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Page 1 Page 2 A lie can travel halfway around the world while the truth is putting on its shoes. Mark Twains quote is more relevant than ever in times of online communication, where information or misinformation, bundled in bits and bytes, streams around the earth within seconds. SUMMARY DISCLAIMERUNICEF working papers aim to facilitate greater exchange of knowledge and stimulate analytical discussion on an issue. This text has not been edited to official publications standards. Extracts from this paper may be freely reproduced with due acknowledgement. For the purposes of this research, no personal data has been extracted and stored for data collection and analysis. This UNICEF working paper aims to track and analyse online anti-vaccination sentiment in social media networks by examining conversations across social media in English, Russian, Romanian and Polish. The findings support the assumption that parents actively use social networks and blogs to inform their decisions on vaccinating their children. The paper proposes a research model that detects and clusters commonly-used keywords and intensity of user interaction. The end goal is the development of targeted and efficient engagement strategies for health and communication experts in the field as well as for partner organisations. Page 3 CONTENT1. Rationale 2. Introduction 2.1 Social Media: the conversation shift 2.2 Social Media: Fertile ground for anti- vaccination sentiment 2.3 Social Media Monitoring 2.4 Influencers 3. Research Objectives 4. Methodology 4.1 Descriptive and Explorative Research Design 4.2 Data Collection 4.3 Limitations 4.4 Ethical Considerations 5. Empirical Findings 5.1 Networks: Volume and Engagement 5.2 Common Arguments 5.2.1 Religious and Ethical Beliefs 5.2.2 Side Effects 5.2.3 Development Disabilities 5.2.4 Chemicals, Toxins and Unnecessary 5.2.5 Conspiracy Theory, Western Plot and Conflict of Interest 5.3 Influencers 6. Discussion and Recommendations 6.1 Discussion 6.2 Recommendation Acknowledgements Literature Appendix 4 555 78 9 1111121313 1414191920212222 23 252527 313134 Page 4 Over the past few years, the region of Central and Eastern Europe and the Commonwealth of Independent States has been troubled by the rise of a strong anti-vaccine sentiment, particularly via the internet. Wide ranging in origin, motive, source, and specific objectives, this online sentiment has succeeded in influencing the vaccination decisions of young parents, in many instances negatively. A number of factors are at play in this online anti-vaccine sentiment. First, vaccination coverage in this region is generally high. As a result, vaccine-preventable childhood diseases like polio and measles have been absent in most countries for the past few decades. This has led to complacency toward the diseases and has unfortunately made vaccines, rather than the diseases, the focus of debate and discussion. Meanwhile, poorly-managed immunization campaigns in some countries have caused widespread mistrust of vaccines and government vaccination programs. Most countries have run sluggish, high-handed public communication campaigns while avoiding transparent dialogue with the public on possible side effects, coincidental adverse events and other safety issues. Moreover, when new vaccines have been introduced, they have often just exacerbated the publics existing doubts, hesitations or outright resistance. Into this mix, rapid penetration of the internet in the region has provided a powerful, pervasive platform for anti-vaccine messages to be disseminated. Rooted in scientific and pseudo-scientific online sources of information, messages are often manipulated and misinterpreted, undermining the confidence of parents and causing them to question the need for, and efficiency of, vaccines. The result is hesitation towards vaccination, which in large numbers poses a serious threat to the health and rights of children.This paper aims to examine this rapidly growing phenomenon and its global lessons. Depending on the nature of the problem, special strategies need to be developed to tactically address and counter, diffuse or mitigate its impact on ordinary parents. The prevailing approach of most governments in largely ignoring these forces is unlikely to address this growing phenomenon. Governments, international agencies and other partners - in particular the medical community - need to combine forces to identify the source and arguments of these online influences, map the extent to which they control negative decisions, develop more effective communication strategies and ultimately reverse this counterproductive trend. RATIONALE Page 5 The first part of this paper describes how anti-vaccination groups communicate and how social networks connect concerned parents in new ways. The second part emphasizes the role of social media monitoring in strategic communication, based on understanding audience needs. 2.1 Social media: The conversation shifts The rise of social networks has changed both the way we communicate and the way we consume information. Even within the relatively recent internet era, a major evolution has occurred: In the initial phase known as Web 1.0, users by-and-large consumed online information passively. Now, in the age of social media and Web 2.0, the internet is increasingly used for participation, interaction, conversation and community building1. At the same time, conversations or social interactions that used to occur in community centres, streets, markets and households have partly shifted to social media2. Parents, for instance, suddenly have an array of collaborative social media tools with which to create, edit, upload and share opinions with their friends, peers and the wider community. These conversations are recorded, archived and publicly available. 2.2 Social media: Fertile ground for anti-vaccination sentiment In todays information age, anyone with access to the internet can publish their thoughts and opinions. On health matters in particular, the public increasingly searches online for information to support or counter specialised, expert knowledge in medicine3. Due to the open nature of user participation, health messages, concerns and misinformation can spread across the globe in a rapid, efficient manner4. In this way, social media may influence vaccination decisions by delivering both scientific and pseudo-scientific information that alters the perceived personal risk of both vaccine-preventable diseases and vaccination side effects. INTRODUCTION 1 Constantinides et al, 2007 2 Phillips et al, 2009; Brown, 2009 3 Kata, 2012 4 Betsch et al, 2012 Page 6 In addition to this accelerated flow of information (whether accurate or not), social media messages tend to resonate particularly well among users who read or post personal stories that contain high emotional appeal. This holds true for anti-vaccination messages too. In other words, both logistically and qualitatively, social media is intensifying the reach and power of anti-vaccination messages. Negative reactions to vaccines are increasingly being shared across online platforms. All of this leads to a frustrating predicament and critical challenge: Immunizations protect people from deadly, contagious diseases such as measles, whooping cough and polio. But parents influenced by anti-vaccination sentiment often believe vaccines cause autism, brain damage, HIV and other conditions, and have begun refusing them for their children. As a consequence, health workers face misinformed, angry parents, and countries face outbreaks of out-dated diseases and preventable childhood deaths5. Why do anti-vaccination messages resonate with so many parents in the first place? Parental hesitation regarding vaccinations is thought to stem from two key emotions: fear and distrust: Vaccination is a scary act for many children and parents. A biological agent is injected into the child. The way the biological agent works in the childs body is for most people unclear, which appeals to parents fears. The high level of distrust stems from the intersection of government, medicine and pharmaceutical industry. The nature of its act and the fact that vaccinations are mostly compulsory leads to worries among citizens. (Seth Mnookin, 2011) This distrust, along with the interactive nature of social media, suggests an urgent need for health workers to become attuned to arguments and concerns of parents in different locations and of various cultural backgrounds. To achieve more synergistic relationships with an audience, organisations need to shift their communications strategy from getting attention to giving attention6. Compounding this challenge is the fact that some anti-vaccination groups are not merely sceptics or devils advocates, but operate in an organized, deliberate and even ideological manner. These anti-vaccination groups often employ heavy-handed 5 Melnick, 20116 Chaffrey et al, 2008 Page 7 communication tactics when dealing with opponents: they delete critical comments on controlled media channels, such as blogs7 ; they mobilize to complain about scientists and writers critical of their cause; sometimes they go going as far as to take legal action to prohibit the publishing of pro-vaccine material. Governments and organisations aim to keep parents accurately informed about vaccinating their children. As more of the public conversation indeed battle takes place across social media, there is an urgent need to understand this online landscape. This, in turn, requires the use of effective monitoring tools. 2.3 Social media monitoring Social media analysis plays an important strategic role in understanding new forms of user-generated content8 . Indeed, this type of monitoring has become a leading trend in Marketing, PR, political campaigns, financial markets and other sectors. As demand for this kind of data increases, more monitoring tools are becoming available. These tools search social networks for relevant content, and archive the publicly available conversation in a database. Researchers conduct their internet analysis primarily by formulating combinations of keywords that can be placed in relation and weighted for importance. There are four different types of social media monitoring: Monitoring by volume looks at the amount of mentions, views and posts a topic, organization or user receives. Monitoring by channels maps and examines the various networks that users use to exchange content. Monitoring by engagement seeks deeper insight into how many users actually respond, like, share and participate with the content. Monitoring by sentiment analysis is a qualitative approach that uses word libraries to detect positive or negative attitudes by users towards an issue9. The first phase in social media monitoring is listening to what users say, because in order, for instance, to engage effectively with parents on social networks, it is important to know what they are talking about10. 7 Kata, 2012 8 Cooke et al, 2008 9 The approach must employ qualitative analysis as machines are not able to track sarcasm or slang. 10 Kotler et al, 2007 Page 8 Social media monitoring is a young discipline that began just a few years ago, and in its initial phase the practice faced a number of challenges. Data was very complex, so first generation monitoring tools produced results that were unstructured and generally overwhelming11. Even when that data was sorted and structured, organizations struggled to generate actionable management recommendations from it12. Since that time, however, social media professionals and research communities have made steady progress in overcoming the early challenges. 