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Main - Programs - National Demographic Security Programmenof the Republic of Belarus, 2011 - 2015




Approved by:

Edict of the President

of the Republic of Belarus

11 August 2001, No. 357

National Demographic Security Programme

of the Republic of Belarus, 2011 - 2015

Programme Information

Title:

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National Demographic Security Programme of the Republic of Belarus, 2011 - 2015 (hereinafter, National Programme)

Developed pursuant to

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Republic of Belarus Law”On Demographic Security"of 4 January 2002; Republic of Belarus Law ”On Demographic Security of the Republic of Belarus" of 4 January 2002 , (National Register of Legal and Regulatory Acts, 2002г, No. 7, 2/829)

Edict of the President of the Republic of Belarus ”On Approval of the Demographic Security Concept" of 9 November 2010, (National Register of Legal and Regulatory Acts, 2010, No. 276, 1/12080)

Edict of the President of the Republic of Belarus ”On Approval of the Demographic Security Programme" No. 136 of 11 April 2011, (National Register of Legal and Regulatory Acts, 2011, No. 43, 1/12462)

Directive of the President of the Republic of Belarus ”On Measures to Improve Public Security and Discipline" of 11 March 2004, (National Register of Legal and Regulatory Acts, 2004, No. 41, 1/5393)

Clients:

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Ministry of Education (support to families and child protection)

Ministry of Health (improving public health and life expectancy)

Ministry of Interior (emigration management)

Oblast executive committees, Minist City Executive Committee (mandated activities)

Lead Client/Coordinator

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Ministry of Labour and Social Protection

Lead

Drafting Organisations:

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Ministry of Labour and Social Protection, Ministry of Education, Ministry of Architecture and Construction, Ministry of Information, Ministry of Culture, Oblast Executive Committees, Minsk City Executive Committee

Goal:

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To stabilise the population at 9.44 - 9.45 million by 2015, and to move towards demographic growth

Objectives

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To increase fertility and strengthen socio-economic support to families with dependent children

to reduce child abandonment and neglect, develop options for family-type placements for orphaned children and children left without parental support

to improve family morale, strengthen and promote family-oriented values and attitudes

to improve reproductive health and care for the mother and child

to reduce total mortality, particularly from preventable causes, increase mean life expectancy at birth

to improve the quality of life for chronic patients and persons with diseases by building on their capabilities and residual health capacity

to manage external migration consistent with national policy goals

Implementation period

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2011 - 2015

Expected outcomes:

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increasing crude birth rate to 11.8 - 12.0 births per 1000 population

to increase total fertility rate (the average number of children that would be born to a woman over her lifetime) to 1.55 – 1.65

to increase to 80% the proportion of orphaned children and children left without parental support placed in family-type care settings

to stabilise and achieve further reduction in infant mortality at 3.8 cases per 1000 live births

to increase to 40% the proportion of uncomplicated births relative to total births

to decrease the severity of primary disability among the working age population to 55%

to decrease mortality at working age to 5.0 deaths per 1000

to decrease total mortality rate to 12.5 deaths per 1000 population

to increase life expectancy at birth to 72 - 73 years

to increase the balance of external migration to 60,000

Sources of financing and amounts

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Total expenditure from all sources in constant 2010 roubles: 770 billion roubles, including:

the republican budget: 546,4 billion roubles

local budgets: 223,6 billion roubles


Chapter 1.

General provisions

This National Programme was developed pursuant to the Republic of Belarus Law "On Demographic Security of the Republic of Belarus", the National Demographic Security Concept of the Republic of Belarus, approved by Presidential Edict No. 575 of 9 November 2010, Directive of the President of Belarus No. 1 "On Measures to Improve Public Safety and Public Order" of 11 March 2004, and the Socio-economic Development Programme of the Republic of Belarus for 2011 - 2015, approved by Presidential Edict № 136 of 11 April 2011 .

The National Programme is based on scientific evidence, and grounded in the principles of continuity, systems approach, and resource mobilisation; it is oriented towards achieving sustainable development, improving conditions for demographic reproductivity, and enabling demograhic growth in the medium to long term perspective.

Chapter 2.

Demographic situation in Belarus: main challenges and trends

For Belarus, the beginning of the XXI century coincided with a range of negative demographic trends, including depopulation and population ageing.

