ВОЗ и ЮНИСЕФ: Продолжение оказания услуг по плановой иммунизации имеет жизненно важное значение во время пандемии COVID-19
избежать дальнейшего воздействия COVID-19 на наши системы здравоохранения, обеспечив продолжение вакцинации людей всех возрастов в соответствии с национальными графиками. Я призываю страны даже в это трудное время продолжать оказание услуг по иммунизации и стимулировать спрос на вакцинацию на протяжении всей жизни человека. Обеспечение приоритетности иммунизации является одной из моих четырех основных областей моей работы и занимает центральное место в концепции ВОЗ в отношении здоровья в новой Европейской программе работы», – заявил д-р Ханс Генри П. Клюге, директор Европейского регионального бюро ВОЗ. ВОЗ и ЮНИСЕФ будут и впредь поддерживать усилия правительств по укреплению их программ иммунизации, в том числе посредством стратегического планирования для оказания услуг по иммунизации на справедливой основе, усиления эпиднадзора за болезнями, предупреждаемыми с помощью вакцин, а также обеспечения участия и просвещения местных сообществ. В новом будущем, в которое мы сейчас вступаем, вакцины будут по-прежнему служить основой для обеспечения здоровья и благополучия для всех. Именно благодаря солидарности, совместным действиям и неустанной приверженности принципу «не оставить никого без внимания» мы сможем вместе создать более здоровое будущее. #ВакциныРаботают Georgia immunization UNICEF/UN0326765/Georgia
Защита детей от кори в Румынии
Родители из общины рома, проживающей в городе Стрехае на юго-западе Румынии, кивают и с облегчением улыбаются после просмотра короткого видеоролика о пользе иммунизации для их детей, показанного местным врачом. Врач отвечает на вопросы родителей, прежде чем они вместе со своими детьми перейдут в следующий кабинет, где всем детям будет проведена вакцинация. Здесь дети разного возраста: те, кто только начинает ходить, и те, кому уже исполнилось 18 лет. Самые маленькие крепко держат своих мам за руку, а те, кто постарше, улыбаются и просят посмотреть фильм еще раз. Производство и показ данного фильма осуществляется в рамках программы ЮНИСЕФ в Румынии по поддержке усилий министерства здравоохранения страны, направленных на повышение показателей охвата иммунизацией и предотвращение распространения кори. С 2000 года показатели охвата иммунизацией в Румынии значительно снизились. В 2017 году только 75 процентов детей получили две дозы вакцины MMR - комбинированной вакцины против кори, эпидемического паротита и краснухи. Этот показатель намного ниже рекомендованных 95 процентов, необходимых для защиты всех детей. В результате низких показателей охвата иммунизацией в Румынии произошла вспышка кори. В 2016 году ею заболели более 15 000 человек, из которых 59 человек умерли. Большинство из них составили дети. В рамках непрекращающихся усилий по повышению охвата детей иммунизацией, в июле 2018 года стартовала организованная министерством здравоохранения Румынии кампания по вакцинации детей, которые не были привиты. Для информирования населения о важном значении иммунизации участники кампании ходили по домам. В целях поддержки данной кампании ЮНИСЕФ разработал серию информационных материалов, предоставляющих предоставить родителям фактическую информацию о преимуществах и самом процессе иммунизации детей в доступной для понимания взрослых форме. В состав этих информационных материалов входит короткометражный фильм, который посмотрели семьи в Стрехае. Фильм демонстрируется семьям из наиболее уязвимых общин Румынии - родителям, живущим в труднодоступных районах, семьям, пострадавшим от нищеты, и общинам рома. Показатели иммунизации среди детей в этих общинах чаще всего самые низкие по стране. В этом фильме рассказывается о необходимости и преимуществах вакцинации, и одновременно даются ответы на часто задаваемые и волнующие родителей вопросы относительно вакцинации: Безопасно ли делать прививку моему ребёнку? Что делать, если она/он заболеют другой болезнью? Что, если мой ребёнок заболеет после прививки? Эта прививка бесплатна? A girl is vaccinated at a community center in Buhuși, in Eastern Romania as part of the UNICEF and WHO supported immunization catch-up campaign. Девочка получает прививку в общинном центре в Бухуши, в восточной Румынии, в рамках кампании по проведению вакцинации детям, которые её не прошли. Эта кампания проводится при поддержке ЮНИСЕФ и ВОЗ. «Вначале родители не хотели прививать своих детей, но потом они доверились нам. Мы рассказали родителям о пользе прививок и попросили их задавать врачу все вопросы, которые могут возникнуть у них в ходе проведения кампании. Таким образом, родители смогли получить чёткое представление о пользе вакцинации», - сказала Габриэла Стан, медицинский работник в городе Бухуши, в Восточной Румынии. Габриэла была членом группы, ходившей по домам, для того чтобы информировать родителей из уязвимых сообществ о преимуществах вакцинации. И хотя за последние несколько месяцев в Румынии произошли положительные сдвиги в деле вакцинации уязвимых детей спасающей жизни прививкой MMR, дети будут по-прежнему находиться в опасности до тех пор, пока охват иммунизацией не достигнет 95 процентов. ЮНИСЕФ в Румынии будет и впредь помогать в проведении информационно-разъяснительных кампаний о важном значении и необходимости вакцинации и поощрять всех родителей и лиц, обеспечивающих уход за детьми, к своевременному проведению этой профилактической процедуры. Таким путём они смогут защитить своих детей от болезней, предотвратимых с помощью вакцинации.
