of investment in the modernizationof industry since the collapse of the SovietUnion. Insufficient implementation of new energy-efficienttechnologies in Ukraine limits globalindustrial competitiveness and causes severe impactson the local and global environment. It isworth noting that low energy efficiency was oneof the major factors exacerbating the financialcrisis in the Ukrainian economy. The means toreduce greenhouse gas emissions in Ukraine includeincreasing energy efficiency and promotingrenewable energy, fuel-switching activities anddeveloping sustainable and low emission transportsolutions.Air pollution. Pollution of the atmosphere remainsone of the most pressing environmentalissues in Ukraine. In 2001–2007, the increase inproduction levels of the major industries causeda steady increase in the volumes of hazardousemissions into the atmosphere from stationarypollution sources, particularly from 2001 to2007 (4.05 million tonnes to 4.81 million tonnes,or by 0.76 million tonnes – 18.7 percent). At thesame time, a decrease in industrial output wasobserved during the financial and economic crisisstarting in 2008 and, as a result, a decrease inemissions into the atmosphere air from stationarysources of pollution: emissions of pollutants decreasedby more than 0.288 million tonnes, or by6 percent compared with 2007. The major air contaminatorsin the country in 2008 were processingindustry enterprises (the chemical industry,the coke and chemical industry and metallurgy)at 33 percent, mining industry enterprises, at 21percent of hazardous emissions, and producers ofelectric energy, gas and water, at 37 percent.The density of emissions from stationary sourcesof pollution calculated per square kilometreamounts to 7.5 tonnes of pollutants and 98 kgper person. However, in some regions, these indicatorssignificantly exceed the average level ofthe country. In particular, in Donetska oblast, aregion with heavy coal mining activity, emissionvolumes calculated per square kilometre werehigher by 7.7 times and by 3.5 times per person;in Dnipropetrovska oblast by 4.0 and 2.9 times;in Luganska oblast by 2.8 and 2.5 times; in Ivano-Frankivska oblast by 2.3 and 1.8 times; and inZaporizka oblast by 1.1 and 1.2 times. Kyiv enterprisesgenerated emissions of 32.3 tonnes ofpollutants per square kilometre, which exceededthe average indicator in the country by four times.The following areas of the country experiencethe highest human-induced burden from thestationary sources of polluting cities: Kryvyy Rig(449,400 tonnes), Mariupol (359,300 tonnes) andBurshtyn (218,300 tonnes).According to data of the State Statistics Committeefor 2009, a decrease in emissions intothe atmosphere from stationary sources hasbeen observed. In particular, the inflow of pollutantsinto the air basin was 3.9 million tonnes(by 597,000 tonnes, or 13.2 percent, less thanin 2008). The above-mentioned increase in emissionsin 2001–2007 and their decrease in 2008–2009 require the introduction of changes intothe values of expected indicators, particularlyconcerning volumes of hazardous emissionsinto the atmosphere from stationary sourcesin 2010–2015.It should be noted that air pollution from mobilesources is significantly hazardous to the population’shealth, especially the urban population.In 2008, the inflow of pollutants into the atmospherefrom mobile sources reached 2,700 tonnes,the vast majority of which – 2,420,300 tonnes,or 90.1 percent – are emissions from automobiles;66,600 tonnes, or 2.5 percent, are fromthe railroads; 16,400 tonnes, or 0.6 percent, arefrom wastewater; 14,400 tonnes, or 0.5 percent,are from aviation transport; and 167,700 tonnes,or 6.3 percent, are from production machinery.Around 1.7 million tonnes (63 percent) of the overallamount of pollutant emissions are caused byautomobiles privately owned by the population.Gases from automobile engines consist of 100 differentchemical components, most of which aretoxic ones. Major toxic air pollutants released fromvehicles and production machinery are: carbonmonoxide (74.2 percent, or 1,991.500 tonnes), nitrogendioxide (11.6 percent, or 311,100 tonnes),non-light organic methane compounds (11.5 percent,or 308.300 tonnes), soot (1.2 percentor 33,300 tonnes) and sulphur dioxide (1.1 percentor 30,000 tonnes). The rest of the emissionsconsist of nitrogen oxide, methane, benzopyreneand ammonia (0.4 percent, or 11,200 tonnes).92MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