By implementing a series of organisational, legal and socio-economic interventions, mandated by the National Demographic Security Programmefor 2007 – 2010, approved by Presidential Edict № 135 of 26 March 2007 (National Legal Register, 2007, № 79, 1/8434), Belarus was able to achive incteases in mortality and mean life expectancy at birth, reduce the rate of depopulation, and improve material and infant mortality and external migration balance.

Crude birth rate increased from 9.9 to11.4 per 1000 population.The targets have been reached for mean life expectancy at birth (70.4 years) and net external migration (10.3 thousand). Infant and maternal mortality rates in Belarus are comparable to those of most European countries.From 2006 to 2010, annual population reduction decreased by almost one-half, from 36,000 to 18,800.

Depopulation has been a persistent demographic trend in Belarus since the early 1990s. From 1993 to 2010, the population declined, in absolute terms, by over 750,000.

Low birth rate has been a key contributor depopulation,representing only 65% of the replacement level. In 2010, total fertility ratewas at 1.49 births per woman of reproductive age, and remained significantly below the replacement level of 2.15 births per woman.

Low fertility was accompanied by the crisis of the family unit. Almost one-half of all marriages (44%) end in a divorce. One in five all all births are out-of-wedlock births. There are over 25,000 orphaned children and children left without parental support, of whom 6.7 thousand are being raised in residential institutions. Every year, nearly 4,000 children left without parental support are identified by the child welfare authorities and placed into care.

The decline in the importance of procreation and a large family in the national value system resulted in the predominance of one-child families in Belarus. The proportion of one-child families is now at 62%, while the share of families with many children is only 6%. In consequence, the number of families in the next generation may drop by one-thid. The proliferation and entrenchment in mass consciousness of the preference for a small family may make the current trends in population replacement irreversible.

In these conditions, restoring the attraction of married life and rebuilding family values should become a top priority for demographic policy.According to poll data, most young people consider family life as their top life value and over 70% desire more than one child.

Public support for the family should therefore apply differential policies; the amount of such support should grow with the birth of each subsequent child.

High mortality, particularly at working age, is another factor behind the ongoing depopulation. Mortality among men exceeds female mortality by 3 times. According to WHO data mortality among men in Belarus at age 15 - 60 exceeds is 3 - 4.5 times above the European Union level.

Rising mortality among the working-age population contributes to the decline in mean life expectancy. Today, mean life expectancy in Belaris is below most developed nations by 11 - 15 years for men and 5 - 10 years for women (at 64.7 and 76.4 years, respectively).

High mortality and low fertility create a high and increasing dependency burden on the working-age population, and on the social protection system If the current trends persist, the ratio of those not in the labour force to the working age population is projected to reach 841 per 1000 by 2030, up from 693 per 1000 in 2010.

Significant reduction of the workforce is expected to result in labour shortages and act a constraint on innovation-driven development. This will results in lost investments in workforce development, and, notably, in the education and upbringing of future workers.

Population health is an important factor impacting mortality in Belarus. Belarus has experienced rising morbidity levels across population groups, accompanied y changes in the age distribution of the disease burdenand growing prevalence of chronic disease.

Morbidity among pregnant women is exceptionally high - over 70% have complications in pregnancy, affecting birth outcomes and child health. Morbidity is also rising among adolescents. Progressive deterioration of the health status in each new generation are reducing the quality of the human capital.

At the root of the complex demographic situation in Belarus is the undervaluing of own and other people's lives and health by most Belarusians, and their disregard for their living environment. Harmful habits such as alcohol and tobacco use, and unhealthy lifestyles are among the leading factors behind the high morbidity and mortality levels in Belarus.

A significant proportion of the lost human capital can be compensated by migration. At present, the main migration flows are to/from Russia, Ukraine, and Kazakhtan. Nearly 90% of immigrants arriving into Belarus are from these three countries. Current migration trends have been characterisedby a positive net immigration. Net immigration, however, has not been high enough to compensate for the population decline.

Belarus should proceed towards implementing targeted migration policies, such as providing incentives to return for Belarusians living abroad, encourging the immigration of skilled workforce for purposes of employment in high priority and labour-deficit sectorsand provision of immigration incentives to foreign students and postgraduates who have successfully completed academic programmes in Belarusian institutions.

