Jamele Rigolini • Sarah Coll-Black • Rafael De Hoyos Navarro • Ha Thi Hong Nguyen
How lessons learned from the COVID-19 response across Eastern Europe and the South Caucasus can be used to build better and more resilient human development systems
Turkey
New EU Member States
South Caucasus
Russian Federation
Eastern Europe
Western Balkans
Source: Authors’ calculations from World Development Indicators (left) and World Bank PIP Database (right). Note: Non-EU ECA excludes HIC but includes Russia.
Crises, conflicts and shocks are on the rise
Financial Crisis
Invasion of Ukraine COVID
Inflation and Energy Crisis
Regional conflicts and tensions
Natural disasters (Earthquakes, Floods and Droughts)
Higher within-country polarization and instability
Human Capital - a foundation for prosperity – is often a victim of crises
School closures affect learning outcomes and students’ lifetime labor income – especially among the poor and vulnerable
Lockdowns and disruptions in health services affect nutrition, mental health, child development and the health of people with NCDs and pre-existing conditions
Crises and shocks also affect labor markets, with disproportionate impacts on youth (an the vulnerable) and leaving long-term scars
Human capital is a long-term investment, and frequent emergencies take away the focus on the need to nurture and invest in it
• The report focuses on the COVID-19 response in Armenia, Azerbaijan, Georgia, Moldova and Ukraine
• It covers the health, social protection and education sectors
• It takes a forward-looking approach – lessons learned can improve response to many future crises in the region and beyond
For the purposes of the report:
The ability to protect human capital and the livelihoods of poor, vulnerable and middle-class households during shocks and crises
Health (Governance & Design). UK and Italy were severely affected during first wave – but learned and boosted resilience by:
Strengthening monitoring systems
Using / establishing of scientific advisory groups
Providing sufficient and stable funding
Implementing innovative approaches to health workforce management (i.e. skill-mixing)
Implementing efficient vaccination programs (UK: 75% of adults with 2 COVID doses within 8-9 months)
Social protection (Delivery). Adaptiveness of legislation and delivery tools helped effective and rapid response:
Ukraine: online applications and case management through Diya platform
Chile: effective use of Household Social Registry to rapidly identify and pay benefits to 73% of population in a few months
Australia: use of a pre-existing single delivery structure, Service Australia, to enroll beneficiaries and deliver different benefits
Education (Data & Information). Denmark and France made effective use of data to guide policy decisions:
Denmark: regular, online assessments of student learning informed returning dates to schools and partial openings
France: use of learning assessments and demographic data to identify learning gaps; reduction of class size in selected schools; use of surveys to assess mental health and home situation during confinement
In both countries, monitoring helped design support measures for students lagging behind
Between 300 and 400 thousands excess deaths by January 2023
GDP dropped by more than 5 percentage points in 2020, and remittances by up to 40 percent
With the exception of Ukraine, poverty estimates increased between 1.4 and 5 percentage points in 2020
Impacts were mitigated by fast and ambitious responses…
…generating an opportunity to learn and better prepare for future crises (this report)
Economic activity bounced back quite significantly in 2021 but…
Full school closures ranged from 63 to 205 days - with some students even forgetting what they had learned
Impacts have been particularly heavy on poor students with inadequate learning environment at home
Limited measures have been taken to close crisis-induced learning gaps
Authors’ imputations based on actual school closures and learning loss studies compiled by Patrinos, Vegas and Carter-Rau (2022).
Essential health service disruptions (18 months into the pandemic)
Deferred treatments have been substantial, at times with longlasting impacts
Impacts on children (reduced vaccinations / antenatal visits; nutrition) remain to be assessed
Hospital Inpatient Services
Appointments with Specialists
Emergency, Critical and Operative Care
Community Care
Rehabilitative and Palliative Care
Deferred treatments are both a result of Government policies and fear of being infected
Primary Care
0% 50% 100%
Percentage of ECA Countries
Source: Global pulse survey on continuity of essential health services during the COVID-19 pandemic, Round 3, 17 ECA countries.
