Equity for Children and Adolescents

in the Middle East and North Africa:

An Opportunity for Growth

A Regional Overview

Prepared for UNICEF MENARO by Alberto Minujin with research assistance of Asmaa Donahue and Carolyn McCaffrey

Table of Contents

List of Acronyms

1. Executive Summary

2. Background

Goal and objectives of the report

Overview of Methodology

3. Context

Demographics

Socio-Economic Indicators

Impact of Inequality on Human Development

Challenges to Monitoring Progress: The Data Gap in the MENA Region

4. Findings

Who Are the Most Vulnerable Children in the MENA Region?

Marginalized Ethnic and Religious Groups

Refugee, Internally Displaced and Stateless Children

Children with Disabilities

Adolescent Girls, Married Adolescents and Adolescent Mothers

Youth

Inequity in Child Wellbeing: Going Beyond the Averages

Shelter

Early Marriage (under age 15)

Access to Education

Gender and Education

Determinants of Child Labor in 8 MENA Countries

5. Conclusion

6. Key Recommendations

Annex I: Methodological Note

Annex II: Data Sources

Annex III: Definitions

Annex IV: Institutional Definitions of MENA Region

Annex V: Statistics

Annex VI: Bibliography

List of Acronyms

CEDAWConvention on the Elimination of all Forms of Discrimination against Women

CRCConvention of the Rights of the Child

DHSDemographic Health Survey

EMROEastern Mediterranean Regional Office, WHO

ESCWAUnited Nations Economic and Social Commission for Western Asia

GCCGulf Cooperation Council: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, & UAE

HDIHuman Development Index

HIV and AIDSHuman Immunodeficiency Virus and Acquired Immunodeficiency Syndrome

IDP Internally Displaced Persons

IHDIInequality-adjusted Human Development Index

FGM/CFemale genital mutilation/cutting

MDGMillennium Development Goal

MENAMiddle East and North Africa

MENAROMiddle East and North Africa Regional Office, UNICEF

MICSMultiple Indicator Cluster Survey

MICS33rd Round of the Multiple Indicator Cluster Survey

NGONon-governmental organization

oPtoccupied Palestinian territory

PPPPurchasing power parity

TFRTotal Fertility Rate

UAEUnited Arab Emirates

UNDESAUnited Nations Department of Economic and Social Affairs

UNDPUnited Nations Development Programme

UNESCOUnited Nations Educational, Scientific and Cultural Organization

UNFPAUnited Nations Population Fund

UNHCRUnited Nations High Commissioner for Refugees

UNICEFUnited Nations Children’s Fund

WBThe World Bank

WEOWorld Economic Outlook database, published by the World Bank

WHOWorld Health Organization

1. Executive Summary

Many children are denied these rights not only because they are poor, but also because they are discriminated against based on their gender, ethnicity, religion, disability, migration or noncitizen status. Inequity occurs when social and cultural attitudes or laws and economic systems deprive children of basic resources and limit their life opportunities because of who they are.

The Middle East and North Africa (MENA) is a demographically and socioeconomically diverse region characterised by disparities both across and within countries. Throughout the MENA region girls and boys experience material deprivation and discrimination, and, when the two types of inequity overlap, children are even more vulnerable to lives of multidimensional, multigenerational poverty and loss of rights.

Indicators of child wellbeing help chart country progress towards achieving development goals, but mask inequities within countries when viewed only as national averages. Although multidimensional child poverty measures provide a more nuanced understanding of the deprivations children face, there is limited data available for the MENA region. By analysing available quantitative and qualitative data on the sources of inequity among children living in MENA countries, this report seeks to present an overview of the region’s most vulnerable population groups, highlight patterns of inequity and propose overall policy responses.

Four main findings emerged through a comparison of disparities in material deprivation based on children’s gender, wealth quintile, rural or urban residence, subregion and their household head’s education level. First, subregion plays a pivotal role in inequity and is often the most important determinant of negative outcomes for children. Second, disparities in children’s wellbeing tend to result from multiple overlapping determinants, even if one determinant is more prevalent than the others. Third, a number of vulnerable groups of children, which are not represented in official data, are denied their rights and experience material deprivation because of discrimination on the basis of gender, ethnicity, religion, disability, migration or noncitizen status. Finally, inequities are greatest among the small percentage of children do not go to school, despite progress towards universal education.