To be effective, migration policies should seek to attract the best immigrants, and to create a suitable environment for their socio-economic adjustment.

Domestically, out-migration has continued from rural areas to large cities, particularly to Minsk City. The number of administrative districts experiencing natural population decline has increased in recent years.Such districts not number 108, representing over 90% of all administrative districts. Urbanisation will inevitably lead to further imbalanced in the geographic distribution of the population.

Based on current demographic trends, overcoming the population decline and resuming population remain highly relevant, and demand continued policy interventions. As projected, the population may decline by one-half in 50 years, given the present levels of mortality and fertility. If these projections materialise, Belarus will reach a point of no return, when the negative demographic trends may become irreversible.

Putting a halt to the depopulation process and effecting the transition towards sustainable development will be contingent on concerted efforts by the government, public and faith-based organisations, and every citizen.

Beyond incentives to have children, protection of the mother and child, and health protection, fundamental changes are needed in the economy, urban development policy, the media and other domains.

Chapter 3.

Goals and objectives

The goal of the National Programme is to stabilise the population at 9.44 - 9.45 million by 2015, and to secure transition to demographic growth.

To this end, absolute population annual population less will be reduced, in absolute terms, from 18,000 in 2011 to 15,000 in 2012, 9,000 in 2013 and 4,000 in 2014, and marginal population increase will be achieved by 2015.

The objectives of the National Programme are as follows:

To increase fertility and strengthen socio-economic support to families with dependent children;

to reduce child abandonment and neglect, develop options for family-type placements for orphaned children and children left without parental support;

to improve family morale, strengthen and promote family-oriented values and attitudes;

to improve reproductive health and care for the mother and child;

to reduce total mortality, particularly from preventable causes, increase mean life expectancy at birth;

to improve the quality of life for chronic patients and persons with diseases by building on their capabilities and residual health capacity;

to manage external migration consistent with national policy goals.

Chapter 4.

Social assistance to families and children

Social capital is built within the family unit, the basis for the survival and development of the Belarusian nation.

There are a total of 2.7 million families, including 1.3 million families with dependent children.

Creating adequate socio-economic, organisational, legal and other conditions that enable families to realise their full potential will be some of the main prerequisite to overcoming depopulation.

In this light, social assistance to families with dependent children is a key policy objective. Belarus has established system of legal safeguards and social incentives to families with dependent children, one of the best in the CIS in terms of reliability.

This includes large-scale social programmes, including provision of financial assistance to families with many children, as well as support to housing provision, supply of free food to children under two years of age, and targeted social assistance. Public assistance is being provided to 448,000 children, (25% of the total child population), including 309,600 children aged 0 - 3 (99% of the children in this age group).

Combined with the favourable age structure of the female population, these policies have contributed to stabilising the birth rate in Belarus. Starting from 2004, there has been a positive dynamic, in birth and fertility indicators (absolute and relative) across all regions. Over the last five years, total births had reached 526,129. In 2007, annual births exceeded 100,000 for the first time over the past decade.

Crude birth rate increased in 2006 - 2010 from 1.28 to 1.49. There has also been an increase in the proportion of second and third births, by 10.9 and 3%, respectively.

However, these positive changes cannot be viewed as sustainable. In the coming decade, the birth rate will be negatively affected by structural factors, related to the relatively small size of the 1990s generation who will be entering reproductive age. The effects of the demographic gap of the 1990s, and of the declining contribution of the 1980s generation to total births are already becoming apparent. In 2010, total births had declined by 1140 relative from the previous year's level.

To overcome these trends, special efforts are need to be made encourage births and modify the prevailing preferences and expectations with regard to the number of children in the familyconsistent with improvements in the standards of living among families with children. Efforts to encourage births should prioritise families with two and three children.

Each new child should be desired, given that the family is the best environmentfor full-rounded child development, socialisation and preparation for family and work life.

However, there has been no decline over the past several years in the number of newly identified orphans and children left without parental support. Round 27% of orphans and abandoned children are being raised in orphanage-type institutions. Over 21,000 children have been designated as 'socially vulnerable'. Some 2360 children designated as in need of government protection reside in social shelters.

A set of policy measures are needed to improve family upbringing, enhance the quality of life, and promote socialisation and transition to independent life for children raised in orphanage-type institutions.

