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.
Conflict in Ukraine
"Before he got hit, Sasha was like a proper child. Now he seems like a grown up. He can tell from the sounds what type of weapon is firing." - 12-year-old Sasha's guardian talking about the changes in him since he was shot in the ankle by a stray bullet. After nearly five years of conflict in eastern Ukraine, 3.4 million people are in need of humanitarian assistance – 60 per cent of them are women and children. Approximately 1.6 million people have been forced from their homes and tens of thousands of civilians have been killed or wounded. The situation is particularly grave for girls and boys living in areas with the fiercest fighting: Donetsk and Luhansk oblasts – within 15 kilometres of the ‘contact line’ – a line that divides government- from non-government-controlled areas. Children face the immediate threats posed by the conflict, and the long-term impact of lost education and trauma. Children living in these areas face grave threats from shelling, landmines and unexploded ordnance. Their lives are also threatened by destruction of vital civilian infrastructure – health centres, schools and water supplies – as a result of the fighting. Millions of people depend on water infrastructure that is in the line of fire. Aleksey washes his face and his missing fingers are highlighted. Aleksey, 14, lost two fingers and a thumb when a discarded shell exploded in his hand. Education – so crucial for a child’s sense of ‘normalcy’ – has been shattered, with more than one in five schools in eastern Ukraine damaged or destroyed. Teachers and psychologists report signs of severe psychosocial distress among children, including nightmares, social withdrawal and panic attacks triggered by loud noises. More than one in four children in Donetsk and Luhansk are thought to need psychosocial support. Few, however, get that support, as the available services are over-stretched and under-funded. “It is extremely painful to recall how we almost died twice. It is hard for us to talk about how we had to leave behind everything we had – a home, a job and friends – so we could stay alive.” - Amina, aged 12, from the village of Mykolaivka in Donestk, now living in Kiev. Immunization coverage has been undermined by a combination of conflict, lack of vaccines and vaccine hesitancy (a reluctance among parents to have their children immunized). The country experienced polio outbreaks in 2015 and is at high risk for polio transmission, according to the Polio Regional Certification Committee.