2.4 Influencers Recent studies on social media networks emphasize the central role played by influential individuals in shaping attitudes and disseminating information13. Indeed, it is argued that a group of such influencers is responsible for driving trends, influencing public opinion and recommending products14. One study found that 78% of consumers trusted social peer recommendations, while just 14% trusted advertisements15. Intensive interaction and content sharing through social media means that an audience instinctively determines its own opinion leaders. What makes opinion leaders particularly interesting and important from our perspective is that they add their personal interpretation to the media content and pass it on to their audience. Depending on whether these influencers speak responsibly or not, this can have positive or negative impact on the goal of disseminating accurate information. In his book The Panic Virus, journalist Seth Mnookin offers some examples of controversial influencers: A British gastroenterologist, Andrew Wakefield, entered into the vaccine discourse and alleged that the measles-mumps-rubella vaccine might cause autism. The medical community eventually dispelled his arguments and he lost his medical license. For a decade Wakefield - though not a public health specialist - very successfully disseminated misleading information and garnered a significant social media following. Meanwhile, actress and model Jenny McCarthy has become another self-proclaimed expert on vaccine safety. Through frequent public appearances she has positioned herself as an 11 Wiesenfeld et al, 201012 Owyang et al, 201013 Tsang et al, 2005; Kiss et al, 2008; Bodendorf et al, 201014 Keller and Berry, 200315 Qualman, 2010 Page 9 educated, internet-savvy mother set on challenging the medical establishments information about vaccinations. This, too, has helped fuel the recent growth in anti-vaccination sentiments. The public following and authority gained by Wakefield and McCarthy demonstrate how with the proliferation of online channels and the user as the centre of attention, it becomes difficult for information seekers to differentiate between professional and amateur content16. By the time the record is set straight, trust in immunization is been partly destroyed. Fostering the positive opinion of influencers in communities can have a disproportionately large impact in terms of online reputation17. Though they may not know each other in the real world, and despite ever-expanding advertisement platforms and sources, consumers around the world still place their greatest trust in other consumers18. Audiences listen to opinion leaders because they are known to be independent, credible and loyal to their peers19. Identifying and influencing the influencers of the social media conversation in the region should therefore be part of any effective strategy to reinforce positive messages in the vaccination debate. Though the internet is increasingly used to search for health information, a number of questions about social media and vaccination decisions are still unanswered: Which channels are used by anti-vaccination groups? What are the key arguments and conversation themes? What makes anti-vaccination messages appealing to parents? Who are the opinion leaders in online discussions? What are the best strategies to respond to anti-vaccination arguments? This paper seeks to understand the internal dynamics of anti-vaccination sentiment in social media networks in Eastern RESEARCHOBJECTIVES 16 Cooke et al, 200817 Ryan et al, 200918 Nielsen, 200919 Weiman, 1994 Page 10 Europe20. These insights are expected to help health workers, partners and national governments to develop appropriate response strategies in order to convince the public of the value, effectiveness and safety of vaccinations. The objectives of this research are: 1. To monitor social media networks, consolidate existing data and information from partners. 2. To categorize and analyse conversation themes, based on volume of discussion, influence, engagement and audience demographic as appropriate. 3. To identify influencers in the different language groups and platforms. 4. To contribute to a set of recommended strategies to address specific anti-vaccine sentiment around the various conversation themes. This content analysis is expected to help us understand the motivations and mind sets behind the sentiment, and offer clues that can inform the development of a strategy to effectively address the phenomenon. The research is also expected to help drawing comparisons between the anti-vaccination sentiment phenomenon and similar sentiments expressed against interventions in nutrition, child protection and other areas of UNICEF practice. This paper is supported by UNICEF Department of Communication in New York and UNICEF Regional Office for Central and Eastern Europe and the Commonwealth of Independent States. The region covers 22 countries and territories: Albania, Armenia, Azer-baijan, Belarus, Bosnia & Herzegovina, Bulgaria, Croatia, Georgia, Kazakhstan, Kosovo (UN Administered region), Kyrgyzstan, TFYR Macedonia, Moldova, Montenegro, Roma-nia, The Russian Federation, Serbia, Tajikistan, Turkey, Turkmenistan, Ukraine, Uzbekistan. UNICEF does not have a country programme in the Russia Federation but is in discussions to develop a new mode of engagement. Page 11 In order to assess the dynamics of the anti-vaccination sentiments in the four languages, a systematic mapping and content analysis via social media monitoring is proposed. For the purpose of stakeholder monitoring in social media, a combination of descriptive and exploratory methods in form of quantitative and qualitative observation is proposed. According Wiesenfeld, Bush and Skidar (2010) it is reasonable to combine both methods because social media monitoring offers the richness of qualitative research, with the sample sizes of quantitative research. It may also give the opportunity to overcome problems associated with each research method in order to understand stakeholders dynamics in social media. 4.1 Descriptive and Explorative Research Design The descriptive methodology involves recording the activities of users and events in a systematic manner. Information is recorded as events occur and archived. Descriptive research in this case involves: Figure 1: Research Process for data gathering and analysis. METHODOLOGY 12 Aggregating text from public accessible social networks in in English, Russian, Polish and Romanian language. Cleaning and categorizing the data over time. The data is categorized and analysed into reoccurring conversation themes, based on volume of posts, engagement and audience demographic as appropriate. The exploratory methodology follows the descriptive research to allow for the interpretation of patterns and to provide background understanding of sentiment and attitudes of users. The results of the structured observation will be put into context by the human judgement of the researcher through the participant observation. In this research, the researcher will be a complete observer and will not interact with the users during the participant observation (Saunders et al, 2009). 4.2 Data Collection Traditional sampling techniques such as random, convenience or judgemental sampling are difficult to apply to a fluid social media environment. On top of the social media measurement process, the selected social media channels feed into the sample set. The posts are further categorized into different issue arenas that will be associated with relevant stakeholders. Figure 1 presents the data collection process for monitoring stakeholders in social media.The process contains the following six steps: 1. Channels: The first step of the data collection process involved the selection of relevant social media channels. Social media monitoring is instead generally considered to provide a complete set of all contributors, because tools like Radian6 or Sysomos are designed to capture a wide range of social media channels, such as blogs, forums, Twitter, Tumblr, Youtube and Facebook. 2. Demographics: The software gathered relevant posts that were posted in English, Russian, Polish and Romanian language3 during the period of 1 May and 30 July 2012. Posts could be submitted from all regions worldwide. 3. Context: The quality of data collection is determined by how well the collected data is gathered with regards to formulated searches. Keyword logic and search profiles were employed to filter the data. The full list of keyword combination can be found in Appendix A. 3The approach must employ qualitative analysis as machines are not able to track sarcasm or slang. Page 13 4. Data Collection: Relevant social media mentions that contained an issue-related keyword in relation to a stakeholder-related keyword was archived in the database. The list of relevant mentions was stored chronologically and assigned an ID. The full list of exported information about each mention was stored in a separate EXCEL file. 5. Data Analysis: The empirical application and content analysis of the relevant posts can be found in Chapter 6. 4.3 Limitations There are limitations in terms of reliability and validity of the recorded data. The data collection covers a three-months period. There is a need for caution when generalizing the data because events and evolution of discussions may alter the findings in other time periods. Therefore, limitations in reliability refer to reproducibility of research results. Reliability in the extent to which measures are free from error and therefore provide consistent results, such as the consistency of data availability in social media monitoring, is the second limitations. Quantitative observation has relatively high reliability because it reduces the potential for observer bias and enhances the reliability of data (Malhorta et al, 2007). However, social media monitoring might carry the risk of monitoring bias, as the relevant posts are extracted through keyword logic that is developed by the researcher. The collected data cannot be regarded as complete. For example, the share of Russian-speaking discussions seems to be fairly low compared to the amount of users accessing social media. Governmental control and censorship might also be contributing for lower volumes.The external validity, which is defined as the extent to which the research results are applicable to other research settings (Malhotra et al, 2007), is relatively low. Because of the richness of data, the sampling needs to be based on the experience of the researcher. As a disadvantage, the lack of established sampling technique in social media limits the ability to generalize the findings to other relevant issue arenas or stakeholders in the population. However, the ability to generalize the results was enhanced by careful use of the theoretical terms and relationships in the stakeholder literature (especially Freeman, 1984; Mitchell et al, 1997; Luoma-aho et al, 2010; Owyang et al, 2010). 4.4 Ethical Considerations Monitoring social media conversations raises two important questions about a) the protection of privacy, and b) ethical concerns. The growth of interest in social media monitoring has Page 14 triggered a new debate about ethics, which centers on what is in the public domain and what is not (Poynter, 2010). Privacy is a big issue, and social networking sites are under public criticism for lax attitudes regarding the security and respect of users privacy (Wakefield, 2011). It is the responsibility of the market researcher to protect a respondents identity and not disclose it to external audiences (Malhotra et al, 2007). Social media monitoring offers a rich volume of data, however the Internet is largely unregulated. The data of users around the world is stored on servers in the US and completely available to the US authorities. What might seem legal to the researcher may not necessarily be deemed morally right by society. Public interactions in social media are available for anyone and can be assigned to a personal IP address, geographic location, language, date and even specific computer. For the purposes of this research, no personal data has been extracted. The IP addresses and geographic locations have not been stored in the excel exports as it is not necessary for the purpose of the research. A unique post ID identifies each post. The following findings start with an overview of the networks used by the anti-vaccination community. Trends in volume and engagement are outlined in 5.1. In 5.2, clusters of common belief of the anti-vaccination sentiment are categorized and explained. The importance of influence in the anti-vaccination discussion is illustrated 5.3 because it is critical to understand that communication needs require adjustment to each country or region, which itself can present a challenge. 