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Programme
04 Октябрь 2017
Immunization
https://www.unicef.org/eca/health/immunization
Immunization is a proven and cost-effective public health  intervention, saving the lives of millions of children and protecting millions more from illness and disability.  Immunization is also a wise financial investment - with every $1 invested in immunization returning an estimated $16 in health-care savings and increased economic productivity.  Most countries in Europe and Central Asia have immunization coverage of 95 percent or more for three doses of diphtheria, tetanus and pertussis (DTP), often seen as the measure of national performance on immunization. However, while most national averages for DTP vaccination may be adequate, the regional average is hovering at around 92 percent, a slight decrease from the previous year, which is not high enough to ensure immunity for everyone. Over 70 percent of the region’s unvaccinated infants are from middle income countries, with Ukraine presenting the lowest coverage rate and the greatest challenge. National averages also mask disparities, with Roma children  and those from other ethnic and vulnerable groups, including refugee and migrant children, all lagging behind. Measles outbreaks are a growing problem. Last year there were over 10,000 cases of measles in the region. Despite increased coverage of the first dose of the measles vaccine among children (up from 63 percent in 2000 to 93 percent in 2016) more work is urgently needed, as children are not fully protected against measles unless they receive two doses. Currently, second dose coverage is at 88 percent, which does not provide adequate protection.            In total, over 500,000 children in the region are still not protected against measles - a life-threatening, but easily preventable disease.   There are also concerns about ‘vaccine hesitancy’ – a growing mistrust of immunization among some parents, fuelled by myths and misinformation. Such hesitancy may stem from negative media stories linking a child’s death to immunization without the full facts. It may be influenced by the region’s anti-vaccine movements, which spread anti-immunization messages. Meanwhile, measures to counter vaccine hesitancy and build parental trust in immunization are hampered by a lack of discussion with parents about its importance and the minimal risks.  A baby girl receives her vaccination at a clinic in Serbia. A baby girl receives her vaccination at a clinic in Serbia. Donor support for immunization is falling in some countries that still require such support. Elsewhere, the concern is to ensure financial sustainability for immunization programmes once countries ‘graduate’ from the support provided by Gavi (The Vaccine Alliance). Ongoing reforms in some countries are affecting both the structure and financing of immunization programmes. Some countries, challenged by competing priorities at home and inaccessibly priced vaccines on the global market, experienced several vaccine shortages in 2015–2016, sometimes causing critical disruptions of services. These issues are particularly acute in middle-income countries, many of which self-procure vaccines and continue to face significant challenges in achieving financial sustainability of their immunization programmes. Some countries also lack adequate monitoring of vaccine coverage, which is critical to understand and address any gaps.   As a result of such challenges, the region faces outbreaks of vaccine-preventable disease, such as a polio outbreak in 2015 and an ongoing measles outbreak in Ukraine  – a country where conflict and economic recession have depleted stocks of vaccines and vaccine hesitancy is reducing immunization coverage. There is also an ongoing large measles outbreak in Romania, with over 10,000 cases of the diseases and 38 deaths. During the last five years, measles outbreaks have been registered in Georgia (2013), Kazakhstan (2014), Kyrgyzstan (2015), and Tajikistan (2017). Outbreaks in one country can spread rapidly to others, signalling the interdependence and vulnerability of all countries, whatever their stage of economic development.  