From year to year, the number of automobiles onthe roads in Ukraine increases and, accordingly,so does the concentration of pollutants. Annualincreases in the volume of pollutants into the atmospherefrom mobile sources were observedin 2001–2009. In particular, these emissions frommobile sources increased by 0.52 million tonnes,or by 26.1 percent, in 2009 compared with 2001,reaching 2.51 million tonnes. As a result of theabove-mentioned factors, a new indicator needsto be introduced – volume of pollution into theatmosphere from mobile sources.Groundwater pollution. The issue of ensuringappropriate ecological conditions for water resourcesremains crucial for all regions of the country.Almost all the groundwater and a significantshare of underground water resources, especiallyin regions with large industrial complexes, sufferfrom human-induced impacts, such as pollution,exhaustion and degradation.According to data of the Central GeophysicalObservatory of the Ministry of Emergencies andAffairs of Population Protection from the Consequencesof the Chernobyl Catastrophe ofUkraine, the country’s water objects remain pollutedmostly by compounds of heavy metals, ammoniumand nitrite nitrogen and sulphates. Casesof high pollution are registered most often inthe Western Bug, Danube, Dnister, Southern Bugand Dnieper rivers, the rivers of Azov region andSiversk Donets and also the Kyiv, Kaniv, Kremenchug,Dniprodzerzhynsk and Dniper reservoirs.Owing to the low quality of purification of reusedwaters, the inflow of polluted reused waters intogroundwater reservoirs increased almost eachyear in 2001–2007, and reached 3,854 millioncubic metres in 2007, which is 846 cubic metresor 28.13 percent more than in 2001.At the same time, during the financial and economiccrisis, in 2008–2009 the disposal of pollutedsewage waters into water reservoirs decreased.In particular, 2,728 million cubic metreswere disposed of in 2008 and 1,766 million cubicmetres in 2009, which is 280 million cubic metresand 1,242 million cubic metres less than in 2001,respectively.Overall, 7,381 million cubic metres (including1,766 million cubic metres of polluted reusedwaters) of sewage waters were disposed ofin 2009, which consisted of 961 million cubic metresor 12 percent less than in 2008 (8,342 millioncubic metres). The largest contaminators are industrialenterprises, mainly of the power-generatingsector, the ferrous metal industry and the coalindustry (Zaporizka, Donetska, Luganska and Dnipropetrovskaoblasts) and the housing and utilityindustry (mostly cities of Kyiv, Dnipropetrovsk,Lviv, Odesa, Kryvyy Rig and Zaporizhzhia). At thesame time, in 2007–2008, a decreasing trend wasobserved in the disposal of waste, including pollutedreused waters, explained mainly by the decreasein industrial production rather than by efficientlyimplemented environmental measures.The quality of reused waters does not comply to agreat extent with established standards. Furthermore,inefficient purification plants are observedin many oblasts. These factors worsen the qualityof water resources.Therefore, a newly introduced indicator – volumeof reused waters disposed of into groundwaterreservoirs – is one of the major indicators characterizingthe influence of human activities onthe environment, particularly on quality of waterresources that are used, inter alia, to satisfy thepopulation’s needs.Increasing forest cover of the territories. The totalland area of forestry and forests in other categoriesof lands is 10.8 million ha, 9.5 million ha ofwhich is covered with forest vegetation. The levelof forest cover over the territory of Ukraine, whichis 15.6 percent, did not change in 2001–2008 andremains insufficient. Forest cover differs significantlyin different natural zones of the country.In particular, forest cover of Polissia is 26.8 percent(the optimal level is 32 percent); of forest andsteppe 13 percent (the optimal level is 18 percent);of steppe 5.3 percent (the optimal levelis 9 percent); Carpathians 42 percent (the optimallevel is 45 percent); and of Crimea 10.4 percent(the optimal level is 19 percent). In terms of areaof forest and forest reserves, Ukraine belongs tothe group of sparsely forested and forest-deficitcountries. For the above reasons, a new indicator,forest cover, must be introduced.CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 93

Enhancing the network of natural reserves, biospherereserves and national natural parks andincreasing the overall area of the Nature ReserveFund. As of 1 January 2009, the Nature ReserveFund (NRF) of Ukraine consisted of 7,425 territoriesand objects, with a total area of 3,041,500 ha withinthe territory of Ukraine and 402,500 ha within theoffshore area of the Black Sea. The ratio of NRF areato state area (the reserve indicator) is 5.04 percent.The structure of the NRF of Ukraine includes 11 categoriesof territories and objects of national andlocal importance. Natural monuments, wildlife reservesand reserved natural boundaries hold thelargest share of these categories – around 90 percentof the number of reserves, parks and otherobjects. More than 80 percent of the NRF area ismade up of wildlife reserves and national naturaland regional landscape parks.According to data, as of 1 January 