UNICEF works to improve children’s health and nutrition across Europe and Central Asia. With our partners, we strengthen health systems, maximize immunization coverage and support policies and financing to safeguard the health of children and women.

A newborn baby in a hospital in Kyrgyzstan that was entirely rehabilitated by UNICEF.

The challenge

Europe and Central Asia has surpassed global progress on child mortality, more than halving the deaths of children under five and infants since 1990. And as progress for the poorest households has accelerated, the health gap between the richest and poorest has narrowed. 

However, persistent inequities reflect a continued failure to invest effectively in child-centred health systems for all. In South-East Europe, for example, child mortality among the Roma population is two to three times higher than national averages.   

Problems missed at an early age can be more difficult and expensive to address later in life.

Such inequities are compounded by a failure to spot problems during pregnancy and during the first 1,000 days of life, when children’s bodies and brains build the foundations for their life-long development. Problems missed at an early age can be far more difficult and expensive to address later in life. 

Across the region, more than half of the children who die before their fifth birthday die in their first month of life.These deaths are often the result of conditions that are readily preventable or treatable at low cost through, for example, access to good obstetric, ante-natal and post-natal care, routine immunization and exclusive breastfeeding. The main killers of children under the age of five in the region are also preventable: pneumonia and injuries. 

Emergencies have an intense impact on child health and nutrition.

The impact of emergencies on children's health and nutrition can be extreme. Children on the move, such as those caught in Europe’s refugee and migrant crisis, for example, often lack adequate clothing, food, shelter or warmth. Access to health services, including immunization, has often been inadequate on their journey.

The region’s existing HIV prevalence, coupled with lack of safe water and sanitation, as well as ongoing challenges related to early child development and protection all heighten the vulnerability of children during emergencies. 

The region is also experiencing vaccine ‘hesitancy’ – the reluctance of some parents to immunize their children, or parental delays in immunization. This hesitancy, often fuelled by misinformation, puts children at risk of contracting, and even dying from, infectious diseases, including polio and measles.

The solution

Investing in the early years is one of the smartest investments a country can make.

UNICEF draws on robust evidence and its own experience to achieve concrete action for the health and nutrition of children across the region. We demonstrate that investing in the early years is one of the smartest investments a country can make to break the cycle of poverty, address inequality, boost productivity, and reduce the burden of non-communicable diseases and poor mental health.  

We raise awareness among the general public and policy makers and other – including health professionals – about the critical importance of good child health and nutrition for societies that are healthy and productive.    

UNICEF does not shy away from asking the tough questions on health and nutrition. Why, for example, do the same disparities affect the same children in the same ways, year after year? Why are some children far more likely to die before their fifth birthday than others? We argue that this is not because the region lacks national plans and systems for health or nutrition: it is because those plans and systems need urgent reform, reinforced by far greater investment to reach children who are slipping through the gaps. 

Empowering communities to increase demand for health services

We use a multi-sectoral approach to help governments strengthen their health systems by, for example, supporting the development of health-related strategies, plans and budgets, reinforcing the skills of health managers and workers, and empowering communities to increase demand for health services.

We aim to prevent neo-natal deaths by helping governments to improve the quality of care for women during pregnancy and around the time of birth. And we recognize that health workers who have the most direct contact with families are best-placed to detect problems early on and refer children when necessary. 

In 14 countries across the region, for example, UNICEF has championed the comprehensive home-visiting approach as a proven, effective and multi-sectoral approach to child health, nutrition and well-being. 

UNICEF also addresses the misinformation that is eroding the region’s near universal immunization coverage and putting children at risk of preventable childhood diseases, while supporting governments in strengthening routine immunization. 

Looking beyond specific areas of health and nutrition, we also help governments improve other areas that are crucial for child survival and well-being, including social protection, early childhood development and education.