Article
25 Апрель 2018
#VaccinesWork to protect children in Ukraine, amid measles outbreak
https://www.unicef.org/eca/stories/vaccineswork-protect-children-ukraine-amid-measles-outbreak
As a mother of two young children, Natalia was once told by her doctor that vaccinations were unnecessary. Now – with a measles outbreak gripping Ukraine –Natalia is glad she chose to ignore the doctor’s advice and instead vaccinate her children. This recent national outbreak has affected 16,500 people and killed 13, including nine children. According to a UNICEF poll taken in 2016, 16 percent of parents in Ukraine have refused vaccinations for their children.  Natalia with her two children in a park in Kyiv. Natalia, with her two young children in a park in Kyiv. “Many parents I know still refuse to vaccinate their children,” says Natalia, whose children received the MMR vaccine against measles, mumps and rubella. “They say the vaccines are bad, that they have adverse effects. My children are fine and I think their health is more important.” Ukraine’s Ministry of Health has been leading the outbreak response since 2017 with support from UNICEF and other partners. While less than half of all children in the country were vaccinated against measles as part of routine immunization in 2016 (via the MMR vaccine), the number more than doubled in 2017 to over 90 percent, according to the Ministry. Valentyna Ginzburg, a doctor who heads Kyiv’s state healthcare department, says she and her team have been working to combat the measles outbreak since first being alerted to a rise in infections following the New Year and Orthodox Christmas celebrations in 2018. “We received information on the incidence rates of measles in Kyiv,” Dr. Ginzburg says. “We knew we needed to take rapid action to prevent a situation similar to other regions, such as Odesa, where there had already been fatalities amongst both adults and children from the illness.” Measles is one of the most contagious diseases around and we understood that if we were not proactive and did not control it, it would have not been long before we had the same situation as in other regions. Dr. Ginzburg Dr. Ginzburg explains how she and her colleagues had to act quickly to stop the spread of the disease in Kyiv. UNICEF/2018/Krepkih Dr. Ginzburg explains how she and her colleagues had to act quickly to stop the spread of the disease in Kyiv. In the four days that followed, 11,000 children were vaccinated in Kyiv. Around 48,000 children were immunized from January to March, a tally that would normally take 12 months to reach. Following national recommendations on outbreak response, authorities in Kyiv launched a ‘situation room’ to collect the latest information and coordinate response actions. Being vaccinated was also made a pre-condition for children attending schools and preschools to help stop the spread. The city administration also encouraged medical specialists to visit schools and raise awareness of vaccination among both teachers and parents.  Maryna Stefanenko, a pediatrician at a clinic on the left bank of Kyiv, gives more details. “We had a lot of people coming in, even those who normally go to private clinics,” she says. Dr Stefanenko’s clinic usually administers around 80 vaccines per day, but during the outbreak they were immunizing around 1,200 people each day.   On the other side of the city, in Obolon district, another clinic rushed to meet demand. A pediatrician there, Dr Natalia Yatsenko, explained that as part of her job, she must sign the paperwork for parents who refuse to vaccinate their children. She says she spends a lot of time explaining the benefits of vaccination, as well as the risks for children who do not receive their shot. Before the measles outbreak, she managed to talk some 10 per cent of objectors into changing their mind. However, during the outbreak, she did not even have to persuade them – many parents who were once against vaccinations were very keen to bring their children to the clinic. A young boy receives several vaccines at a time at Dr Natalia Yatsenko clinic in Kyiv. A young boy receives several vaccines at a time at Dr Natalia Yatsenko clinic in Kyiv. Another factor in the response? The effects of armed conflict in eastern Ukraine. “We had some internally displaced people from the eastern regions who came to our clinic,” says Yatsenko. “They told us that their children’s vaccination records had been falsified, and now they wanted to vaccinate them for real. So we vaccinated them.” “We also vaccinated some parents,” adds Stefanenko. “The parents bought the vaccines for themselves from the pharmacy then brought them to us and we administered the shots.” Dr. Ginzburg also advocated with the Kyiv authorities to address one of the biggest issues the country is struggling with - access to vaccines for adults and health workers. “All health workers had to be checked and those who required vaccination had to be immunized,” she says. “Then we were sure that, no matter what, the doctors wouldn’t be incapacitated.” The city administration also made sure the municipal pharmacy chain had measles vaccines available for adults. Artem, six, receives his second dose of the MMR (mumps, measles, rubella) vaccine in Kyiv. Artem, six, receives his second dose of the MMR (mumps, measles, rubella) vaccine in Kyiv. Although vaccines for children were available in 2017, increased demand had depleted stocks in some regions. To help replenish stocks, a new expedited supply of MMR vaccines was delivered by UNICEF at the request of the Ministry of Health at the end of February 2018, and another 800,000 doses are due this month, to ensure sufficient vaccines for both routine immunization of children and those who may have missed their immunizations in previous years. Significant progress has been made in reaching more children with vaccines, yet still an estimated 1.5 million children die globally from vaccine preventable diseases every year and an estimated half a million children in the region are still not immunized. Millions of lives can be saved by extending basic health services like routine immunization to the most vulnerable and disadvantaged, and UNICEF is on the ground immunizing millions of children each year . Vaccines protect children against disease and death, saving up to three million lives every year. In short, #VaccinesWork. 
