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9.2 Children and young people in underdeveloped regions and rural areas

The 2008 Demographic and Health Survey (DHS), dividing Turkey into five regions, put the infant mortality rate at 16 per 1,000 live births in the “West” region and 39 in the “East” region (For the 1998-2008 period, under-five mortality was 50 per 1,000 live births in the “East” compared to a national average of 33). The rate of stunting (significantly low height for age) among young children was 20.9% in the “East” compared to 7.6% in the “West”, while only 60% of two year-olds in the “East” were fully immunised compared to a national average of 74%. The same survey showed that only 79% of mothers received medical guidance and care before birth in the “East”, which was thirteen percentage points below the national average, that only 74% of births in the “East” were assisted – seventeen percentage points below the national average - and that only 33% of mothers in the “East” receive assistance from a doctor (rather than a nurse or midwife) during birth. These statistics are following an improving trend, but discrepancies undoubtedly remain today. For 2010, the Turkish Statistical Institute (Turkstat) put infant mortality in 2012 at 14-16 per 1,000 in three of the twelve “level three” statistical regions: Northeast Anatolia, Central East Anatolia and Southeast Anatolia. Indicators for children’s education generally point both to lower provision and lower performance in eastern regions. Teachers may be inexperienced and teacher absenteeism high. Net secondary school enrolment in the 2010-11 school year was 80-90% in many provinces in Western Turkey but as low as 30-40% in some Eastern provinces, with enrolment among boys often running much higher than enrolment among girls. Eastern provinces have tended to produce fewer candidates for the university entrance examination, relative to their populations of young people, and have lower success rates. Young people growing up in these regions are clearly disadvantaged in terms of professional and other opportunities.

Rural areas: Based on official population data, just over 16% of the population lives in places outside municipal boundaries, as of the end of 2011. The proportion is probably slightly higher for children (but not for young people over 18). In these rural areas, employment is concentrated in agriculture where rewards are low and few people earn pensions. Turkstat’s annual Household Budget Survey for 2011 indicated that average monthly consumer expenditure per household was TL2,364 in urban areas but only TL1,547 in rural areas (defined in this case as towns or villages with a population of up to 20,000). Levels of education are below the national average, young people may be migrating to urban areas, and infrastructure and services may be limited or may not always reach the more remote settlements. The 2008 Demographic and Health survey shows that almost a quarter of rural households still use unimproved sanitation facilities. Half (50.15%) of under-fifteens living in rural areas were in “food and non-food poverty” in 2009, according to Turkstat. In the 1999-2008 period, under-five mortality was 43 per 1,000 in rural areas, according the 2008 DHS, compared to a national average of 33. Full immunisation among two year-olds was 60% compared to a national average of 74%. Ensuring de facto access to health services and formal education remains a challenge, notwithstanding conditional cash transfers, the “green card”/universal health insurance systems, the use of bussing and weekly boarding schools and other efforts of relevant government ministries and local authorities.

The boundaries between rural and urban areas are not always easy to define, and some rural areas may be relatively prosperous due to intensive agriculture, tourism or proximity to major cities. Nevertheless, a needs assessment of rural children and young people might well find a fairly common profile for each gender and age group. Key elements would probably include poor diet or malnutrition, imperfect parenting and lack of ECD services, problems of housing, hygiene and infrastructure, a variety of risks specific to rural areas (such as the risks of drowning in lakes, rivers or irrigation canals, or diseases associated with animals like Crimean-Congo Haemorrhagic Fever), family labour in agriculture from an early age, and limited opportunities for education, socialisation, technology use or personal development through arts, sports, leisure, travel etc.

Public policy: Regional and rural development is one of the five axes of the Ninth Development Plan for 2007-2013. In addition to the regular funding and activities of local administrations and municipalities, several strategies and projects have been adopted for the purpose of regional development. Among these are the Southeast Anatolia Project (GAP), the East Anatolia Project (DAP), the Eastern Black Sea Project (DOKAP), the Zonguldak-Bartin-Karabuk and Yeşilırmak Basin regional development projects, and the National Rural Development Strategy and village support (Köydes) and municipality support (Beldes) programmes. Incentives are available for private investment in underdeveloped regions. From now on, regional development agencies are expected to play an important role in regional development initiatives in all parts of the country.

However, these initiatives are primarily geared towards infrastructure or promoting private enterprise, and they do not highlight child poverty or other children’s issues, or the problems of young people. On the other hand, improvements in national policies affecting children and young people tend to reach the underdeveloped regions and rural areas last. This is very likely to be the case, for example, with compulsory secondary education, which has been introduced for the first time in the 2012-13 school year.

Policy options: The needs of children in underdeveloped regions are diverse, as these regions differ among and within themselves with respect to climate and geography, population density, distance from major centres, ethnic and cultural factors, fertility rates, migration trends, the degree of urbanisation and similar indicators. Accordingly, ways need to be found to integrate goals, indicators and programmes related to children and young people into the work of regional development administrations and provincial, municipal and village authorities, and to spread good practice in this area. At the same time, national government ministries with responsibilities for health, education, social assistance and services, youth, development etc. need to increase their focus on equity as a guiding principle, and in this light review existing policies and establish new procedures for ensuring equitable access to protection and services for families and children in those places where these are least available.

For children and/or young people in rural areas, special programmes might be considered, given the common issues which they face and their otherwise very low claim on resources. Although the Ministry of Agriculture and Village Affairs was renamed the Ministry of Food, Agriculture and Livestock in 2011, it remains coordinator of the multi-sectoral Rural Development Plan  for 2010-2013, and the Agriculture and Rural Development Support Institution (TKDK), which manages EU “IPARD” funds earmarked for this purpose, continues to operate under this Ministry.   

UNICEF Turkey Country Office, Yukarı Dikmen Mah. Alexsander Dubçek Cd. 7/106, 06450 Çankaya/Ankara. Telephone: +90 312 454 1000 Fax: +90 312 496 1461 E-mail: ankara@unicef.org