5.1 Networks: Volume and Engagement During May to July 2012, the researchers recorded messages with anti-vaccination sentiment from 22,349 participants. The majority of participants spoke English, followed by Polish, Russian and Romanian. EMPIRICALFINDINGS Page 15 Figure 2: Participants of anti-vaccination discussions per language. Across all four researched languages, blogs are the most frequently used channel for posting anti-vaccination content in social media. Blog is short for weblog, which is a website normally maintained by an individual (or group of individuals) and updated with regular entries. Entries are typically displayed in chronological order and tagged with relevant keywords and phrases. Blog visitors usually have the opportunity comment and share the content on blogs. Blogs are by far the most important channel in terms of volume of posts in Romanian (86% of all posts) and Polish (85% of all posts). In Russian discussions, 65% of all posts are submitted on blogs and in English nearly half of the anti-vaccination content (47%) is posted on blogs. Facebook is the second largest channel in terms of volume of posts. The social network has a share of 25% in English speaking networks, 13% in Polish, 8% in Romanian, and 5% in Russian channels. Facebook allows users to build personal profiles accessible to other users for exchange of personal content and communication via the Facebook. Twitter, which allows users to send brief (<140 character-long) updates, is the second largest channel in Russian-speaking (24% of the total volume) and fourth with 5% in English-speaking anti-vaccination communities. Other channels to consider are News websites and Forums in which users post comments to engage in discussions about specific topics. Since 68% of all participants in the anti-vaccination discussions during the observed time-period speak English, the dataset is able to reveal more accurate insights into demographics compared to the other languages. Insights in all languages can be found in Appendix 4, while the following analysis focuses on the English Page 16 data set. The English dataset also reveals that blogs have generally the highest rates of mentions (61%), conversations (67%), posts (67%) and interactions (43%). Based on the volume of posts, it is a logical consequence that most engagement takes place on blogs. Engagement is defined as followed: Post: An initial message submitted to a social networking site, i.e. a blog post, Facebook status, tweet, video, etc. Interaction: Any activity created as a direct response to an initial post, i.e. comments, likes, retweets, @replies, etc. Conversation: The sum of a post and all its related interactions. Note: a post with at least one interaction is considered as conversation. Mention: An appearance of search terms in a public social media space. Figure 3: Distribution by channel for Romanian, Russian, English and Polish networks Page 17 Blogs, forums, and Facebook are the leading networks for anti-vaccination discussions in English during the observed time-period. In other words, the anti-vaccination sentiments are expressed on those platforms through posting user-generated content. However, while conversations on forums only makeup 2% of total conversations, they account for 25% of all interactions among users. This indicates a heavily engaged audience. It can Figure 4: Mentions, Conversations, Posts and Interactions per channel. Page 18 be argued that opinions are formed during interactions among users and therefore, it is vital to add pro-vaccination content to the discussions on forums. Similarly, Facebook only contains 9% of conversations, but 21% of interactions. Both channels are important to consider for interactions with the anti-vaccination sentiment even if more posts occur on blogs. Similar findings occur in Forums. Forums are designed to be interactive conversation, where topics are discussed in greater depth. The English dataset is a reflection of this distinguish feature 16% of all posts and 25% of all interaction occur on Forums. The figures show that while the volume of content on Forums is relatively low, the engagement is an important strength that shaped the opinion in the anti-vaccination community. Figure 5 indicates that the data skews towards female audiences when issues such as developmental disabilities (59%), chemicals and toxins (56%) and side effects (54%) are discussed within the anti-vaccination sentiment, whereas men focus on arguments around conspiracy theory (63%) and religious/ethical beliefs (58%). Anti-vaccination social media participants are approximately 56% female and 44% male. Figure 5: Gender comparison in English per argument. Page 19 5.2 Common Arguments The amount of argument-mentions in anti-vaccination sentiment changes significantly by language during the observed time-period. Figure 6 illustrates that conspiracy theory and religious/ethical beliefs are the main topic trends in English, while religious/ethical beliefs drive the majority of discussions in Russian speaking anti-vaccination discussions. Polish anti-vaccination discussions are driven by arguments about side effects and chemicals and toxins in vaccines. The issue of chemicals and toxins is the major driver in Romanian discussions during the observed time-period. The arguments are described in detail in the following sections. The categories are based on keyword strings that were narrowed down over time. Issues should not be regarded in a static way, they might overlap and are interconnected. 5.2.1 Religious and Ethical Beliefs Religious and ethical discussions are especially active in discussion in Russian, with 96% of all anti-vaccination discussions focused on that issue. In English discussions, 32% of all anti-vaccination discussion use religious and ethical arguments. The arguments are less relevant in Polish (5%) and Romanian (0%) speaking anti-vaccination discussions. The main train of thought derives from Figure 6: Allocation of arguments by language for the anti-vaccination sentiment. Page 20 the belief that humans are created just as they should be and external interference is not required. My body was designed by God to be self healing and self regulating and no man will be able to do better than God is a quote by a female blog commentator from the US. Another user states, anything that involves substances that should never belong in a humans body, should not be injected or consumed without that individuals consent. Anti-vaccination advocates believe in homeopathy and alternative medicine. My BodyMy Decision writes a community member from Australia. A broad sentiment that mandatory vaccination is a violation of human rights can also be detected. From an ethical standpoint, the anti-vaccination community claims that it is a basic human right to be free from unwanted medical interventions, like vaccine injections. The same kind of argumentation can be recorded in all four languages. On June 15th 2012, the Polish Parliament voted to change the existing laws on vaccinations. The Act on Preventing and Fighting Infections and Infectious Diseases in Humans and in The Act on National Sanitary Inspection has created controversy among social media users because of it makes vaccination mandatory. The anti-vaccination advocates were sending petitions to the Polish President demanding him to stop the act. The petition received support from some representatives of the Catholic Church, but not an official support from the church as whole. Radio Maryja, the most powerful independent catholic media in the country, also critiqued the act based upon: The argument that vaccines are made based on cell lines derived from the bodies of babies killed by abortion. The notion of unethical activities by campaigning teenagers and women to be vaccinated against HPV infection and it is promoting immoral, and disorderly behaviour in the area of sexuality. 5.2.2 Safety and efficacy Side effects are the most common anti-vaccination theme in Polish networks (28%), but they also play a role in English networks (9%) and Romanian (5%). The argument is mentioned in less than 1% of all anti-vaccination discussions in Russian language. Typically, parents who reach out to online communities because they are unsure about vaccines trigger the discussions about side effects. Individual stories from parents are powerful because they humanize the discussion. One user writes, My baby is 5 months old, not vaccinated and he is going through pertussis right now! Its very scary! I HATE it! I have 3 children, the other 2 were vaccinated but Im scared to vaccinate my baby! Any other mommys new at Page 21 this? This quote reflects a level of fear and uncertainty about the right thing to do, even though the mother has experienced both the effect of vaccines and vaccine-preventable diseases. Another parent writes: My brother, sister in law, and all three kids under the age 5 were vaccinated for whooping cough and they all got it! An argument in a Russian network claims that live vaccines can mutate in the organism and create deadly strains. The fear of side effects leads to discussion about vaccines causing diseases and death. A user from the UK argues, The only way you can get this virus is if it is injected into you. Besides individual stories, argumentation backed by figures without context or sources are equally powerful in fostering fear of vaccines. For example, a member in one English network posts: Vaccinated children have up to 500% more diseases than unvaccinated children. Community members in Russia postulate that vaccinated children get sick 2-5 times more often than non-vaccinated children. For example in Romania, school nurses perform the mandatory vaccination during class, which is seen as a human rights violation and a safety issue. Parents are sceptical about the skills of the school nurses and feel surpassed by authorities in its decision to have children vaccinated. A user in a Polish anti-vaccination community states: I am a mother of two disabled children. When my daughter was five months old, she had a negative reaction to the vaccine, now she has been diagnosed with autism and mental retardation. For 10 years, I did not vaccinate my children and I would not want the right to decide on this matter taken away from me. I am an educated person, and have researched the subject and do not believe in the efficacy or safety of vaccinations. 5.2.3 Developmental Disabilities Another reoccurring argument in the anti-vaccination sentiment claims that vaccines contain toxins and harmful ingredients. Injecting vaccines into the body of a child leads to brain injury and developmental disabilities. This theme is discussed in 15% of all English and Polish speaking anti-vaccination discussions. Development Disabilities was in less than 1% of anti-vaccination discussions mentioned in Russian or Romanian networks. The arguments evolve from sentiment surrounding vaccines posing challenges to the immune system and producing antibodies that may cause autoimmune diseases. Another notable argument is that vaccines are not able to fight off the mutant viruses that develop over time. Across communities, anti-vaccination advocates link vaccines to Page 22 epilepsy, autism and neurodegenerative diseases (Parkinson and Alzheimer). A member of the Polish community writes: Mercury causes developmental disorders in children (including epilepsy and autism), in adults, neurodegenerative diseases (Parkinsons and Alzheimers), and degenerative changes in the reproductive systems of men and women, impairing their ability to reproduce offspring. It is notable that figures are used based on estimates by the author without links to sources. A Russian speaking user notes that vaccinations against pandemic influenza H1N1, also known as swine, can lead to the development of Guillain-Barr syndrome, acute poliradikulita in adults, according to Canadian researchers, published in the journal JAMA. 5.2.4 Chemicals, Toxins and Unnecessary(administration of vaccines) Our doctor has advised us to avoid vaccines in absence of a direct disease risk, since the long-term side effects have not been studied writes a member of an English-speaking community. One common argument recorded in the anti-vaccination sentiment is that studies about risks and impact of vaccinations are insufficient. Vaccines have not been tested enough and have concerns regarding the lack of long-term side effects studies. Another user states that I would really want to know whether and how well vaccine manufacturers test their final vaccine products () and how much contamination they discover. A common belief is that children having a vaccine-preventable illness just need food, water, and sanitation. In Polish communities, members use the example of Scandinavian countries lobbying for a ban of questionable and potentially harmful ingredients in vaccines. The notion that Scandinavian countries banned Thimerosal a long time ago and they have a much lower percentage of children with autism was classified was an important argument for users. Drawing on that example, the most common belief in Polish communities is that mercury may cause autism. A Russian-speaking user concludes, a recent large study confirms the results of other independent observations, which compared vaccinated and unvaccinated children. They all show that vaccinated children suffer 2 to 5 times more often than non-vaccinated children. Sources or links to the recited studies are not provided. 