Article
27 Сентябрь 2018
Astana Global Conference on Primary Health Care
https://www.unicef.org/eca/stories/astana-global-conference-primary-health-care
What is the Astana Global Conference? On 25-26 October 2018, world leaders, government ministers, development partners, civil society and young people will meet in Astana for the Global Conference on Primary Health Care, jointly hosted by the Government of Kazakhstan, UNICEF and WHO. Participants will renew their commitment to primary health care as the means of achieving universal health coverage, SDG3 and other SDG goals to which health is a contributing factor. The Conference will mark 40 years since the first Global Conference on Primary Health Care, held in 1978 in Almaty (then Alma-Ata), Kazakhstan. The Declaration of Alma-Ata endorsed at that conference was a seminal document that founded a movement and advocacy for primary health care. The 2018 Conference will endorse a new Declaration of Astana which emphasizes the critical role of primary health care in promoting good health, social and economic development and global security. It aims to refocus efforts to ensure that everyone everywhere can enjoy their right to the highest standard of health. What is primary health care? Primary health care is an approach to designing and delivering frontline health services that lays a foundation for achieving universal health coverage. Universal health coverage is one of the targets of the third Sustainable Development Goal (SDG3): Ensure healthy lives and promote well-being for all at all ages. Primary health care includes three core elements: Affordable and accessible health services, including quality primary care, and essential public health functions that promote health and well-being, prevent illness and protect populations against outbreaks of disease. Empowered people and engaged communities, to whom health services are accountable, and who are also responsible for their own health. Inputs (policies, actions, resources) from all sectors that influence health and well-being, ranging from agriculture, manufacturing, education, water, sanitation and hygiene, transport and the media etc. A one-year-old girl is administered her first dose of the mumps, measles and rubella (MMR) vaccine at a clinic in Kyiv, Ukraine. A one-year-old girl is administered her first dose of the mumps, measles and rubella (MMR) vaccine at a clinic in Kyiv, Ukraine. How does primary health care contribute to universal health care? Universal health care is based on the principle that all individuals and communities should have access to quality essential health services without suffering financial hardship. Primary health care contributes to this by ensuring that health services are available, accessible and affordable – including services that prevent illness, cure disease and promote good health. How is UNICEF contributing to the event in Astana and to primary health care? UNICEF is working closely with WHO and the Government of Kazakhstan to support and prepare for the conference. All UNICEF offices are mobilizing government and civil society partners, and making sure the core elements of primary health care are prioritized in the allocation of funding and resources, and in follow up actions. UNICEF is coordinating a Youth Forum that will be held on the day prior to the main event to bring the voices of young people into the conference. UNICEF is also part of a core group of global and regional partners working to support primary health care at country and sub-national levels. The group, which includes UN agencies, donor governments, philanthropic foundations, multilateral agencies like the Global Fund, Gavi and others, is developing a set of operating principles that will prioritize the three core elements described above, and ensure primary health care remains in place after their support has ended. This will be reflected in UNICEF’s own programmes with governments and partners. Ahead of the Global Primary Health Care Conference in Astana, 25-56 October, UNICEF Executive Director Henrietta H. Fore shares the path to achieving “Health for all” – the vision of the SDGs. In her address, UNICEF Executive Director Henrietta H. Fore, highlights the importance of investing in the quality of primary health services and extending their reach to ensure access for the most vulnerable and underprivileged communities. #PrimaryHealthCare #HealthForAll #Astana2018 Success stories: How primary health care helps families and children In remote Kyrgyzstan simple solutions save newborn lives How visiting nurses help prevent child deaths in Kazakhstan Fathers in Turkmenistan carve out their immediate and long-term parenting roles Investing in better care during baby’s first days is saving lives in Kyrgyzstan Saving newborn lives in remote mountainous areas of Kyrgyzstan   “In Focus” reports: A healthy start in life for every child Immunization   More information about the Astana Global Conference WHO Global Conference on Primary Health Care website The Declaration of Alma-Ata Provisional conference programme
Programme
04 Октябрь 2017
Health
https://www.unicef.org/eca/health
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.