2009, therewere 610 territories and objects of the NRF ofnational importance in Ukraine: 17 naturaland 4 biosphere reserves, 20 national naturalparks, 306 wildlife reserves, 132 naturalmonuments, 17 botanic gardens, 7 zoologicalparks, 19 arboreta and 88 parks/monumentsof garden and park art. The total actual areais 1,571,100 ha (within the territory of Ukraine),or around 52 percent of the total area of theNRF and 2.6 percent of the territory of Ukraine,and 402,500 ha within the offshore area of theBlack Sea (the botanic wildlife reserve known asthe Phyllophora Field of Zernov).The share of territory and object areas of specificcategories of the NRF include: natural reserves5.3 percent; biosphere reserves 7.2 percent;national natural parks 24.9 percent; wildlife reserves38.0 percent; natural monuments 0.8 percent;regional landscape parks 20.2 percent; reservedstows 3.0 percent; arboreta 0.1 percent;zoological parks 0.01 percent; dendrologicalparks 0.05 percent; and parks/monuments of gardenand park art 0.44 percent.The share of areas of NRF objects in the territoriesof administrative units (the reserve indicator) alsodiffers significantly. It is the lowest – around 1 percent– in Vinnytska, Dnipropetrovska and Kirovogradkaoblasts, and highest – 9.9–14.8 percent– in Volynska, Zakarpatska, Ivano-Frankivska,Khmelnytska and Chernivetska oblasts and the cityof Kyiv. However, in Sevastopol, it is 30.3 percent.Reserve territories amount to around 2–5 percentin Donetska, Zhytomyrska, Zaporizka, Kyivska, Luganska,Mykolaivska, Odeska, Poltavska, Cherkaskaand Kharkivska oblasts and in the AutonomousRepublic of Crimea, and to 6–9 percent in Lvivska,Rivnenska, Sumska, Ternopolska, Khersonska andChernigivska oblasts.The area of natural reserves, biosphere reservesand national natural parks increased from 1.6 percentin 2001 to 1.9 percent in 2008 (by 0.3 percent)or from 970,800 ha to 1,146,800 ha, respectively.According to data from the Ministry for EnvironmentalProtection of Ukraine, there was a significantincrease in the overall NRF area in 2009,by 226,500 ha. As of 1 January 2010, it had reachedover 3,268,000 ha, or 5.4 percent of the country’sterritory. The increase owed mainly to the creationof 18 national reserve parks.Therefore, the ratio of the NRF area to thestate area (the reserve indicator) increasedfrom 4.2 percent to 5.4 percent (by 1.8 percent)in 2001–2009, which is lower than forecast indicators(2007 7.5 percent and 2001 8.6 percent).As a result, indicators were revised, particularlyfor 2011 and 2015.Box 19. The impact of the global economic crisison the achievement of Goal 7 is as follows: (1)use by the Ukrainian population of additionallypurified drinking water will be limited since it isbeing traded on a commercial basis, owing toa decrease in purchasing power; (2) a growingnumber of the Ukrainian population will revert toused automobiles, thus significantly reducing thefleet renewal of private cars, which would betterfulfil requirements for decreasing the emissionsof pollutants – sales of new cars have decreasedby 71.4 percent, accompanied by significantbuoyancy in the used car market; (3) the levelof pollution of the atmosphere by stationarysources will increase in the future as a result ofdevelopment of the main industries and increasein output. At the same time, the influence ofpollution from mobile sources will also increase.This is related to the population’s incapacityto renew the fleet of cars, since some time willelapse (from six months to two years) betweenthe increase in production output by the mainindustries and significant revival in the consumermarket.94MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

ІІІ. ChallengesAccess to drinking water (centralized supply).Consumption of low quality water has negativeimpacts on the health of the population and, ultimately,the possibility of ensuring sustainabledevelopment. The problem is not just an unsatisfactoryenvironmental situation with respect towater resources, and non-compliance with watersanitary standards in many areas, but also, ingeneral, the lack of centralized water supply systems,mostly in rural areas. Insufficient financing,particularly of construction and reconstruction ofcentral water supply systems, is a serious problemhindering the achievement of Goal 7, which concernsaccess of the population to drinking water.The main problems are: (1) unsatisfactory environmentalconditions of groundwater and undergroundsources of drinking water; (2) non-compliancewith sanitary protection principles at manysources and drinking water supply objects; (3)unsatisfactory technical conditions and deteriorationof water supply and water outflow systems;(4) insufficient level of resources and energy-savingtechnologies in enterprises providing drinkingwater as well as water outflow; and (5) unsatisfactoryfinancing of