UNICEF's annual report on the "State of the World's Children," released today, measures the progress of states in fulfilling their obligations to create a proper environment for children to develop.
The report says threats posed by poverty, conflict, and HIV/AIDS are threatening to reverse broad gains made in child welfare worldwide.
Sub-Saharan Africa continues to be afflicted by all three scourges and remains the region of most concern. But UNICEF senior program officer Gaspar Fajth tells RFE/RL that these lingering threats can also be found in much of the former Soviet Union and parts of Eastern Europe.
"The main message is that all of the three -- the big three threats -- [are] present in the region, not to the same degree in each country, but basically almost none of the countries are entirely free of these problems," Fajth says.
The report compares country records in areas including health, education, and economic performance.
Mortality of children under five -- a key indicator of child care -- remains a problem area for many former Soviet states, especially in Central Asia and the Caucasus.
The UN's Millennium Development Goals call on countries to reduce their under-five mortality rate by two-thirds between 1990 and 2015. Yet the report finds that 10 former Soviet states are "seriously off-track" from these goals. These states include Russia, Belarus, Ukraine, Latvia, Georgia, Azerbaijan, Kazakhstan, Tajikistan, Turkmenistan, and Uzbekistan. They continue to suffer, at differing levels, from the HIV/AIDS epidemic, poverty, and the lingering effects of internal wars.
UNICEF's Fajth helped research the new report, as well as a study released in October that found millions of children in former socialist states are living in severe poverty.
Fajth says that, despite the region's problems, many of its states are in better positions to find solutions than other troubled countries because of an abundance of skilled professionals, such as teachers and doctors.
The difficulty, he says, is getting governments to provide a coherent strategy for improving conditions for children.
"If there is no transport, it is useless [that] there is a hospital," Fajth says. "If there is no medicine, it is useless that there is a doctor, so governments would need [to say], 'Well, let's sit down and have a look at child well-being. Let's sit down and have a look at what the Millennium Goals means for us.' "
Another problem Fajth cites is the slow reform of the child protection system that existed under communism. That system relied on orphanages, and an estimated 1 million children still remain in such institutions.
He says they represent a failure in government planning to prevent the breakdown of families.
"Many children are losing their parents because they are dying," Fajth says. "Many children are losing their family because the family breaks up, because of migration, because of problems with conflict and also because of just very poor lifestyles of parents. Often, the state intervenes and deprives parents of their children and puts them in orphanages."
Health experts say there have been a number of individual success stories involving child care in former communist states in transition. Macedonia, for example, has sharply reduced child mortality rates through implementing programs aimed at prenatal care.
The UNICEF report says Belarus, Georgia, Kyrgyzstan, and Ukraine now have national programs to prevent mother-to-child transmission of HIV/AIDS by providing anti-retroviral treatment to pregnant women and to babies at birth.
But Nina Schwalbe, a senior fellow in international health at the Open Society Institute, says that, regionwide, there are still serious problems in prioritizing health-care spending for children.
"The ministries of health are also chronically underfunded, both in terms of human capacity, in terms of training to deal with the changes that occurred in their health systems and also just their physical material resources in their departments," Schwalbe says.
UNICEF officials say states throughout the region have experienced some economic growth. But in many cases, the distribution of wealth has been unequal.
(This report can be accessed at http://www.unicef.org.)