Reduction of social mobility and communication campaigns
Establishment of intersectoral steering groups
Expansion of testing and contact tracing capacity; use of health information systems to monitor the spread of the pandemic
Optimization of hospital care and expansion of the healthcare workforce
Acquisition/production of medical equipment and vaccines / pharmaceuticals
Financial measures to alleviate the cost of COVID-related care
Many hospital beds but not enough equipment
Weak primary care networks with scarce human and financial resources
Crisis planning and pandemic preparedness varied substantially; not all countries conducted regular health sector drills
Severe staff shortages, worsened by the pandemic
High levels of mistrust / vaccine hesitancy
Use of social assistance, social insurance and employment programs to support people who lost income or were seen to be vulnerable
o Horizontal/vertical expansion of last resort income support; payments to vulnerable children, disabled, and pregnant women
o Expansion of unemployment insurance, wage subsidies and pensions
Use of subsidies to cover utility bills, food purchases and tuition Expansion of public works
Expansion of social services (e.g. bringing food to isolated elderly)
The spending level and composition of the response varied substantially across countries – but the social assistance response remained modest overall
Social Assistance (other than Utility)
Unemployment Benefits
ALMPs (other than WS) + Tax Rebates
Wage Subsidies (WS)
Utility Subsidies
Limited preparation affected the effectiveness of the response
o Some countries had to establish new, ad hoc institutional structures to manage their overall COVID-19 response
o Emergency funding was often channeled to pensioners / formal sector because of greater voice and limitations of social assistance
Social assistance responses often provided more aid to existing beneficiaries, but limited the expansion to those made poor(er) by the pandemic
Social Assistance application rules were not always eased, and communication campaigns were limited (in contract with employment programs)
Schools were fully closed for 64 to 205 days
School closures substantially affect learning – especially of the poor and vulnerable
Remote learning based on a combination of online platforms and media broadcasts, synchronous and asynchronous instruction
Subsidized / free internet access, online textbooks, (devices), and access to distance learning applications and platforms
Development / expansion of online teacher training and support
Some psychosocial and mental health support
Countries failed to learn from emerging evidence to adjust policies and minimize learning disruptions
o Schools were closed for excessively long
o Limited efforts to address pandemic-related learning gaps
Limited support to teachers in terms of connectivity, equipment and training
Poor connectivity and learning environment at home & learning fatigue
Remote learning, even if effectively implemented, is a poor substitute to face-to-face learning
The importance of preparing for future crises cannot be stressed enough
Most countries have disaster risk management policies, but they neglect the human development sectors:
o The health sector should have effective preparedness plans, monitoring systems, crisis-specific legislation/financing, and hospitals should conduct regular emergency drills
o In social protection, legislation should enable programs to be rapidly scaled up, with relevant changes to both eligibility and benefit rules set out in advance
o In education, alternative learning modalities should be designed and piloted regularly, and student performance should be more closely monitored
Systems that can deliver quality services in normal times tend to respond better to crises:
Effective public health systems are better equipped to monitor the spread of a pandemic, and a trained and qualified health workforce needs less additional support during stressful times
Social protection systems that have invested in administrative tools to identify people in need of support were able to identify and enroll new beneficiaries more rapidly
Education systems with many students with poor learning outcomes faced a higher risk of students falling further behind during school closures
Let’s not lose sight of the need to strengthen human development systems by protecting, financing, and improving delivery
While a crisis may be over, crisis-induced human capital gaps are often not
o Learning losses are massive, deferred medical treatment has affected the health of many people, and precarious employment may leave long-term scars
Proper crisis responses must support people in the medium to long term
It is essential to invest in remedial education, catching up on the provision of medical care, and favor youth insertion in the labor market
Digitalization enabled more effective responses
Health information systems, social registries, online learning and training platforms, integrated M&E systems, and payment and learning/training platforms improved substantially crisis responses
Further Digitalization can support more effective delivery in both normal and crisis times
However, digitalization is sustainable only if systems are properly maintained and updated, and if people are digitally literate
Digitalization needs to be gradual and accompanied by training and governance / legislative reforms
Human capital spending in the region was (mostly) low to begin with – and the COVID-19 pandemic has put further strain on public finances
With recurrent crises hitting the region, it is vital to protect as well as improve fragile human capital endowments to support greater productivity and prosperity
One should not lose attention to the long term - it is not the moment to let spending fall even further
In SP, level and length of support should be tailored to needs and vulnerabilities
o Across SP choose which program to expand, within programs choose how to expand
In Education, policy responses (i.e. school closure policies) should change over time to incorporate emerging evidence
The use of behavioral approaches could help improving the population’s following of public health policies
Poorly designed responses – even if delivered effectively – can substantially limit impacts
Putting the household at the center requires however a solid intersectoral governance and M&E structure
o E.g., Lockdowns require not only income support measures but also measures to support parents, children, and teachers with distance learning and remote working
Maximizing response impacts also requires considering tradeoffs across sectors and programs
Disaster response is about helping people cope with crises and shocks
During a crisis there may be little time for evaluations – but monitoring systems should be already in place to support evidence-based response decisions
o Some crises (COVID-19) can also last for a long time – reinforcing the need for evidencebased decisions
COVID-19 responses could have been more effective if regularly evaluated and improved
o Large-scale student assessments would have enabled the design of more effective responses
o The design of social programs changed little over time
Investing in digitalization, monitoring and evaluation can – again –support both long-term system strengthening and resilience