activities envisaged by theState Programme on Drinking Water of Ukrainefor 2006–2020 and the Complex Programme onthe Provision of Centralized Water Supply Systemsto Rural Areas that Utilize Imported Water, duringthe 2001–2005 Period and Forecast by 2010.Air pollution. The high level of air pollution remainsan important challenge for the state. Theannual concentration of dust, nitrogen oxides,formaldehyde, sulphur dioxide and other substancesexceeds established standards.The main challenges regarding this unsatisfactorysituation are the following: (1) non-fulfilment ofmeasures by polluting enterprises in terms of decreasingvolumes of emissions within set terms; (2)low rates of introduction of modern technologiesfor emission purification; (3) lack of efficient purificationof enterprises’ emissions from extraneousgas substances; (4) lack of sanitary protectionareas between industrial and residential districts;(5) inadequate financing of measures for decreasingemissions into the atmosphere at state andlocal levels; (6) elimination of green zones withinareas; and (7) continuous increases in the numberof automobiles and decreasing renovation ratesof the motor vehicle fleet.Pollution of groundwater reservoirs. Major challengesin implementing actions to stabilize volumesof disposal of sewage waters in groundwaterreservoirs and to gradually decrease theirpollution are: (1) the significant deterioration ofsewage systems and purification facilities; (2)non-implementation of measures for improvingthe quality of sewage water disposal into waterreservoirs by contaminating enterprises duringset time intervals; (3) non-implementation of thelatest technologies for sewage water purification;and (4) degradation of the ecosystems of theAzov and Black Seas.Enhancement of forest cover of territories. Plantinghighly productive forests and sustainableprotective forest plantations and increasing thesize of the forest area are of special importancefor Ukraine. In this regard, the main priority in theforestry sector is the timely and quality replantingof forests immediately after felling, increasingtheir area at the expense of agricultural lands andcreating protective forest plantations and afforestationbelts, with the aim of ensuring broadenedrecovery and increased productivity of forestplantations. According to scientific studies, inorder to reach the optimal level of forest cover(around 19–20 percent) it is necessary to increasethe area of forests by 2 million ha. This will helppreserve the environmental balance in almost allterritories of the state and will help increase theresource potential of forests.The major problems and obstacles in enhancingforest cover in Ukraine are: (1) slow rates of treeplanting to create new forests, particularly afforestationbelts; (2) obsolescence of forestry-basedand fire-fighting equipment; (3) inadequate inventoryof forests; (4) inadequate system of forestmanagement, inventory and monitoring; and(5) insufficient financing of activities of the Programmeon Forests of Ukraine.Enhancement of the network of natural reserves,biosphere reserves and national naturalparks and increasing the general area of theNRF of Ukraine. Low rates in relation to enhancingand creating new territories and objects ofCHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 95

Box 20. Influence of climate changes on achievingGoal 7.Based on the analytical review of possibleinfluences of forecast climate changes, it can bestated that:• Each year, Ukraine has increased the amount ofCO 2-equivalent emissions that it emits into theatmosphere. Greenhouse gas emissions havegrown continuously – from 395 million tonnesin 2000 to 443.18 million tonnes in 2006.Without taking into account the effects ofthe economic crisis with respect to the maincontributors to greenhouse gas emissions, thatis, the metallurgy and chemical industry, theoverall increase in greenhouse gas emissionsis 8 million tonnes a year.• Independently from variations in temperature,climate changes will lead to economiclosses for the population, decreases in livingstandards for the most vulnerable populationgroups and increases in social tension withinsociety, which will demand additional stateefforts to resolve.• Changes will facilitate technologicaldevelopment, promote scientific researchand attract investments. This can spur on theeconomy’s ‘ecologization’ processes, particularlyin relation to gas consumption, making gasreduction joint implementation projectsmore attractive and ensuring a decrease ingas consumption by up to 1,218 million cubicmetres per year.• Overcoming consequences of climate changeswill cost 1–2 percent of GDP annually for thecountry.