Demographic Challenges and the Implications for Children in CEE/CIS

The paper discusses some of the implications of recent demographic changes in the CEE/CIS on children of the region. The first part of the paper documents the striking changes in population size and structures which have occurred since the beginning of transition, and which have led to a substantial reduction in the child population. It is argued that they have been mainly driven by the drop in birth rates which has characterised the whole region, but which has been most dramatic in the CEE and Western CIS. Some countries in these subregions now rank among those with the lowest levels of fertility in the world, and the shrinking cohorts of children in these countries face the prospect of a growing old-age dependency burden. The second part of the paper discusses recent data on infant and under-five mortality, which are direct measures of child wellbeing and of the success of policy measures aimed at improving child survival and development. The paper highlights the marked differences not only in levels, but also in progress in reducing mortality rates across the CEE/CIS. Whereas some countries of Central Europe have made impressive progress during the past decade and now rank among those with the lowest levels of infant mortality in the world, the high levels in the Caucasus and Central Asian countries are a matter for concern. The paper also draws attention to the substantial monitoring challenges which still exist in estimating and tracking infant and child mortality, particularly in these latter two subregions, despite the recent official adoption of the internationally recommended definition of ‘live births’. Official estimates based on civil registry records lead to an underestimation of the scale of the child survival problem and detract policy attention from the urgent need to improve the quality of pre and post natal care, mainly through incentives and training for medical staff. Without improvements in monitoring, it will be difficult for these countries to devise appropriate policy responses to correct the problems and remove existing barriers to improving child survival.