5.2.5 Conspiracy Theory, Western Plot and Conflict of Interest In English-speaking anti-vaccination communities (24%), a strong distrust against governments and pharmaceutical industry is Page 23 recorded. The same applies for Polish (5%), Russian (1%) and Romanian (3%) at a smaller scale. However, the U.S. and western governments are viewed critically when discussing about governments and conflict of interest. In Polish networks excessive vaccinations are seen as promoted by pharmaceutical companies in order to gain profits. The role of the pharmaceutical industry is discussed mostly negatively. The sector is regarded as corrupt marketing machine. An English-speaking user states that: In the vaccine industry, scientific fraud and conflicts of interests are causing a similar cycle of deaths and injuries that is being concealed and denied by regulators and vaccine manufacturers. The industry is viewed as profit-driven and has moved from its original purpose to save lives and protect humans. Romanian discussions directly blame the U.S. for purposefully infecting people with HIV using polio vaccines. Users create a direct link between vaccines and widespread HIV in Romanian orphanages. In the same sense, users claim that vaccines are being used against the Romanian populations. According to members of the anti-vaccination sentiment, vaccines against polio and chickenpox are used in Romania, which are not used in the U.S. anymore. Polish anti-vaccination communities state the examples of swine flu and bird flu two years ago. According to the users, both cases are plots by giant pharmaceutical companies. Some countries desperately bought a huge quantity of vaccines, while Poland acted rationally and did not buy the vaccines, which saved the state budget a couple of billion. The activists are suspicious because the epidemic ended after the new vaccines were purchased by several governments. The distrust against governments is also reflected in conspiracy theories. Patterns in English-speaking communities suggest that immunization is used to control and reduce the world population. One strain of argumentation is that vaccines that are not allowed in developed countries are imported to developing countries in order to reduce population growth. 5.3 Influencers Opinion leaders in anti-vaccination sentiment show varying characteristics across countries. However, they often appear to be well educated in alternative medicine. Some have no college education; others are in the medical field (such as nurses). A high level of volume and interaction can be recorded for influencers. They often subscribe to social channels of homeopaths and Page 24 alternative medicine advocates but they can be found across platforms. The following section lists a range of influencers that are active in different channels or languages: Name Position Facebook Fans Twitter Followers Blog Language Dr. Tennpen-ny The Voice of Reason about Vaccines 36,282 1,475 Yes English The Truth About Vac-cines Answering questions from concerned parents 21,246 N/A Yes English International Medical Council on Vaccination Purpose is to counter the messages asserted by pharmaceutical com-panies, the government and medical agencies that vaccines are safe, effective and harmless 7,983 N/A Yes English The Refusers "Vaccination choice is a fundamental human right." 9,069 12,457 Yes English Mothering Magazine Mothering is the pre-mier community for naturally minded par-ents. 66,504 102,173 Yes English Oglnopo-lskie Sto-warzyszenie Wiedzy o Szczepieniach STOP NOP Protest against new laws for mandatory vaccinations in Poland and against disinforma-tion campaigns about the effectiveness and safety of vaccines. 3,203 N/A Yes Polish STOP Pr-zymusowi Szczepie Petition campaign against new new laws for mandatory vaccina-tions in Poland. 2,866 58 Yes Polish Table 1: Examples of influencers in the anti-vaccination sentiment in social media. Page 25 With respect to the above-mentioned arguments, opinion leaders in the anti-vaccination movement put an emphasis on highlighting negative stories that focus on individual cases. In some cases, they blame outbreaks on shedding vaccinated children who get unvaccinated children sick. The argumentation is based on the conviction that vaccines are unsafe and dont work. A list of common arguments by arguments by influencers per language can be obtained in Appendix B. In this section the research question will be discussed in light of the theoretical and empirical findings. It needs to be noted that the discussion only focuses on engagement with anti-vaccination advocates in the four researched languages. This does not include pro-vaccination movements, medical professionals, partners or others. The discussion will propose a model that illustrates the different drivers of anti-vaccination sentiment based on three elements. The recommendations section builds on the three elements of the model and provides practical advice for communication strategies. 6.1 Discussion In order to develop engagement and messaging strategies for anti-vaccination sentiment, it is vital to have an abstract understanding of what drives users to become suspicious about vaccinations. Based on the findings, the paper proposes a model of anti-vaccination sentiment identification and salience. We classify three main spheres that attribute to a negative sentiment towards vaccine, which help us in the identification of trends within the anti-vaccination sentiment. The classification is illustrated in the following figure: DISCUSSION &RECOMMENDATIONS Page 26 The first attribute is the individual sphere. The main motivations for users to get involved are highly personal matters driven by concern and fear. When it comes to vaccinations, some parents are not sure what the right decision is. Am I a good mother if I do not get my child vaccinated or is it my responsibility as a caring parent to ensure the best protection for my child? Personal testimonies of other parents, especially negative stories, have a huge impact on the parent and fuel the concern. The second element that characterizes the anti-vaccination sentiment is the contextual sphere. The main driver behind the contextual sphere is a distrust of governments, pharmaceutical industry, scientific bodies and international organizations. It seems to be overwhelming for parents to understand the role of the big players. An interesting observation is that users in the contextual sphere do not seem to have a general resentment against vaccines per se but most arguments focus on lack of transparency in the decision processes as well as the potential conflict of interests trigger distrust. The third attribute is labeled as transcendental sphere. Negative attitudes towards vaccinations are derived from idealistic, religious and ethical beliefs. Arguments are rooted in strong beliefs and appear dogmatic, such as God creates us in the most ideal way or a body has its natural balance. Figure 7: Model of anti-vaccination sentiment identification and salience. Page 27 Individual, contextual and transcendental sphere are the key attributes of a member of the anti-vaccination movement. We argue that the various combinations of these attributes are indicators of the salience of members. We can identify four groups that derive from Figure 3. In order to understand salience within anti-vaccination community members, we propose the following classification Core Members are users that apply to all three spheres. They are concerned about side effects, distrust the government and live according to strong religious or ethical beliefs. Intense Members are members that apply to two of the three spheres. For example, a user might have concerns about vaccinations based on an individual sphere and also carry distrust against the pharmaceutical industry. But they are not driven by any idealistic beliefs. Alert Members are users that apply only to one of the three spheres. The doubt about vaccines derives only from one sphere and has human characteristics. They seem to be less convinced of the harm of vaccinations than the other two member groups. There is a fourth group of users, the Non-Members. They simply do not apply to any of the classification. We argue that Alert Members are easier to convince of the necessity of vaccines than Intense Members. Core Members are the hardest to convince, because the arguments against vaccines are based on various foundations. The findings also show that the intensity of argumentation, the interaction and the volume varies between the spheres. Therefore, the next section outlines practical recommendation on how to draft engagement strategies for each sphere. 6.2 Recommendations The following graphic summarizes the framework for the engagement and messaging plan that enables communication officers and health workers to react to the anti-vaccination sentiments. The framework is designed to be customizable for local realities. However, it does provide an overarching guidance for communication and campaigning initiatives. Members of the individual sphere should be approached with an emotional appeal. Users in this sphere go online and search for information in order to make an informed decision. Content that encourages parents to get their children vaccinated needs to be easy to find. Hence, search engine optimization plays an important role in the outreach strategy. Search marketing is used to gain visibility on search engines when users search for terms that relate to immunization. In order to appear on top if the search Page 28 results two general approaches should be considers: Organic search (SEO): When you immunization or vaccines into a search engine like Google or Yahoo!, vthe organic results are displayed in the main space of the results-page. For example, when parents search for information about vaccinations, pro-vaccine information should rank on top of the search engine results. By optimizing websites and posts, organizations and governments can improve the ranking for important search terms and phrases (keywords). Engaging actively in discussion and providing links to pro-vaccination content also helps to increase the visibility in the ranking. Paid search (SEM) enables to buy space in the sponsored area of a search engine. There are a variety of paid search programs, but the most common is called pay-per-click (PPC), meaning the information provider only pays for a listing when a user clicks the ad. The emphasis of the content strategy is to empower parents to ask doctors the right question in order to build confidence for the decision making process. Rather than criticising parents choices not to vaccinate, the messaging should promote an individuals ability to make the world a safer place for children. The communication strategy should also highlight the individual right and responsibility to choose to vaccinate. Through emotional Figure 8: Engagement Matrix for core spheres of the anti-vaccination movement. Page 29 messaging, hesitating parents should receive key information and explain how their choices affect their own children and the ones of others. The communities in the contextual sphere source their scepticism from general distrust against the large players involved in the vaccination industry. The engagement strategy should be based on a rational appeal that focuses on the hard facts of vaccines. It is important to avoid obvious communication tactics. Transparency about vaccines, testing, ingredients, potential side effects, funding and preventable diseases is crucial to reduce distrust. The messaging should also take into account past errors in vaccine campaigns by governments and suppliers in the regions and most importantly focus on the lessons learnt and how processes have been improving since then. Transparency can be built through a multi-channel approach that features the development of vaccines with expert testimonies. Successful cases, such as the near eradication of polio as a global effort, help to reduce distrust as well. This can be backed by official statistics on how infant mortality rates have been reduced over the past 20 years. Countries that generally have a favourable public perception, such as Scandinavian countries,