• In order to adequately respond to changes,there is a need to improve the environmentalprotection system, based on the developmentof targeted projects and the attraction ofnon-state financial sources to implementthem. This would aim to overcome negativeenvironmental consequences and conductpreventive measures to halt biodiversityloss, including through the degradation ofsoils and pollution, to improve the quality ofgroundwater and underground water and toeliminate and mitigate the related impacts ofnatural and human-induced emergencies, etc.• Efficiency in implementing changes within theenvironmental protection system would ensurethe needed systemic approach and consistencyand coherence with the development of othernational protection components.the NRF, as well as losses of biodiversity, are causefor concern.Major problems include: (1) insufficient developmentof the system of territories and objects ofthe NRF of Ukraine; (2) the financing deficit of existingand newly created objects of the NRF andunsatisfactory financing of activities for formingeco-networks; (3) lack of fixed borders of NRF objects;(4) slow rates of natural recovery (on locality)of coastal lines of water reservoirs; (5) insufficientlevel of development of the recreational infrastructureof NRF institutions; and (6) the threat ofdisappearance of many animals and plant speciesthat are registered in the Red Book of Ukraine.IV. Moving ForwardA wide range of environmental issues to achieveGoal 7 must be resolved, including the population’saccess to drinking water (a centralized watersupply) of improved quality as well as stabilizingenvironmental pollution.Furthermore, the focus should be put on improvingwater resources management, supportinginternational cooperation on environmental protectionand nature conservation issues. A consistentenvironmental policy must include increasedaccessibility of good quality drinking water for thepopulation, stabilization of the disposal of pollutantsby 2015 and an increase in the NRF area andforest cover.With regard to sustainable environment development,efforts should be aimed at:(1) Creating systems of centralized water supplyin areas that use imported or low qualitydrinking water; stabilizing the financial andeconomic situation of water supply and wateroutflow enterprises; improving standardizationand rate-setting systems for drinking water supply,particularly through their compliance withEU requirements; increasing quality of water incentralized water supply sources; completing the‘passportization’ of water supply sources and takingmeasures for their protection; improving thedifficult situation of and ensuring compliancewith regimes of sanitary control of drinking wa-96MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

ter supply sources; improving technological processesof drinking water purification; introducingtechnologies into industries intend to use marine,mineral underground and mine waters; preventingunderground water pollution; enhancingworks creating a network of artesian wells aimingat providing the population with drinking water;improving quality control and control of the integrityof the distribution network, which will ensurea decrease in water losses; standardizing pollutantemissions; allocating waste in compliancewith the requirements of European Council Directive96/61/EU; establishing the basin principleof water resources management; cleaning riverbeds and maintaining the necessary sanitary conditionof rivers; decreasing volumes of untreatedreused water disposal; conserving the ecosystemof the Black and Azov Seas; recovering the situationof marine, deltoid, coastal and river ecosystems;creating and normalizing water protectionzones and coastal protection lines and recoveringtheir natural borders;(2) Improving systems for treating residential andindustrial waste and creating capacities for wastedeactivation and processing; implementing Europeandirectives and rules of procedure with respectto waste treatment; decreasing backgroundconcentrations of emissions to the maximum allowedlevel, particularly in carbon oxides, nitrogenand sulphur, dust, formaldehyde and phenol;developing technological standards for pollutantemissions into the atmosphere, particularly formetallurgical production; decreasing emissionsof pollutants from automobiles by introducingecological norms on the content of pollutants influe gases in accordance with Euro III and EuroIV standards;(3) Systemically adjusting taxes for emissions ofpollutants depending on their volume and onair pollution, and conducting annual indexation;preventing climate change and ozone layer destruction;introducing further economic mechanismsdetermined by the Kyoto Protocol to theUNFCCC, particularly a functioning and workableGreen Investment Scheme to allow for sale of assignmentamount units, with the proceeds beinginvested in greenhouse gas emission reductionprojects; developing national, regional andsectoral plans on adaptation to climate change;establishing a data bank on environmentallyfriendly