Article
13 Май 2021
Safeguarding the health of refugee and migrant children during COVID-19
https://www.unicef.org/eca/stories/safeguarding-health-refugee-and-migrant-children-during-covid-19
"When COVID arrived here, I thought: ‘It's over, it will spread throughout the building’. I didn't think it was possible to avoid the spread of the outbreak. Instead, we have had very few cases and we owe this, above all, to the support we received from INTERSOS and UNICEF."  Josehaly (Josy), a refugee living in Rome A field worker from Intersos fastens a mask for a young refugee girl in Rome. A field worker from Intersos fastens a mask for a young refugee girl in Rome. The ‘RM Child-Health’ initiative is funding work across five European countries to keep refugee and migrant children connected to health services. While the COVID-19 pandemic was not foreseen when the initiative was first launched, the strategic principles underpinning the ‘RM Child-Health’ initiative – flexibility, responsiveness to real needs, and building on what works – meant that UNICEF and partners could swing into action to safeguard the health and wellbeing of refugee and migrant children and overcome intensified and unprecedented challenges. Since the launch of the 27-month ‘RM Child-Health’ initiative in January 2020, activities were adapted quickly to address access to health services during the COVID-19 crisis in Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia. This €4.3 million initiative, co-funded by the European Union Directorate-General for Health and Food Safety, has shown refugee and migrant children and families how to protect themselves and others, and that they have every right to health care – even in a pandemic. The rapid escalation of the COVID-19 pandemic in Europe in 2020 exacerbated the already worrying state of health and wellbeing of the region’s most vulnerable people, including refugee and migrant children, and has had a protracted impact on their access to health and other vital services. The situation has been particularly dire for refugees and migrants who are not in formal reception sites, and who are, therefore, harder to reach and monitor. Refugee and migrant families living in over-crowded conditions with limited access to sanitation are at high risk of infection. These communities have often had to face a ‘double lockdown’, confined to their settlements and camps and having little or no access to accurate information on protecting themselves and others.  The additional pressures have been severe. UNICEF and its partners in Bulgaria have seen appeals for support double from 30 to 60 cases per day. Far more refugees and asylum-seekers have been in urgent need of financial and material support, having lost their incomes because of the pandemic. There have been increased requests for support to meet the cost of medical care for children, which is not covered by the state budget, and more requests for psychosocial support. This increase in demand has, of course, coincided with serious challenges for service delivery. Restrictions on movement have curtailed in-person services, and partners have had to adapt the way in which they connect with refugees and migrants. The pandemic has had a direct impact on the provision of group sessions to share health-related information, as well as on the timely identification of children and women suffering from or at risk of health-related issues. The impact on vital services for timely and quality maternal and child health care, psychosocial support, recreational and non-formal services, and on services to prevent and respond to gender-based violence (GBV) has been profound. In Bulgaria, UNICEF and its partners were able to take immediate measures with support from the ‘RM Child-Health’ initiative to alleviate the impact, including online awareness raising and information sessions and the use of different channels for communication, including social media. UNICEF’s partners, the Council of Refugee Women in Bulgaria (CRWB) and the Mission Wings Foundation (MWF) adapted service delivery to allow both face-to-face interaction (while maintaining social distancing for safety) as well as assistance online and by telephone. Partners were able to continue to provide direct social services support while also delivering online consultations to refugees and migrants on cases of violence, as well as referral to specialized services. In Greece, the initiative supported the development of child-friendly information posters and stickers for refugee and migrant children and their families on critical preventive measures and on what to do and where to go if they experience any COVID-19 symptoms. In Italy, the initiative has supported