FROM FAITH TO ACTION: INTER-RELIGIOUS ACTION TO PROTECT THE RIGHTS OF CHILDREN AFFECTED BY MIGRATION WITH A FOCUS ON EUROPE AND CENTRAL ASIA ii Authors: Susanna Trotta (Joint Learning Initiative on Faith & Local Communities [JLI]), Christine Fashugba (UNICEF), Johanne Kjaersgaard (UNICEF/Princeton), Mario Mosquera (UNICEF), Olivia Wilkinson (JLI). Reviewers: Kerida McDonald (UNICEF), Anna Knutzen (UNICEF), Seforosa Carroll (WCC), Frederique Seidel (WCC), Jean Duff (JLI). Suggested Citation: Trotta, S., Fashugba, C., Kjaersgaard, J., Mosquera, M., Wilkinson, O., (2021). From Faith to Action: Inter-religious action to protect the rights of children affected by migration with a focus on Europe and Central Asia. UNICEF Europe and Central Asia Regional Office and Joint Learning Initiative on Faith & Local Communities: Geneva and Washington DC. Project Leads: Mario Mosquera (UNICEF), Olivia Wilkinson (JLI). Cover photo credit: UNICEF/UN012796/Georgiev Acknowledgements This publication is part of a collaboration between the United Nations Childrens Fund (UNICEF), the World Council of Churches (WCC), and the Joint Learning Initiative on Faith and Local Communities (JLI). We are grateful for the contribution of the three case study organizations highlighted in this publication, Apostoli, Ecumenical Humanitarian Organization, and Zentralrat der Muslime in Deutschland. iv list of Acronyms CCME Churches Commission for Migration in Europe ECARO Europe and Central Asia Regional Office EHO Ecumenical Humanitarian Organization in Serbia FBO faith-based organization ICMC International Catholic Migration Commission JLI Joint Learning Initiative on Faith & Local Communities NGO non-governmental organization SAR search and rescue UASC unaccompanied and separated children UNICEF United Nations Childrens Fund WCC World Council of Churches ZMD Zentralrat der Muslime in Deutschland list of boxes Box 1 - The Humanitarian Corridors Initiative, Italy Box 2 - The Vaiz, Turkey Box 3 - Learning to Live Together: Arigatou Foundation, Interfaith Council on Ethics Education for Children, and Global Network of Religions for Children Box 4 - Refugees Hosting Refugees Box 5 - Ecumenical assistance for asylum seekers: Oekumenischer Seelsorgedienst fr Asylsuchende, Switzerland Box 6 - Search for Common Ground against violent extremism among young returnees, Kyrgyzstan Box 7 - Goda Grannar (Good Neighbours), Sweden Box 8 - Faith Over Fear movement supported by UNICEF and Religions for Peace From Faith to Action v contents Acknowledgements iii List of acronyms iv List of boxes iv Executive Summary 1 Introduction 2 Situation Analysis Summary 3 Faith Activities to Support Children on the Move 5 Promising Practice Case Study #1: Ecumenical Humanitarian Organization, Serbia 12 Promising Practice Case Study #2: Apostoli, Greece 16 Promising Practice Case Study #3: Central Council of Muslims, Germany 20 Glossary 24 Annex 1 - Legal and Political Framework 25 Annex 2 - Country-specific information 28 Endnotes 33 UNICEF/UNI197534/Gilbertson VII Photo From Faith to Action 1 executive summAry Five main areas in which faith actors have a positive impact on children on the move in Europe and Central Asia1. Providing assistance for children on the move along safe and unsafe migration routes, and when they arrive. For example, faith actors perform or fund search and rescue (SAR) operations, establish safe and legal routes for children to travel (e.g., humanitarian corridors), and provide shelter, food, and legal advice and other essential services for children and their families. 2. Facilitating integration and social inclusion by enhancing access to social services (particularly education) and bringing host communities and newcomers closer together by fostering empathy, cultivating welcoming practices, and identifying shared spaces. 3. Offering spiritual and psychosocial support that can enhance resilience, sustain a sense of belonging, and facilitate the process of migration and integration. 4. Fostering social cohesion, combating xenophobia and discrimination, promoting inter-religious dialogue, speaking out for peaceful coexistence, and addressing the root causes of conflict that have forcibly displaced children and families. 5. Advocacy to influence decision-makers towards more inclusive approaches in response to the displacement of children and families. Strategies include building inter-religious coalitions for advocacy, using their influence to speak to policymakers on migration, and advocating for the rights of children and for governments and communities to welcome refugees and migrants. This publication aims to highlight the actual and potential roles of faith actors in contributing towards an effective and holistic response to child displacement in Europe and Central Asia. These roles range from providing shelter and other material support to fostering psychosocial and spiritual wellbeing, speaking out against xenophobia, promoting peaceful coexistence, and influencing policymakers to protect the rights of children on the move. While it must be recognised that faith actors have also played negative roles, this publication aims primarily to serve as a useful tool to improve cooperation between faith actors and other stakeholders, such as UNICEF and national authorities, in the protection of children and youth on the move. This publication aims to highlight the actual and potential roles of faith actors in contributing towards an effective and holistic response to child displacement in Europe and Central Asia. We developed this publication through an extensive review of academic articles, research reports, conference reports, and other documents focusing on key issues affecting young refugee and migrants and on the roles of faith actors in supporting children on the move. This publication is organized into an introductory section, a central section underlining different areas in which faith actors are engaged with some remarks on challenges and opportunities, and a final section highlighting three case studies with faith-based organizations (FBOs) working with children and youth on the move in Germany, Greece, and Serbia. This publication illustrates a plurality of ways in which faith actors actively support children and youth on the move, namely, by ensuring their protection and social inclusion, providing spiritual and psychosocial support, countering xenophobia and discrimination, and advocating for policy changes. 2 introduction This publication emerges from discussions in Europe and Central Asia about the role of faith actors in protecting children on the move. The content was developed in preparation for the conference From Faith to Action: Inter-religious action to protect the rights of children affected by migration with a focus on Europe and Central Asia held online on 10-11 December 2020. The primary topics include the need to safeguard and protect children, the realities of migration and forced displacement, inter-religious cooperation and the roles of faith actors, and how these threads intersect in the Europe and Central Asia region. The publication starts with some key facts and figures on the current situation of migrants and children on the move in Europe and Central Asia. We have also included information on the impact of COVID-19 in the region. The first section ends with an overview of key issues affecting children on the move and their families. The second section presents an overview of faith-based engagements with children on the move in Europe and Central Asia. It is structured in five subsections: Faith actors support to provide protection for children on the move. Social inclusion and access to social services. Spiritual and psychosocial support for children on the move. Faith actors efforts to combat xenophobia and foster peaceful societies. The role of faith actors in policy and advocacy. These subsections build on previous work, including the Faith Action for Children on the Move forum held in Rome in 20181 and the Faith and Positive Change for Children, Families and Communities Initiative (FPCC)2, a collaboration between UNICEF, the Joint Learning Initiative on Faith & Local Communities (JLI), and Religions for Peace. The From Faith to Action initiative is built on the principle that a child is a child, and reinforces the principle of the best interest of the child. The next section highlights challenges and opportunities for discussion during the conference, and focuses on the five main thematic areas indicated. The publication also includes a glossary and annexes citing relevant legal and policy documents and country-specific information. The final section includes three case studies. The first one, developed with the Ecumenical Humanitarian Organization, focuses on their work in providing material and psychosocial support to children on the move in Serbia. The second one, developed with Apostoli, illustrates their engagements towards the inclusion of youth on the move in Greece. The last one, developed with the Central Council of Muslims in Germany, describes their activities, including policy and advocacy efforts, to foster social cohesion and mutual support between established communities and newcomers. From Faith to Action 3 situAtion AnAlysis summAry in family incomes. Cuts in remittances may cause children and youth to drop out of school and seek work, migrate, or put them at risk of child marriage or trafficking.7 Social distancing restrictions may further impede the limited education opportunities that may be available to most displaced children.8 The lack of devices or stable internet access can be a barrier to online learning. 9 As governments tighten border controls and impose stricter health requirements on new arrivals, some have been criticized for using COVID-19 as an excuse to toughen immigration policies, suspend asylum procedures, and retreat from international legal obligations to rescue and provide safety as has been the case for many refugee and migrants crossing the Mediterranean.10 Some nationalist and populist voices see refugees as transmission threats and push for hard-line immigration policies, feeding into populist rhetoric in fear of the other.11 At the same time, responses to COVID-19 have also played unifying role. Advocacy and humanitarian organizations continue to push for a narrative that sees the pandemic as an opportunity to expand health care and social protections for refugees and migrants.12 Multilingual information dissemination, including health and public safety instruction, has become common practice in several European countries.13 Key issues faced by children on the move and their familiesExploitation (including online exploitation), smuggling and trafficking Children on the move are exposed to great risks and are vulnerable to trafficking, smuggling and various forms of exploitation.14 Around 75% of 14 to 17-year-old refugees and migrants crossing the Mediterranean from North Africa to Italy experience exploitative practices such as arbitrary detention or forced labour.15 Since digital tools are especially important for children who travel unaccompanied or separated from family, they are at high risk of online exploitation.16 In 2020, an estimated 94,800 refugees and migrants arrived Europe from countries as diverse as Afghanistan, Algeria, Bangladesh, Morocco, Tunisia, and Syria. Nearly one in every five (18.5%)1, was a child. At the end of 2020, there were some 60,000 refugee and migrant children in Bosnia and Herzegovina, Bulgaria, Greece, Italy, Montenegro, and Serbia. Among them were 12,000 unaccompanied and separated children (UASC) whose lives depended on humanitarian assistance. UNICEF and partners worked tirelessly to reach approximately 51,000 refugee and migrant children with a range of support2 to protect their health and well-being. The COVID-19 pandemic certainly affected the influx of refugees and migrants into Europe. UNICEF and humanitarian partners had to adapt quickly to the fast-moving situation across the Europe and Central Asia region, and ensure that children were prioritized in procedures related to disembarkation and accommodation. The European Union (EU) registered a 33% overall decrease in the number asylum applications. However, the decrease was not evenly spread across Europe, and many local communities received unexpectedly large surges of new arrivals3. The pandemic raised many additional concerns about the health and safety of children and families. Refugee and migrants living close together have often faced a double lockdown with additional restrictions imposed on their confinement in settlements and camps, that compounded their stress and isolation. As classroom learning adapted to online modalities, a major challenge was connecting refugee and migrant children to education opportunities when access to Internet technology and digital devices was very difficult. The impact of COVID-19 The COVID-19 pandemic has created additional stress on humanitarian supply chains3 and heightened risks faced by displaced populations. Children and families often live in overcrowded settings4 with limited access to clean water, hygiene and other basic services,5 and are often excluded from access to information.6 Displaced children and youth are witnessing a decline 1 UNHCR data for Italy, Greece, Bulgaria, Spain as of 31 December 2020. Operational Portal Refugee Situations: Mediterranean situation, 2 UNICEF Refugee and Migrant Response in Europe Humanitarian Situation Report 2020 No. 38 3 https://ec.europa.eu/info/strategy/priorities-2019-2024/promoting-our-european-way-life/statistics-migration-europe_en Of the 94,800 refugees and migrants who arrived in Europe in 2020, nearly one in five was a child. 