technologies and methods to decreasethe volume of human-induced emissions of contaminantsand greenhouse gases, increasing theirabsorption; establishing a system of control overhuman-induced emissions and absorption ofgreenhouse gases by legal bodies; introducinga system of monitoring and reporting on usageof ozone-depleting substances and ensuring itscontinuous functioning in accordance with therequirements of the Montreal Protocol;(4) Decreasing the volume of massive forest felling;increasing forest area through afforestationefforts; improving forest quality and the age compositionof forests; rehabilitating forests that arepolluted with radionuclides; and ensuring thatstate forest inventory and monitoring are properlycarried out;(5) Enhancing the network of the NRF; preservingthe plant and animal gene pool within territoriesand objects of the NRF; ensuring environmentallybalanced nature resource management withinterritories and objects of the NRF; creating marinenatural reserve zones and forming a marineeco-network; creating a recreational base withininstitutions of the NRF; developing ecotourism;halting biodiversity losses and improving naturalecosystems and landscapes; developing andimplementing state target programmes on developingnatural reserves; strengthening qualitycontrol for the water industry, centralized watersupply for rural areas and treatment of hazardouswaste; strengthening the responsibilities ofofficials and citizens in relation to violations ofadministrative legislation on natural environmentalprotection; and eliminating the imbalance betweenharm caused to natural resources and fineamounts.Another important step to ensure sustainableenvironmental development would be the approvalof the Strategy of National EnvironmentalPolicy and Strategy of Sustainable Developmentof Ukraine. CHAPTER TWO. MILLENNIUM DEVELOPMENT GOALS, ADAPTED FOR UKRAINE 97

ANNEXESAnnex 1Development GOALS FORMULATEDby THE UNITED NATIONS MILLENNIUM DECLARATIONOfficial List of MDG Indicators (effective from 15 January 2008)Goals and Targets(from the Millennium Declaration)Indicators for monitoring progressGOAL 1: Eradicate extreme poverty and hungerTarget 1.A: Halve, between 1990 and 2015, theproportion of people whose income is less than onedollar a dayTarget 1.B: Achieve full and productive employmentand decent work for all, including women and youngpeopleTarget 1.C: Halve, between 1990 and 2015, theproportion of people who suffer from hungerGOAL 2: Achieve universal primary educationTarget 2.A: Ensure that, by 2015, children everywhere, boysand girls alike, will be able to complete a full course ofprimary schoolingGOAL 3: Promote gender equality and empower womenTarget 3.A: Eliminate gender disparity in primary andsecondary education, preferably by 2005, and in all levels ofeducation no later than 2015GOAL 4: Reduce child mortalityTarget 4.A: Reduce by two-thirds, between 1990 and 2015,the under-five mortality rate1.1 Proportion of population below $1 (PPP) per day1.2 Poverty gap ratio1.3 Share of poorest quintile in nationalconsumption1.4 Growth rate of the GDP per person employed1.5 Employment-to-population ratio1.6 Proportion of employed people living below$1 (PPP) per day1.7 Proportion of own-account and contributingfamily workers in total employment1.8 Prevalence of underweight children under-fiveyears of age1.9 Proportion of population below minimum levelof dietary energy consumption2.1 Net enrolment ratio in primary education2.2 Proportion of pupils starting grade 1 who reachlast grade of primary2.3 Literacy rate of 15–24 year-olds, women andmen3.1 Ratios of girls to boys in primary, secondary andtertiary education3.2 Share of women in wage employment in thenon-agricultural sector3.3 Proportion of seats held by women in nationalparliament4.1 Under-five mortality rate4.2 Infant mortality rate4.3 Proportion of 1 year-old children immunizedagainst measles98MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Goal 5: Improve maternal healthTarget 5.A: Reduce by three quarters,between 1990 and 2015, the maternal mortality ratioTarget 5.B: Achieve, by 2015, universal access to reproductivehealthGOAL 6: Combat HIV/AIDS, malaria and other diseasesTarget 6.A: Have halted by 2015 and begun to reverse thespread of HIV/AIDSTarget 6.B: Achieve, by 2010, universal access to treatmentfor HIV/AIDS for all those who need itTarget 6.C: Have halted by 2015 and begun to reverse theincidence of malaria and other major diseasesGOAL 7: Ensure environmental sustainabilityTarget 7.A: Integrate the principles of sustainabledevelopment into country policies and programmes andreverse the loss of environmental resourcesTarget 7.B: Reduce biodiversity loss, achieving, by 2010, asignificant reduction in the rate of lossTarget 7.C: Halve, by 2015, the proportion of peoplewithout sustainable access to safe