Based on these findings, this report makes the following five key recommendations:

Improve data collection and strengthen evidence on the deprivations experienced by vulnerable groups of children in order to make them visible to policy makers and to monitor inequity and discrimination.
Implement affirmative action policies such that all children – regardless of gender, ethnicity, religion, disability or citizenship – have equal access to basic services, programmes and protection.
Target investments in programmes focused on vulnerable children in such a way that recognizes their potentially significant contributions to the economic and civic life of their communities.
Develop child-led communication strategies that build on children’s capacity to convey messages that raise awareness in their communities about discrimination, rights and benefits.
Identify opportunities to advance the equity agenda in ways that support participation of adolescents and youth.

By adopting policies that promote child equity, governments not only uphold the rights of all children, but also invest in the future human capital that children represent.

2. Background

Under the Convention on the Rights of the Child, all children have the right to the care, resources, and support needed for their survival and development; to be protected from violence, abuse and exploitation; and to express themselves and be heard as participants in decision making about matters concerning them. In reality, many girls and boys are not able to enjoy their rights not only because they are poor but also because they face discrimination on the basis of their gender, ethnicity, religion, disability, migration or other status. Inequity occurs when social and cultural attitudes or laws and economic systems deprive children of basic resources and jeopardize their life opportunities because of who they are.

Figure 2.1illustrates how discrimination overlaps with material deprivation to place children at greater disadvantage. Material deprivation, such as income poverty or lack of access to quality basic social services,negatively impacts children’s wellbeingregardless of discrimination (the lower left, pink box). This form of disadvantage is captured by traditional below-poverty line measures and GINI coefficients. In addition, children may experience discrimination on the basis of their gender or ethnicity, creating barriers to better schools and upward mobility, but not necessarily leading to materially deprivation (the upper right pink box). Such would be the case of young women in middle-income households who are able to complete their education through university, but are prevented by gender discrimination from finding employment in their chosen profession. The combination of discrimination and material deprivation, however, increases children’s vulnerability and traps them in multidimensional, multigenerational poverty as discrimination blocks their access to social programs and services targeting the poor and are denied their rights (upper right red box).

Figure 2.1: Conceptual Framework for Child Equity

Sources of Inequity / Material Deprivations
(income and
basic social services)
Yes / No
Discrimination
(gender, ethnicity, disability, noncitizen,
geography, etc.) / Yes /
No

Children may experience overlapping forms of discrimination which are not taken into account when programmes focus on only one form of deprivation. For example, rates of early school leaving may be much higher than the national average in a remote, economically depressedgovernorate where the country government has not adequately invested in infrastructure. Attendance rates may be especially low among adolescent girls there and in neighboring districts because of local households do not see an economic or socio-cultural benefit in girls’ secondary education. On a national level, education budgets, teacher training and curriculum may disregard the special needs of children with disabilities, resulting in structural barriers to their attending school. Without education, disabled children in this example’s governorate are even less likely to become economically independent as adults. These inequities have life-long impacts as children who experience them enter adulthood without the same preparation and access to opportunity needed to increase their earning potential and leave poverty.

The discussion of equity comes at a time of unprecedented social and political change in the Middle East and North Africa (MENA) led by the region’s youth. On the one hand, vast improvements in health, child survival and education have resulted in the largest and most educated population of youth in the region’s history. On the other, youth are pushing back against a wave of disappointment in and frustration with the pervasive lack of gainful employmentand channels for meaningful civic engagement. Youth-led movements in the regionhave called attention to the need to ensure that equitable access to basic necessities like decent housing, education and healthcare are coupled with equitable access to the means to build their futures. Until they do, MENA countries will continue to miss a host of opportunities that theirconsiderable wealth of youth present: the economic contribution, energy, innovative ideas and aspirations that young women and men bring.

Goal and objectives of the report

The findings reported in these pages are based on an initial equity analysis of social and economic disparities in the MENA region that moves beyond national averages. They seek to present an overview of the region’smost vulnerable population groups, highlight patterns of inequity, and propose overall policy responses. A series of country-specific equity profiles have been developed in tandem with this report as tools to support advocacy for children’s equity.

The analysis and findings presented here are by no means comprehensive, but rather are intended to provide a springboard forfurther exploration of vulnerable groups in the MENA region and the multidimensional disparities that lock them into long term disadvantage. It seeks to raise awareness about the situation of child inequity and call for building more evidence to support policies to address it. In order to do so, disaggregated data on children’s wellbeing and other information must be made available to researchers. The lack of available data from many countries on such basic indicators as child health, education or sheltergreatly limited the scope of this report.