There is a need to move away from paternalistic approaches to public assistance to familiesthat view citizens as passive recipients of services with no independent role in improving their lives. The new approach should be based on the principle of partnership between the state and the public.

The aim is to form an attractive model of a happy and successful family with two or more children, capable of spiritual and moral growth, and full realisation of each member's capacity.

Specific activities to assist families and children, as specified in Annex 1, include:

encouraging families, as a matter of priority, to have two or more children, by raising the size of lump-sum and monthly allowances, and introducing additional incentives;

improving the housing, taxation and lending policies in favour of families with children;

preserving the family environment and promoting family-type placements for children left without parental support;

improving systems for promoting transition to independent living for children who had been raised in orphanage-type institutions;

developing innovative solutions and methodological support for orphanage-type institutions performing the selection, training and ongoing support to families providing care for orphaned children;

promotion, particularly among young people, of family values and the image of a happy and successful family with two or more children as the new social norm.

The above interventions are expected to result in the following outcomes by 2015:

crude birth rate will increase from to 12.0 per 1000 population (from 11.4 per 1000). Crude birth rate is projected to reach 11.4 in 2011, 11.5 in 2012, 11.6 in 2013 in 2014 and 11.8 - 12.0 per 1000 population in 2015.

total fertility rate is projected to reach1.55 – 1.65 in 2015, including 1.50 in 2011, 1.51 in 2012, 1.52 in 2013, 1.53 in 2014, and 1.55 - 1.65 in 2015.

to increase the share of orphaned children and children left without parental support who are placed in family-type care to 80% by 2015, including to 76% in 2012, 77% in 2012, 78% in 2013, and 79% in 2014.

Chapter 5.

Improving population health and life expectancy at birth

Population health is the most valuable asset of the state and society.

With respect to the health system, the main policy goal is to maintain provision of accessible and high-quality health services.

In recent years, the health system has been rebuilt; the asset base has been renovated. Research clinics have been established at the national level, modern technologies have been introduced, and a cadre of high-skilled health workers has been trained.

These improvements have led to progressive improvements in the infant and under-five mortality rates since 2006. Maternal mortality ratio has declined to 0.9 maternal deaths per 100,000 live births, and infant mortality rate to 4.0 infant deaths per 1,000 live births, i.e. to levels comparable with most European nations.

With the new technologies, neonatal clinics are able to provide intensive care to infants born at 500 - 1000 grams. Fertility treatment with assisted reproductive technologies has resulted in successful birth of over 600 children. Treatment success rates are above 40%.

Several population health indicators have improved, including mortality from myocardial infarction, by 12.3%, from cerebrovascular diseases, by 11.1%, from craniocerebral trauma, by 7%, from diseases of the respiratory system, by 31%, from infectious diseases, by 2.4 types, from Hepatitis A, by 2.1 times, from sepsis, by 2.7 times. The risk of mother to child HIV transmission has decreased by 2.7 times. The incidence of primary disability has decreased by 14% to 48.6 cases per 10,000 population.

However, multiple challenges still remain unaddressed. Population ageing contributes to growing prevalence of chronic diseases and disability.Over 504,000 residents of Belarus have been diagnosed with a disability. Around 46,000 new disability cases are being diagnosed annually, of which 42% are among working-age population.

Over 50% of all disability cases are related to unhealthy lifestyles and behaviours, including tobacco use, lack of physical activity, and excessive alcohol consumption. According to poll data, some 60% of schoolchildren aged 16 and below admit to having experimented with tobacco and 90% with alcohol.

High adult mortality rates are a combination of three factors - people's health choices, the structure of the disease burden, and the age distribution of the population. Total mortality rate was at 14.4 deaths per 1000 population in 2010, and working age mortality at 5.5 deaths per 1000. Of all deaths recorded in 2010, 23% were at working age.

The leading causes of total mortality are cardiovascular diseases (54%), neoplasms (over 13%), and external causes (10%).

The annual number of deaths from external causes (14,000) is unacceptably high, and comparable to the population of many administrative districts.

Infant and under-five mortality from external causes is also excessive. Most infant and child deaths from such causes (e.g. accidental drowning, road accidents, fires, and accidental poisonings) are the result of poor parental supervision.