drinking water and basicsanitationTarget 7.D: By 2020, to have achieved a significantimprovement in the lives of at least 100 million slumdwellers5.1 Maternal mortality ratio5.2 Proportion of births attended by skilled healthpersonnel5.3 Contraceptive prevalence rate5.4 Adolescent birth rate5.5 Antenatal care coverage (at least one visit and atleast four visits)5.6 Unmet need for family planning6.1 HIV prevalence among populationaged 15–24 years6.2 Condom use at last high-risk sex6.3 Proportion of population aged 15–24 years withcomprehensive correct knowledge of HIV/AIDS6.4 Ratio of school attendance of orphans to schoolattendance of non-orphans aged 10–14 years6.5 Proportion of population with advanced HIV infectionwith access to antiretroviral drugs6.6 Incidence and death rates associated withmalaria6.7 Proportion of children under 5 sleeping underinsecticide-treated bednets6.8 Proportion of children under 5 with fever whoare treated with appropriate anti-malarial drugs6.9 Incidence, prevalence and death rates associatedwith tuberculosis6.10 Proportion of tuberculosis cases detected andcured under directly observed treatment shortcourse7.1 Proportion of land area covered by forest7.2 CO2 emissions, total, per capita and per$1 GDP (PPP)7.3 Consumption of ozone-depleting substances7.4 Proportion of fish stocks within safe biologicallimits7.5 Proportion of total water resources used7.6 Proportion of terrestrial and marine areasprotected7.7 Proportion of species threatened with extinction7.8 Proportion of population using an improveddrinking water source7.9 Proportion of population using an improvedsanitation facility7.10 Proportion of urban population living in slumsAnnex 99

Goal 8: Develop a global partnership for developmentTarget 8.A: Develop further an open, rule-based, predictable,non-discriminatory trading and financial systemIncludes a commitment to good governance, developmentand poverty reduction – both nationally and internationallyTarget 8.B: Address the special needs of the least developedcountriesIncludes: tariff and quota-free access for the least developedcountries' exports; enhanced programme of debt relief forheavily indebted poor countries (HIPC) and cancellation ofofficial bilateral debt; and more generous ODA for countriescommitted to poverty reductionTarget 8.C: Address the special needs of landlockeddeveloping countries and small island developing States(through the Programme of Action for the SustainableDevelopment of Small Island Developing States and theoutcome of the twenty-second Special Session of theGeneral Assembly)Target 8.D: Deal comprehensively with the debt problemsof developing countries through national and internationalmeasures in order to make debt sustainable in the long termSome of the indicators listed below are monitoredseparately for the least developed countries (LDCs),Africa, landlocked developing countries and smallisland developing States.Official development assistance (ODA)8.1 Net ODA, total and to the least developed countries,as a percentage of OECD/DAC donors’ grossnational income8.2 Proportion of total bilateral, sector-allocableODA of OECD/DAC donors to basic social services(basic education, primary health care, nutrition,safe water and sanitation)8.3 Proportion of bilateral official development assistanceof OECD/DAC donors that is untied8.4 ODA received in landlocked developing countriesas a proportion of their gross nationalincomes8.5 ODA received in small island developing Statesas a proportion of their gross national incomesMarket access8.6 Proportion of total developed country imports(by value and excluding arms) from developingcountries and least developed countries, admittedfree of duty8.7 Average tariffs imposed by developed countrieson agricultural products and textiles and clothingfrom developing countries8.8 Agricultural support estimate for OECD countriesas a percentage of their gross domestic product8.9 Proportion of ODA provided to help build tradecapacityDebt sustainability8.10 Total number of countries that have reachedtheir HIPC decision points and number thathave reached their HIPC completion points(cumulative)8.11 Debt relief committed under HIPC andMDRI Initiatives8.12 Debt service as a percentage of exports ofgoods and servicesTarget 8.E: In cooperation with pharmaceutical companies,provide access to affordable essential drugs in developingcountriesTarget 8.F: In cooperation with the private sector, makeavailable the benefits of new technologies, especiallyinformation and communications8.13 Proportion of population with access to affordableessential drugs on a sustainable basis8.14 Telephone lines per 100 population8.15 Cellular subscribers per 100 population8.16 Internet users per 100 populationSource: http://unstats.un.org/unsd/mdg/Host.aspx?Content=Indicators/OfficialList.htm.100MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Annex 