4 Obstacles to family reunificationUnaccompanied and separated children (UASC) form a significant percentage of children on the move.17 Although all children have the right to be with their families or guardians, obstacles to family reunification are common.18 Family reunification processes may impose, for example, increased income requirements, expensive medical tests, restrictions on who can apply, and long waits under the Dublin regulations.19 Detention of refugee and migrant childrenEnding detention of refugee and migrant children is one of the priorities of the international community.20 However, in there was an increase in the number of immigration detentions of children arriving in Europe.21 Urgent measures that are being called for include scaling up of efforts to end new detentions, the release of child detainees into non-custodial and community-based alternatives, and the improvement of conditions in detention centres where alternative measures are not possible.22 Access to healthcare Children need to live in a safe environment and should have continuous access to quality healthcare. In unsafe and overcrowded living conditions, children are often exposed to heightened risks of contracting COVID-19 or the inability to access health services such as vaccination.23 Access to educationA quarter of children who arrived in Europe through the Central or the Eastern Mediterranean routes in 2017 had not completed any formal education, while a further 33% had only attended primary school.24 For children on the move, access to education is crucial to overcome cultural and linguistic barriers. However, most reception centres often do not have learning facilities or teaching personnel. Discrimination and xenophobiaNationalistic, xenophobic, misogynistic, and explicitly anti-human rights agendas of many populist political leaders have required human rights proponents to rethink many longstanding assumptions. Highly politicised narratives that support pushback operations and restrictive policies fuel xenophobic sentiments, putting children at risk of experiencing violence and discrimination.25 Preventing and combating xenophobia and discrimination against young refugees and migrants is crucial in efforts aimed at protecting their rights, fostering their livelihoods, ensuring access to health and education services26 and overcoming language barriers that severely affect their social inclusion.27 UNICEF/UNI309268/Onat From Faith to Action 5 fAith Activities to support children on the move Given this framework of compassion and a history of providing front-line support to vulnerable communities, it is no surprise that many governments, as well as local, national and international organizations have chosen to engage with faith actors as key partners in responding to the refugee and migration crisis in Europe and elsewhere in the world. In this section, we explore some of the ways in which religious leaders, faith communities, and FBOs are providing protection and spiritual support for children on the move, combatting xenophobia, helping to build peaceful societies and advocate for the rights of young refugees and migrants. i. Faith actors support to provide protection for children on the moveFaith actors contribute to enhancing child protection in multiple ways. In this section, they are outlined according to migration stages, i.e., along migration There is a consensus across religious traditions about the dignity of every child.28 The fundamental principle of respect for human life is found in religions that believe all human beings, including children, deserve to be respected and treated with dignity, and forms the basis of faith-based motivations to support children on the move.29 Religious groups, institutions and practitioners have a long and proud history of protecting vulnerable migrants and families, persecuted individuals, and unaccompanied children. Under Canon Law in Medieval times, anyone who feared for their life could find sanctuary in the closest church.30 In Europe, Belgian nuns rescued young Jews from the Nazis in the World War II,31 and Hungarian refugees found shelter and assistance in churches in Austria and elsewhere during and after the 1956-57 crisis.32 UNICEF/UN020042/Gilbertson VII Photo 6 routes and after arrival. Overall, safe and legal routes for displaced people, including children, are narrowing. For a long time, faith actors have been involved in campaigning for, organizing, and implementing sponsorship programmes for refugees. In Canada, FBOs have been a strongly involved in the private sponsorship system,33 and similar initiatives have been established in other countries. In 2016, an ecumenical initiative in Italy (see box 1) worked in collaboration with the government to grant a number of exceptional humanitarian visas to create a humanitarian corridor for refugees stranded in Lebanon and other countries to come to Italy. This initiative expanded to other European countries such as France, Belgium and Andorra.34 Recently, the Community of SantEgidio signed an agreement with the German government to transfer refugee and migrant families from the Greek island of Samos to Germany35 and inaugurated a new corridor from Lesvos to Italyprioritising families and unaccompanied minors.36 Box 1 - The Humanitarian Corridors Initiative, Italy37 Humanitarian Corridors is a small-scale initiative run by the Federation of Evangelical Churches in Italy (FCEI), the Tavola Valdese of the Waldensian Church and the Community of SantEgidio in cooperation with the Ministries of the Interior and of Foreign Affairs in Italy. The FBOs and the Government define the programme as establishing a legal and safe alternative to deadly sea routes, smuggling, and trafficking. Over a two-year period, the initiative enabled 1,000 visas to be granted to refugees who qualified as being in particularly vulnerable conditions. Among them were babies as young as five days old.38 Authorities have afforded FBOs with flexibility in the selection of the programmes beneficiaries while meeting government security requirements. Beneficiaries were selected independently from their ethnicity or religion. FBOs provided funding for accommodation and services for the reception of refugees during their initial period of permanent settlement in Italy. Additionally, in instances where the timeframe for the application for international protection was potentially very tight, FBOs negotiated with the state to obtain extensions. Through this initiative FBOs have, arguably, created privileged channels within the asylum application in Italy, that favours asylum seekers who have access to the programme. However, this privileged position also works as an avenue for lobbying towards the improvement of the Italian asylum system in general. Displaced people are often exposed to hardship along migration routes. Faith communities and FBOs are among the first to provide assistance, from the distribution of food to the provision of shelter and legal advice, especially to vulnerable groups like children. All faiths share a tradition of providing sanctuary and assistance to strangers. This tradition lives in multiple forms today,39 and is often characterised by a multi-religious configuration, as in the case of the City of Sanctuary UK movement.40 In Germany, Kirchenasyl, a highly organized network of churches41, is ready to host refugees and migrants who risk of being deported. However, in recent years, this network has been under pressure from the German government with ongoing legal challenges, and shrinking numbers of people who have access to church asylum.42 All faiths share a tradition of providing sanctuary and assistance to strangers. In Hungary, Catholic and Lutheran Bishops mobilised against the anti-refugee narrative by hosting families and individuals on the move, and providing legal advice, translation services, and assistance in finding work.43 However, this help has been curtailed since Hungary passed a law in favour of detaining asylum seekers while their status is being determined.44 ii. Social inclusion and access to social servicesEducation is key to building peaceful societies. Faith actors play a significant role in education globally,45 including providing education to children on the move in formal and informal contexts. Catch-up classes, language classes, and activities supported by volunteers from the faith community are often key to social inclusion and integration.46 Faith actors, at times, associate schooling with peace building and with the prevention of trafficking and exploitation of children.47 Jesuit Relief Services have highlighted the importance of providing education for refugee girls.48 However, there is also evidence that education from religious institutions has sometimes been influenced by politicisation and securitisation, and this highlights the need for teachers to receive training and support on issues such as countering extremism.49 Since the onset of the pandemic, online education and increased dependence on digital technologies by children have heightened the risk of online exploitation. Religions for Peace and ECPAT International have issued guidance for religious leaders on how to protect children from online sexual exploitation.50 From Faith to Action 7 Faith and Positive Change for Children offers guidance documents for religious leaders, faith communities and FBOs to help address challenges in the times of COVID-19 for example, adapting rituals, helping those at risk, and combating misinformation.51 The World Council of Churches has issued guidance52 that gives practical advice encouraging members to trust evidence-based guidance on COVID-19 safety, for example, following physical distancing and using technology to conduct religious services. Box 2 - The Vaiz of Bursa, Turkey53 Turkey hosts 3.6 million refugees the highest number of any country worldwide.54 In Bursa, the government mobilises the Vaiz, a network of state preachers, to support displaced people. The Vaiz provides direct services, delivers welcoming messages to positively influence the local faith community, advocates with the Government to to let Syrians refugees access healthcare, school, and other social services,55 and sponsors refugee children and youth events in the local community.56 More significantly, the state preachers have also used their influence to overcome bureaucratic and legal hurdles to the issuing of birth certificates and wedding registrations for displaced people who do not have the necessary paperwork.57 May countries had to divert and prioritise healthcare staff and resources to treat the sick and fight the spread of COVID-19. As a result, basic health services, including routine childhood immunization, were often temporarily suspended.58 As these services resume, faith actors can play crucial roles in supporting immunization uptake and countering anti-vaccination narratives, including religious objections, as illustrated by numerous studies.59 Religious beliefs and practices can foster wellbeing and support the integration of refugee and migrant children on the move. A recent study found that young Coptic Christians in Italy highly valued their sense of belonging to their faith