outreach teams and community mobilization, providing refugee and migrant families with the information and resources they need to keep the pandemic at bay. In Rome, for example, health promoters from Intersos continued to work directly with refugee and migrant communities in informal settlements, not only to prevent infection but also to keep their spirits high, as one health promoter explained: "We have organized housing modules that are not only designed to keep the community safe, but also to stop loneliness overwhelming the people forced into isolation. The entire community has assisted people affected by the virus by cooking, washing clothes and offering all possible support, particularly to the children."  UNICEF and its partners in Italy, as in other countries, have aimed to maintain continuity and unimpeded access to key services. Child protection, for example, has been mainstreamed into all project activities, and additional measures have been introduced, with a ramping up of activities to raise awareness and share information. UNICEF partners adapted quickly to the pandemic, with Médecins du Monde (MdM) activating a hotline number to provide remote counselling and psychological first aid (PFA). Centro Penc shifted to remote case management and individual psychological support, strengthening the capacity of cultural mediators to support GBV survivors, with UNICEF’s support. Young people were consulted and engaged through UNICEF’s online platform U-Report on the Move, with young U-reporters sharing information on the increased risks of GBV, as well as on available services. In Serbia, the initiative has supported UNICEF’s efforts to improve the immunization process for refugee children and migrants by strengthening the assessment and monitoring process. As a result of such efforts, refugees and migrants have been included in the national COVID-19 Immunization Plan.  
Programme
02 Октябрь 2017
Roma children
https://www.unicef.org/eca/what-we-do/ending-child-poverty/roma-children
The Roma are one of Europe’s largest and most disadvantaged minority groups. Of the 10 to 12 million Roma people in Europe, around two-thirds live in central and eastern European countries. While some have escaped from poverty, millions live in slums and lack the basic services they need, from healthcare and education to electricity and clean water.  Discrimination against Roma communities is commonplace, fuelling their exclusion. Far from spurring support for their social inclusion, their poverty and poor living conditions often reinforce the stereotyped views of policymakers and the public. And far from receiving the support that is their right, Roma children face discrimination that denies them the essentials for a safe, healthy and educated childhood.   Discrimination against Roma children can start early, and have a life-long impact. The problems facing Roma children can start early in life. In Bosnia and Herzegovina, for example, Roma infants are four times more likely than others to be born underweight. They are also less likely to be registered at birth, and many lack the birth certificate that signals their right to a whole range of services.   As they grow, Roma children are more likely to be underweight than non-Roma children and less likely to be fully immunized. Few participate in early childhood education. They are less likely than non-Roma children to start or complete primary school, and Roma girls, in particular, are far less likely to attend secondary school. Only 19 per cent of Roma children make it this far in Serbia, compared to 89 per cent of non-Roma children.  There are also disparities in literacy rates across 10 countries in the region, with rates of 80 per cent for Roma boys and just under 75 per cent for Roma girls, compared to near universal literacy rates at national level.    Roma children are too often segregated into ‘remedial’ classes within regular schools, and are more likely to be in ‘special’ schools – a reflection of schools that are failing to meet their needs, rather than any failure on their part.   In Roma communities, child marriage may be perceived as a ‘valid’ way to protect young girls, and as a valued tradition. In reality, such marriages deepen the disparities experienced by girls, and narrow their opportunities in life.  In many Balkan countries, half of all Roma women aged 20-24 were married before the age of 18, compared to around 10 per cent nationally. Child marriage and school drop-out are closely linked, particularly for girls, and such marriages also expose girls to the dangers of early pregnancy and childbirth, as well as a high risk of domestic violence. 

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