Overview of Methodology

Quantitative and qualitative data were used to identify sources of inequity in child well-being in the MENA region. The information provided in “Who Are the Vulnerable Children of the MENA Region?” of the Findings sections was the result of a literature review and processing available statistical information. Sources included reports and data files produced by international organizations, nongovernmental organizations and scholarly researchers, and media reports. The quantitative portion of the study used MICS 3 data and other household survey micro data files to compare the likely impact of five variables – gender, geographic location, subregion, wealth quintile and household education – on different indicators of child well-being. For each variable, a ratio between best and worst outcomes was calculatedto show the relative gap, or disparity, between disadvantaged and advantaged children. Disadvantage and advantage were assumed as follows:

Disadvantaged / Advantaged
Female / Male
Rural / Urban
Worst subregion / Best subregion
Poorest quintile / Richest quintile
Household head has no education / Household head has at least a secondary education

The results are produced in bar charts, such as in Figure 4.1. The vertical line at 1 indicates complete equity; the more the ratio exceeds 1, the greater the gap. For example, Figure 4.1 shows that 25% of Moroccan children lived in overcrowded or inadequate households, but children in rural areas were 7.3 times more likely that children in urban areas from suffer from shelter deprivation, and children whose head of the household had no education (the most disadvantaged) are 6 times more likely than children that lived in a household which it head had at least a secondary education (the most advantaged) to face severe shelter deprivation. A more detailed explanation of the methodology is provided in Annex I of this report. Definitions for each of the indicators are included in Annex III.

This report follows the definition for the MENA region used by UNICEF: Algeria, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, occupied Palestinian territory (oPt), Oman, Qatar, Saudi Arabia, Syria, Sudan, Tunisia, UAE, and Yemen. One of the challenges of comparing data for the MENA region from different sources is that not all institutions use the same regional definitions or even refer to the region as “MENA”. Regional definitions followed by the different data sources used in this report are listed in Annex IV.

3. Context

Demographics

With populations ranging from 1.2 millionin Bahrain to over 81 million in Egypt, the Middle East and North Africa is a demographically diverse region. Despite this variation in population size, however, MENA countries share some common characteristics. Over the last 50 years, improvements in health, sanitation and education have led to rapid increases in life expectancy and child survival, and a much slower decline in fertility rates. As a result, the MENA region now has the largest youth population in its history – more than half (51.8%) of the region’s population is under the age of 25. Over 100 million people – 30% of the region’s population – are between the ages of 15 and 29, a trend that will peak in the next 10 years in most of the MENA’s middle and high income countries (Dhillon and Yousef 2007; Khalif 2009).

The populations in the least developed countries (LDC) are the youngest in the region, with nearly half (46.5%) of the people in Yemen, Djibouti and Sudan under the age of 18. Figure 3.1 demonstrates this concentration of youth and suggests that Yemen may be in the early stages of demographic transition – the gradual shift from high birth and mortality rates to lower birth rates and longer life expectancy. Yemen, Djibouti and Sudan are all struggling to provide their populations with adequate education, healthcare and other basic services. The challenge for these pre-transition countries will be to invest the resources needed to quickly build up quality services and programs for children and adolescents.

Figure 3.1: Classic population pyramid

In middle-income countries (MIC), where this demographic transition is already in progress, populations are currently experiencing a youth bulge such that one fifth (20.4%) of people living in middle-income MENA countries are between the ages of 15 and 24. This so-called “youth bulge” presents a demographic dividend if, following the example of Asian economies, middle-income countries like Egypt and Algeria – where the youth bulge is particularly pronounced (see Figures 3.2 and 3.3) – can harness the tremendous potential of a large working-age population with a low dependency ratio. The opportunity implied here is therefore also a challenge: governments must invest in expanding opportunities for young women and men and improving education to include curriculum that is more relevant to the labor market’s needs.

Figure 3.2: Youth bulge

Figure 3.3: Youth bulge

Migration patterns in the MENA region have skewed this population bulge significantly in Gulf countries, where foreign born workers in their 30s and 40s, and especially male migrants, make up a large part of the labour force. Figures 3.4and 3.5 reveal this migration effect in Saudi Arabia and particularly in the United Arab Emirates.

Figure 3.4: Immigration effect

Figure 3.5: Immigration effect

Socio-Economic Indicators

The Middle East and North Africa is a socioeconomically diverse region. GDP per capita at purchasing power parity (PPP) ranges from an average of just over US$2,500 in the less developed countries – Djibouti, Sudan and Yemen – to an average of more than US$30,000 in the higher income Gulf countries (excluding Qatar, the richest country in the region, whose GDP per capita is over US$88,000). Most of the MENA population – 85 % of the region’s 355 million people – lives in middle-income countries, where GDP per capita ranges from US$1485 in the occupied Palestinian territories to more than ten times that figure in Lebanon (World Bank 2011).

Disparities characterise the MENA region not only across countries, but also within them. GDP per capita, however, only measures national averages, which mask inequities within each country.

Table 3.1: Socio-economic Indicators