community, both in terms of the religious freedom in Italy and as cultural and religious identity.60 Similarly, a study conducted in Germany, the Netherlands and the UK explained how religion can be beneficial to the social integration of Muslim migrants with their own faith/ethnic community and does not hamper integration with broader society.61 A survey conducted among churches in 19 European countries in 2014-2015 revealed that one-third had between one in 20 and one in five young members with a migration background.62 Box 3 - Learning to Live Together: Arigatou Foundation, Interfaith Council on Ethics Education for Children, and Global Network of Religions for Children63 The Global Network of Religions for Children, the Arigatou Foundation and the Interfaith Council on Ethics Education for Children in collaboration with UNICEF, UNESCO, and education professionals and academics, including those from different religious traditions, developed a methodology to foster peaceful coexistence and mutual respect in interfaith and intercultural contexts. The methodology is used in both formal (e.g., schools) and informal (e.g., refugee camps) contexts and includes activities, interfaith prayers for peace, feedback mechanisms and learning modules on different themes. In Greece, a similar programme named Learning to Play Together64 has been developed using physical education and sports to engage young refugees and migrants who come from different geographic, cultural, religious and linguistic contexts. iii. Spiritual and psychosocial support for children on the moveResearch indicates how spirituality can contribute to the resilience of children during and after their displacement.66 Fostering resilience is particularly important for children who experience and are exposed to stress, risks and violence during their migration processit includes developing a sense of belonging, acknowledging the importance of education and schooling, and connecting with the community.67 Faith actors support this resilience through the provision of community, space, and resources for sustained and holistic care. Often, these spaces are designed to aid children in finding their place in society and their identity within the faith communities by offering them psychosocial and spiritual support. Another component in the building of childrens identities is the ongoing incorporation of faith into psychosocial and resilience programs,68 which provide coping strategies for children on the move.69 8 Box 4 - Refugees Hosting Refugees Recent research has focused on hosts, refugees and refugee hosts (i.e., refugees hosting other refugees). Research from University College London65 examines the roles that members of local faith communities, faith leaders and FBOs can play in promoting social justice and social integration for refugees living in Cameroon, Greece, Malaysia, Mexico, and Lebanon. The study found that in Greece, members of refugee communities collect and distribute material support for other refugees, including baskets to break the fast during the holy month of Ramadan. Box 5 - Ecumenical assistance for asylum seekers: Oekumenischer Seelsorgedienst fr Asylsuchende (OeSA), Switzerland70 OeSA is an ecumenical organization reflecting a collaboration between the Methodist Church, the Reformed Church and the Catholic Church in Basel, Switzerland. OeSA offers several services to asylum seekers of any (or no) faith and any country of origin, including psychosocial and spiritual support during Refugee Status Determination (RSD). OeSA is also a place where asylum seekers can meet, take German lessons, attend music workshops, and where their children can attend activities organized twice a week.71 Volunteers working for this initiative are also of different religious and cultural backgrounds [who can] easily share the motivating vision and the working style of the organization.72 The sensitivity of OeSA workers towards faith-related issues has allowed them, for instance, to negotiate extra permits for Muslim asylum seekers who are staying in Registration and Procedure Centres (RPCs)73 to stay in the mosque longer during Ramadan. Working with the childrens faith communities can help achieve integration and long-term wellbeing.74 When building resilience and providing comprehensive psychological support for children on the move, it may be necessary for faith-based organizations and local faith communities to provide support to parents, caregivers and other adults in the childrens lives. This is fundamental when responding to the needs of traumatised children. iv. Faith actors efforts to combat xenophobia and discrimination and to foster peaceful coexistenceThe role of faith actors in the Global Compact for Refugees has been recognized within the plans of several anti-discrimination, xenophobia and intolerance measures and programs. Peer-to-peer workshops that bring together a particular group, for example, young people, new arrivals, or members of a faith community with a similar migration background can be used to strengthen such initiatives. In this way, relationships of trust create a safe environment to address issues such as religious prejudice, discrimination, and extremismfaith actors often become the main points of reference for displaced minors.75 Multi-religious initiatives can play a pivotal role in integration processes in countries of arrivals. The European Council of Religious Leaders and University of Winchester Centre of Religion, Reconciliation and Peace analysed case studies featuring the cooperation of at least two organizations belonging to different religious traditions in Germany, Poland, Sweden (see box 8), and the UK. 83 The study counters the idea that faith actors only support communities of their own religious tradition, and outlines potential benefits of multi-religious cooperation in integration processes by achieving shared objectives through enhanced dialogue, and combating racism and radicalisation.84 UNICEF/UN0354305/Canaj/Magnum Photos From Faith to Action 9 Box 6 - The work of Search for Common Ground against violent extremism among young returnees, Kyrgyzstan76 In Kyrgyzstan, youth radicalisation,77 especially among labour migrants and returnees, is a key issue.78 Search for Common Ground has been engaged in several programmes to prevent and combat violent extremism in the country. In 2016-2017, in partnership with the State Commission on Religious Affairsm (SCRA), the group implemented a project that used social media as a tool for deradicalization targeted and included young people, including returnees from Syria. An evaluation of the project suggested that, as a result, youth participants, as well as grant recipients, expanded their knowledge about radicalisation, extremism, and fanaticism, and gained skills in critical thinking and problem-solving.79 In 2018, the youth-led project called #JashStan80, supported by the United Nations Peacebuilding Fund, produced a reality television series turning violent and radical discourse into tolerance and peaceful coexistence. In July 2020, Search for Common Ground announced that the European Union Instrument Contributing to Stability and Peace (EUIcSP) would support a two-year project,81 which will draw on its research on the risks of radicalisation and violent extremism among Central Asian migrant workers in Russia. The project will engage religious and traditional leaders and include psychosocial support.82 Xenophobia and discrimination against refugees based on religion, nationality and ethnicity are on the rise across the region.89 To combat stigma and discrimination, faith actors promote sensitisation and advocate against xenophobic mind-sets, as well as working to protect refugees directly from discriminatory experiences and attacks.90 Public condemnation of xenophobic threats or attacks by religious leaders can have significant effects on faith communities and support efforts to eradicate, or, create further partnerships to counter the violence.91 Faith communities, particularly those that participate in interfaith initiatives can also be instrumental in reconciliation and healing following a conflict.92 Local faith actors and interfaith councils can provide expertise within countries of origin to address root causes of conflict and displacement. They can help remove obstacles to return and address issues of reintegration in the country of originespecially when tensions among religious and ethnic groups are still present.93 Box 7 - Goda Grannar (Good Neighbours), Sweden This multi-religious collaboration between the Stockholm Mosque, the Katarina parish and Islamic Relief started in 2015, as a makeshift shelter for transit migrants. It later became a much more multifaceted initiative, offering asylum seekers a wide range of services, from language cafs to counselling on issues such as employment, education and healthcare.85 In particular, they support newly arrived families with young children to find preschool and activities to help them create a network in their new community. After initial scepticism shown by some members of the local faith communities,86 the collaboration has proved to be successful and has grown in numbers and even expanded to other districts and faith actors, such as the Syrian Orthodox Church and the Negashi Mosque.87 In addition to the more practical work on integration, members of different faith communities have started a dialogue about their religious beliefs, traditions and values through this project, which has led to improved social relationships.88 v. Faith actors and policy/advocacyFaith actors are often part of networked organizations that allow them to have a strong impact within the international arena. For instance, Eurodiaconia is a European network of 52 churches and Christian NGOs94 who are active in many areas, including migration and forced displacement. The network organizes events at the European level, and recently, published the report, Fostering Cooperation Between Local Authorities and Civil Society Actors in the Integration and Social Inclusion of Migrants and Refugees,95 on the European Commissions European Web Site on Integration (EWSI), which consolidates information and good practices. Eurodiaconia recommends strengthening multi-stakeholder platforms and using transparent monitoring and evaluation mechanisms. It also suggests promoting mutual knowledge exchange among all stakeholders involved, including migrants. In April 2020, 67 NGOs and FBOs (including the International Catholic Migration Commission (ICMC), Caritas, and HIAS Greece) signed a letter, urgently requesting the relocation of displaced children stranded in Greece to other EU member states.96 In September 2020, a wide alliance (including Caritas Europe, the Churches Commission for Migrants in Europe (CCME), the European Council on Refugees and 10 Exiles, the ICMC, the International Rescue Committee, the Red Cross, and the SHARE Network) released an advocacy statement to the European Commission on the situation of migrants and refugees in Europe.97 The alliance asked for a more equitable sharing of responsibility in responding to the needs of people on the move and for safe and legal passages to Europe.98 Faith actors, at times, have been excluded from decision-making processes on migration at the policy level. Recently, however, governments and international organizations are more aware of the roles that faith actors play in responding to migration and forced displacement. In the 2018 Global Compacts on Refugees and on Safe, Orderly and Regular Migration faith actors were included as relevant stakeholders. Box 8 - Faith Over Fear movement supported by UNICEF and Religions for Peace109 UNICEF and Religions for Peace in 2017, launched the movement, Faith Over Feara global multi-religious advocacy initiative. Its aim is to spread positive messages about migration and faith to promote a welcoming culture towards displaced people among faith communities. One example from Germany (provided by the WCCs Churches Commitments to Children for this campaign) is a video110 telling the story of a Christian retired couple from Bonn who met two Syrian Muslim refugees at a local church. As their friendship became stronger, the German couple decided to host the Syrians, several weeks before they had their first child. They ended up living together for over eight months and now feel that they belong to the same extended family, celebrating Ramadan and Christmas together.111 The campaign also features a social media toolkit112 to facilitate