The health of school-age children is also a matter for serious concern. Around 90% of schoolchildren are designated as "completely healthy" upon admission to grade 1. By the time of graduation from secondary school, this proportion is down to 80%. Chronic disease prevalence at school age has increased by 2.5 times. Impairment of vision, disorders of posture, gastrointestinal diseasesand other 'school-related' conditions contributed a substantial proportion of this increase.

Reckless behaviour in adolescence is a common cause of sexually transmitted infections, mental disorders, alcohol, tobacco and drug dependence, resulting in substantial damage to reproductive health in adulthood.

Analysis of the individual components of reproductive health reveals the following problems. High prevalence of abortions, and low motivation for health-promoting behaviour contribute to high morbidity in pregnancy (of 100 pregnant women, 73% are diagnosed with at least one disease), and high prevalence of pregnancy complications (only 36% of births are normal). One in five married couples need treatment for infertility, including 50% for male infertility.

Early diagnosis, identification and response to health risks, improved access to health care, better reproductive, maternal and child care services, and improved management and prevention of chronic conditions are some of the most relevant priorities of the health system with regard to demographic security.

Specific measures towards improving population health and mean life expectancy are listed in Annex 5, and include:

improving reproductive health services, expanded provision of premarital counselling, new treatments for female and male infertility and assisted reproductive technologies;

abortion prevention, through partnerships between the state, faith-based organisations, and the media;

improved preventive and health promoting interventions among children, including measures to prevent disorders of possture, chronic diseases and complications thereof;

strengthening interagency coordination to reduce infant and child mortality from external causes, strengthening parental responsibility for the life and health of their children;

wider public education about the risk factors for chronic diseases;

medical screening, particularly among the working age population, supported by adequate preventative and curative care;

implementing new curative, diagnostic and rehabilitation technologies in the care for chronic patients at all levels of health service provision;

completing work on establishing a medical rehabilitation system, opening rehabilitation hospitals in the regions, improving and upgrading the equipment and asset base of medical rehabilitation wards, and introducing new rehabilitation technologies;

implementing electronic patient records, electronic health passports, better monitoring of chronic patients and persons with disabilities, development of telemedicine;

Implementation of the above measures will produce the following outcomes:

stabilising and reducing infant mortality to at 3.8 cases per 1000 live births;

increasing to 40% the proportion of uncomplicated births relative to total births

reducing the proportion of newly diagnosed severe disability cases, relative to total cases, to 55% by 2015, including to 59.5% in 2011, 58.5% in 2012, 57.5% in 2013, and 56% in 2014.

reducing mortality at working age from 5.0 deaths per 1000 population by 2015, including to 5.4 deaths per 1000 in 2011, 5.3 deaths per 1000 in 2012, 5.2 deaths per 1000 in 2013, and 5.0 deaths per 1000 in(from 11.4 per 1000). Crude birth rate is projected to reach 11.4 in 2011, 11.5 in 2012, and 11.6 in 2013 and 5.1 deaths per 1000 population in 2014.

reducing total mortality to 13.0 - 12.5 deaths per 1000 population by 2015, including to 14.3 deaths per 1000 in 2011, 13.9 deaths per 1000 in 2012, 13.5 deaths per 1000 in 2013, and 13.3 deaths per 1000 population in 2014.

increasing mean life expectancy at birth to 72 - 73 years by 2015, including to 71 years in 2011, 71.2 years in 2012, 71.4 years in 2013, and 71.6 years in 2014.

Chapter 6.

Harnessing the development potential of external migration

for Belarus

One consequence of globalisation has been an increase in international migration. Belarus has been a part of this exchange both as a donor and recipient of migrants.

International migrants are attracted to Belarus by its favourable geographical location,political and economic stability; extensive family ties with the nationals of Belarus, simple naturalisation procedures, and good opportunities for employment and social adjustment. These have been some the most significant pull factors for immigration.

Under the existing immigration legislation, Belarus hosted 33,000 temporary residents and 13,000 landed immigrants in 2010 alone. Over 3,500 ethnic Belarusians acquired Belarusian citizenship.

To stabilise the demographic situation in Belarus, a two-pronged strategy should be pursued: attracting select categories of immigrants to compensate for the population decline, while also maintaining and strengthening domestic human capital.

Immigration is viewed mostly positively by the multi-ethnic and tolerant Belarusian society. However, as further increases in immigration are expected, systematic interventions are needed through the media to prevent hostility towards immigrants from the Belarusian public.