2Updated MATRIx of TARGETS AND INDICATORS of THE NATIONAL MDGsTargetGOAL 1: REDUCE POVERTYTarget 1.A: Eradicate poverty accordingto the criterion of US $ 5 (PPP) per dayby 2015Target 1.B: Decrease share of poorpopulation (according to the nationalcriterion of poverty) to 25% by reducingthe number of poor amongchildren and employed peopleTarget 1.C: Decrease by 10 timesby 2015 the number of people whosedaily consumption is below the actualsubsistence minimumGOAL 2: ENSURE QUALITY LIFELONG EDUCATIONTarget 2.A: Increase enrolment rates ineducationTarget 2.B: Raise the quality ofeducationGOAL 3: PROMOTE GENDER EQUALITYTarget 3.A: Ensure gender representativenessat the level of no lessthan 30–70% in representative bodiesand high-level executive authoritiesTarget 3.B: Halve the gap in incomesbetween women and menIndicator1.1. Share of population whose daily consumptionis below US $ 5 (PPP), %Values of indicatorsfor 2015Establishedin 2003Revisedin 20105.5

GOAL 4: REDUCE CHILD MORTALITYTarget 4. A: Decrease the mortality rateamong children up to 5 years of age byone-fourth4.1. Mortality rate among children of upto 5 years of age, number of children ofcorresponding age who died per 1,000 livebirths4.2. Infant mortality rate, number ofinfants up to one year of age who diedper 1,000 live birthsGOAL 5: IMPROVE MATERNAL HEALTHTarget 5.A: Halve the maternalmortality rate5.1. Maternal mortality rate, number ofmaternal deaths per 100,000 live births5.2. Abortion level, number of abortionsper 1,000 women of fertile age12.3 11.09.3 9.319.8 13.024.4 15.1GOAL 6: REDUCE AND SLOW DOWN THE SPREAD OF HIV/AIDS AND TUBERCULOSIS AND INITIATE aTREND to DECREASE THEIR SCALESTarget 6.A: Decrease HIV prevalencerates by 13%Target 6.B: Decrease tuberculosismorbidity level by 20% (comparedwith 2005)GOAL 7. ENSURE ENVIRONMENTAL SUSTAINAbILITYTarget 7.A: Increase by 2015 share ofthe population with access to centralizedwater supply, inter alia 90% of theurban population and 30% of the ruralpopulationTarget 7.B: Stabilize by 2020 greenhousegas emissions at 20%below 1990 levelsTarget 7.C: Stabilize pollution of waterreservoirs by 2015. Stabilize at the levelof 8,500 million tonnes per year thevolume of sewage disposal to surfacewater reservoirs, million cubic metresper year6.1. Number of people newly diagnosed 12.4 49.1with HIV per 100,000 population6.2. HIV prevalence rate, % - +4.06.3. Number of people who died from0.5 8.0AIDS, per 100,000 population6.4. Level of mother-to-child transmissionof HIV, %5 2.06.5. Number of people diagnosed with40.0 67.5tuberculosis for the first time (includingtuberculosis of respiratory organs)per 100,000 population6.6. Number of tuberculosis deaths10.0 15.0per 100,000 population7.1. Share of urban population with accessto centralized water supply, % of overallurban population7.2. Share of rural population with access tocentralized water supply, % of overall ruralpopulation7.3. Volume of emissions of pollutants intoatmosphere from stationary sources, milliontonnes per year7.4. Volume of emissions of pollutants intoatmosphere from mobile sources, milliontonnes per year7.5. Volume of reused water disposals, millioncubic metres per year93 9075 304.1 4.7- 3.2- 8,500102MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

Target 7.D: Increase forest cover of theterritory of Ukraine to 16.1% and areaof nature reserve territory by 2015Enhance the network of nature reserves,biosphere reserves and nationalnatural parks to 3.5% of the overallterritory of Ukraine and to 9.0% of theoverall area of territories and objects ofthe natural reserve fund7.6. Forest cover and ratio of lands coveredwith forests, % of overall area of the territoryof Ukraine7.7. Share of area of natural reserves, biospherereserves and national natural parks,% of overall area of the territory of Ukraine7.8. Share of area of territories and objectsof the natural reserve fund, % of overallarea of the territory of Ukraine- 16.110.4 3.5- 9.0Annex 103

Progress towARDS ACHIEVING THE MDGs in SELECTED COUNTRIESAnnex 3CountryGOAL 1:EradicateExtremePoverty andHungerGOAL 2:AchieveUniversalPrimaryEducationGOAL 3:PromoteGenderEqualityandEmpowerWomenGOAL 4:ReduceChildMortalityGOAL 5:ImproveMaternalHealthGOAL 6:CombatHIV/AIDS andOtherDiseasesGOAL 7:EnsureEnvironmentalSustainabilityAlbaniaArmeniaKyrgyzstanTajikistanUkraine** Progress for Ukraine was identified during the revision of the national targets and indicators.Source: UNDP. Beyond the Midpoint: Achieving the Millennium Development Goals: UNDP, 2010. – 156 p.– goals that have been achieved or probably will be achieved by 2015– mixed or achievable progress by 2015, if proper actions are taken urgently– goals will not be achieved by 2015104MILLENNIUM DEVELOPMENT GOALS. UKRAINE – 2010

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