the engagement of religious leaders and faith communities who are willing to share their stories of choosing faith over fear. A number of faith actors made recommendations during the development of the Compacts. The Interfaith Conference on the Global Compacts on Migration and Refugees brought together faith actors and policymakers and called for a greater acknowledgement of the roles played by FBOs.99 The JLI published a policy brief100 on Faith Actors and the Implementation of the Global Compact on Refugees, outlining issues, examples and recommendations of burden and responsibility sharing, reception and admission, meeting needs and supporting communities, and durable solutions. Faith actors are often part of networks making a strong impact in the international arena. Since the Global Compacts were adopted, faith actors have released statements on the importance of following their principles and guidelines, and faith communities have been urged to act to assist migrants and refugees accordingly.101 The 2019 Local Humanitarian Leadership forum in Beirut, Lebanon, emphasized that engaging local faith actors is in line with the commitments of the Global Compacts on Migration and on Refugees.102 The forum emphasized the need to localize assistance to migrants and refugees by effectively engaging local faith actors.103 Faith actors are often involved in advocacy efforts on issues affecting children on the move. They organize themselves in coalitions and take part in multi-religious campaigns, such as campaigning against the detention of children due to their immigration status104 or family separation,105 and support the right to birth registration.106 Faith actors use their influence to foster peaceful coexistence and combat violence in the name of religion through advocacy initiatives. They use statements to declare unity and speak out against xenophobia, such as the Athens Declaration, United Against Violence in the Name of ReligionSupporting the Citizenship Rights of Christians, Muslims and Other Religious and Ethnic Groups in the Middle East. 107 During the 2015-2016 refugee and migrant crisis in Europe, many religious leaders, faith actors and multi-faith alliances mobilised to push for a welcoming response and to fight against hostile populist reactions. For instance, in the UK, a multi-religious coalition of over 200 Christian, Jewish, Muslim, Sikh, Buddhist and Hindu religious leaders reacted to the refugee and migrant crisis by issuing an open letter108 to the then Prime Minister, Theresa May. They urged the government to establish legal routes for refugees from Syria and other countries, especially for those who had family in the UK. The study Faith and Childrens Rights, conducted by Arigatou International in collaboration with the International Dialogue Centre (KAICIID) and World Vision International, collected recommendations for action from religious leaders, child rights advocates, and children themselves. Participants demonstrated that the deepening of faith actors understanding of childrens rights may help communities to see the common ground between rights and religion, leading to the formation of fruitful partnerships. Such ideas can be incorporated into sermons and activities in religious communities. Faith actors can refer to legal agreements such as the Convention on the Rights of From Faith to Action 11 the Child and use the power of its mandate as a tool to advance initiatives that support children and families in their communities.113 The expertise of faith actors can significantly strengthen policy concerning the criteria for resettlement and engagement with host communities to guarantee welcome and protection of unaccompanied or separated children. This will also ensure to put in place special measures to counter risky transit and post-arrival integration, including education and trauma healing. Such endeavours can assist in counteracting negative responses to resettlement and ensuring effective integration processes.114 Opportunities and ChallengesAs this publication illustrates, engaging faith actors can result in more effective responses to the vulnerabilities of displaced children. To summarise, faith actors can contribute to: Assisting children on the move along migration routes. This includes performing or funding SAR operations, engaging in the creation and implementation of safe and legal routes, and providing basic services such as shelter, food and legal advice to children on the move and their families after arrival. Offering spiritual and psychosocial support that can enhance childrens resilience to sustain their sense of belonging and support them through their migration process. Facilitating integration and social inclusion by enhancing access to social services (in particular education) and promoting empathy, welcoming practices and shared space between the host community and the newcomers. Fostering social cohesion and inter-religious dialogue to combat xenophobia and discrimination. Advocating for and influencing policy makers towards more inclusive response approaches to displaced children and their families. Some challenges have also emerged from this review of faith actors engagements in response to the displacement of children and their families. In particular: Faith actors support can be hampered by legal challenges. For example, the legal cases against Kirchenasyl (church asylum) in Germany and the increasing detention of asylum seekers in Hungary. They require help to combat the criminalisation of migrants support. Faith actors, especially faith communities, are often heterogeneous and complex entities, which can have internal tensions and challenges. These need to be identified, and, if possible, addressed through dialogue. Recognition of the plurality and nuanced nature of faith actors is critical to avoid stereotyping. Some faith actors might lack institutional capacity required by common humanitarian standards to implement large-scale refugee response projects. When collaboration is established between international organizations and local and national faith actors that there can be opportunities for enhanced visibility, mutual understanding, finding points of complementarity, and capacity sharing. Faith actors and their activities are not exempt from politicisation. For example, they can fuel anti-migrant sentiments to ensure the support of political actors. Their engagement can also be instrumental in achieving other actors political agenda. To establish a long-term relationship of trust with key local faith actors, these factors need to be taken into consideration and addressed through in-depth knowledge of the local political context and trust building in the partnership. Recognition of the plurality and nuanced nature of faith actors is critical. 12 promising prActice cAse study #1: ecumenicAl humAnitAriAn orgAnizAtion, serbiA EHOs work in Serbia is multifaceted. It ranges from fostering the inclusion and empowerment of marginalised groups such as the Roma community116 and supporting children and the elderly117 to peacebuilding work with young people from different ethnic and faith communities.118 Since 2015, EHO has been assisting migrants and refugees in transit through Serbia.119 Part of this engagement focused on children on the move and access to education in particular. A previous project120 on social inclusion, now concluded, specifically addressed the needs of children on the move by supporting their inclusion in local schools through training local teachers in intercultural work to promote welcoming approaches and counter prejudice and discrimination. This previous project focussing on inclusion was financially supported by Swiss Church Aid (HEKS/EPER)121 and implemented in partnership with the local government. Building on it, EHO started a new project in 2019 called Empowerment of Refugee 1. The Ecumenical Humanitarian Organizations work with children and women on the move in SerbiaThe Ecumenical Humanitarian Organization (EHO) is a development organization guided by Christian ethical values. A member of Act Alliance,115 it was founded in 1993 in Novi Sad, Serbia, on the initiative of the World Council of Churches (WCC). The founding churches are the Slovak Evangelical A.B. church in Serbia, the Serbian Reformed Christian church, the Apostolic Exarchate for Greek Catholics in Serbia and Montenegro and the Evangelic Christian A.B. church in Serbia-Vojvodina. The ecumenical nature of the organization is unique in Serbia. It contributes to the expansion of its engagement, both in terms of areas and type of intervention as well as in geographical terms within Serbia. For EHO, respect for human rights and the dignity of all people is a core value. UNICEF/UNI220347/Pancic From Faith to Action 13 Women and Children, financially supported by the Evangelical Lutheran Church in America (ELCA), which is the main focus of his case study. 2. The context: Children and youth on the move in SerbiaUNHCR data on Serbia reflecting mixed migration movements from January until 27 September 2020 shows that, after a sharp drop in arrivals between April and the beginning of June, the number of arrivals rose considerably. During the whole period, 1,129 unaccompanied minorsaround 84% of which were maleentered the territory.122 According to the latest data (September 2020) from UNHCR and the Serbian Commissariat for Refugees and Migration (hereinafter Commissariat),123 Serbia currently hosts almost 26,000 refugees, 197,000 IDPs, and around 1,900 people at risk of statelessness. The number of people living in some of the Asylum Centres (AC) and Reception and Transit Centres (RTC) around the country has been growing in the last months. For example, a UNHCR assessment of the sites from August 2020 reported that the Sombor RTC was operating at full capacity with 753 people (of which 10% were children).124 The numbers rose to 854 by the end of August and to 1,141 at the end of September.125 Serbia is one of the countries in the Balkan region where the effects of restrictive policies on border crossings are more visible. In September 2020, the number of migrants and refugees who were pushed back from neighbouring states (3,115) was more significant than the number of arrivals, and the highest since UNHCR started monitoring them in 2016.126 In September, the total number of migrants and refugees hosted in RTCs or ACs in the country was 5,064526 were children, including 174 unaccompanied minors.127 Numerous sources have identified a significant increase in violent border enforcement practices and pushback operations in the areas close to the borders to Hungary and Croatia, where EHO operates.128 Since the onset of the COVID-19 pandemic until the beginning of November, Serbia had 55,676 confirmed cases and 861 deaths.129 The COVID-19 crisis worsened the situation for many refugees and migrants. A 2020 report by Save the Children highlighted how physical distancing is virtually impossible in often overcrowded transit centres in the Western Balkans.130 Due to further restrictions on freedom of movement, only a few NGOs were allowed to keep working inside RTCs and ACs.131 New rules on sanitization and the use of masks were introduced in all centres.132 Children on the move, and especially unaccompanied minors, have faced and continue to face several obstacles to their right to educationfrom language barriers and lack of documents necessary for enrolment to adequately trained teachers.133 However, in the last years, several efforts have been made to ensure access to education for children in RTCs and ACs centres in Serbia.134 For instance, a transportation service for children living in a reception centre and attending a local school was organized by IOM Serbia in collaboration with the Commissariat and funded by the EU Regional Trust Fund in Response to the Syrian Crisis and the MADAD Fund.135 Moreover, before the second lockdown began, several children living in RTCs and ACswith the support of UNCHR Serbiahad either started going to school or received vouchers for the purchase of books and other school materials.136 3. EHOs Empowerment of Refugee Women and Children ProgramBuilding on the social inclusion project described in Section 1, the program Empowerment of Refugee Women and Children137 is currently implemented by EHO in the RTCs of id, near the border to Croatia and Bosnia-Herzegovina, and Sombor, near the border to Hungary. The geographical position of both camps plays an important

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