Proactive efforts will be made to inform foreign nationals about the opportunities and benefits of immigration to Belarus.

The extensive potential of Belarusian agriculture, and the availability of decent housing in rural areas are factors that will facilitate the flow of immigrants to areas experiencing labour shortages, thereby improving the geographic distribution of the population.

Provision of financial support to immigrants wishing to move to Belarus and settle here can help attract additional numbers of immigrants.

Securing the national interest and maintaining socio-economic and political stability will remain the top priorities for international migration policiesin Belarus.

Specific interventions for pursuit of domestic development objectives through immigration policies are listed in Annex 3. These interventions include:

establish a mechanism for implementing selective approaches to immigration based on educational criteria, intention to invest, educational attainment, and age;

providing financial support to immigrating skilled professionals and their families for the adaptation period;

encouraging the settlement of immigrants in a pattern most consistent with the development needs of the regions;

developing and implementing interventions to facilitate the adaptation of immigrants and their integration in the Belarusian society;

utilising the capabilities of Belarusian consular missions, and the Diaspora for attracting immigrants.

As a result of these interventions, net annual immigration is projected to reach 60,000 in 2015, including 10,000 in 2011, 11,000 in 2012,12,000 in 2013m and 13,000 in 2014.

Chapter 7.

Informational support

The media are some of the most powerful tools to influence the demographic situation, owing to their ability to shape mass consciousness.

The widening range of information technologies and growing product diversity are some of the most characteristic trends in media development in Belarus.

There are over 1370 printed publications, 241 television and radio broadcasters, and nine news agencies active in the country. Cable television providers alone are rebroadcasting more than 100 foreign channels. Demography, lifestyles, and individual life pathsare some of the most widely featured themes in the Belarusian media today. However, family values, child upbrining and youth matters have a much lower profile in the media environment.

The objectives of the National Programme are contingent on teh pursuit of information policies that seek to promote family values, healthy lifestyles, child safety and exposure of children and young people to the best achievements of the world and national culture.

To contribute to the achievement of demographic policy goals,media interventions be targeted towards achieving the following outcomes:

increasing the share of documentaries and shows on national television presenting local perspectives on youth, social and demographic policies.

promoting meaningful debate in the state media of the problems and challenges facing young families and families with many children; providing consultations on radio and television on health and health promotion;

forming a pool of journalists from the national media writing on demographics; improving the professionalism of journalistic coverage of these matters, by organising meetings with experts, and conducting workshops and roundables;

expanding public education and consultative interventions on support for families, the elderly and the disabled, collaboration with NGOs, international organisations and leading religious denominations.

establishing a festival of pro-family and patriotic cinema;

conducting and information campaign to promote a positive view of immigration among the general public and encourage tolerant attitudes for foreign nationals.

As a result of this intervention, the share of programming on youth, social, educational and demographic issues will represent at least 3.5% of average daily air time.

Chapter 8.

Academic and research support

The National Programme is grounded in scientific research in demographics. As suggested by the findings of this research, demographic security is fast becoming an urgent challenge, calling for appropriate interventions by the state to turn around the negative demographic trends. The National Programme is based on the 2009 Population Census Data , demographic projections, quality of life studies among various groups of population, and opinion poll data on public perceptions of demographic and social policy matters.

The National Programme reflects the demographic trends highlighted in this research, and the action areas to react to these trends.

Academic and research support for the National Programme will be provided by research institutes and higher education institutions, based on the available experienceand progressive ideas on demographic security.

Academic studies will develop multiple scenarious and projections for population size, geographic, age and sex structure up until 2020, and formulate priorities for the state family policy.

This will also lead to methodological recommendations for public policy on achieving demographic security in Belarus.

Chapter 9.

Financing

The financing for the National Programme is presented in Annex 4.

Total expenditure from all sources shall amount to 770 billion in constant 2010 roubles, including:

the republican budget: 546,4 billion roubles

local budgets: 223,6 billion roubles

Such funding does not include the social insurance funds and national budget expenditures on increasing state allowances and benefits to families with children. The amounts of funding for these purposes will be subject to review to reflect the changes in the minimum subsistence leveland revisions to the state budget and the budget and the extrabudgetary Social Protection Fundunder the Ministry of Labour and Social Protection.