Maintaining routine immunization services vital during the COVID-19 pandemic – WHO and UNICEF
The COVID-19 pandemic is a stark reminder that infectious diseases know no borders. All countries are vulnerable, regardless of income levels or the strength of their health care systems. Across the European Region, where tens of millions of people have been living in lockdown for weeks, and over 100,000 people have died, the speed and devastation of the novel coronavirus has completely upended lives. The urgent need for a COVID-19 vaccine underscores the pivotal role immunizations play in protecting lives and economies. As scientists around the world work to develop a vaccine against the novel coronavirus and health care capacities are stretched in responding to COVID-19, national routine immunization programmes are more critical than ever before. Governments across the Region must use every opportunity possible to protect people from the many diseases for which vaccines are already available. When routine vaccinations are missed, the risk of disease outbreaks increases. In 2018, approximately 527 000 children missed their first-dose of measles-containing vaccine in the WHO European Region. One year later in 2019, the measles virus exposed immunity gaps in Europe, infecting over 100 000 people, across all age-groups. Protecting children, adolescents and adults from vaccine-preventable diseases through vaccination is a must for the sustainability of health care systems. “We know that vulnerability to infectious diseases anywhere is a threat to public health everywhere,” said Ms. Afshan Khan, UNICEF Regional Director for Europe and Central Asia. “It is critical that routine immunization programmes continue during this crisis, while adequately protecting health workers and individuals receiving vaccinations. Reaching the most vulnerable children who have missed routine immunizations in the past should be prioritized.” If, during these unprecedented times, local COVID-19 response measures cause temporary interruptions of routine immunization services, countries should plan to resume immunization services as quickly as possible after the situation stabilizes. Countries should be prepared to vaccinate those at higher risk and ensure everyone, including the most marginalized, will have equal access to a COVID-19 vaccine when it becomes available. “ We can prevent further impact of COVID-19 on our healthcare systems by assuring that individuals of all ages remain vaccinated according to national schedules. I urge countries to maintain immunization service delivery and drive demand for vaccination, through the life-course even at this difficult time. Prioritizing immunization is one of my four flagship areas and central to WHO’s vision for health in the new European Programme of Work” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. WHO and UNICEF will continue to support governments’ efforts to strengthen their immunization programmes, including through strategic planning for equitable provision of immunization, strengthening vaccine-preventable disease surveillance and community engagement and education. As we step into a new future, vaccines will continue to serve as a foundation for health and wellbeing for all. It is through solidarity, joint action and tireless commitment to leaving no one behind that we can create a healthier future together. #Vaccineswork Georgia immunization UNICEF/UN0326765/Georgia
Protecting children against measles in Romania
Parents living in Strehaia, a Roma community in South-West Romania, nod and smile in relief after watching a short video shown by their local physician on the benefits of immunizing their children. The physician answers questions from the parents before they gather their children and move to the next room where all of the children are vaccinated. The children range in age from young toddlers to 18 years old. The young ones hold their mothers’ hands tightly, but the older ones laugh and ask to watch the film again. The film is part of UNICEF Romania’s ongoing support to the Ministry of Health’s efforts to increase immunization coverage and prevent the spread of measles. Vaccination coverage in Romania has declined since 2000. In 2017, only 75 per cent of children had received two doses of Measles, Mumps and Rubella (MMR) vaccine – a coverage rate far below the recommended 95 per cent needed to protect all children. As a result of low immunization coverage, Romania has experienced a measles outbreak, with over 15,000 people affected since 2016. This includes 59 deaths, the majority being children. As part of ongoing efforts to increase immunization coverage, in July 2018 Romania’s Ministry of Health launched a door-to-door catch up campaign to vaccinate children who missed their vaccinations. In support, UNICEF developed a series of materials to provide parents with easy to understand, factual information about the benefits and process of children being immunized. These materials include the short film watched by families in Strehaia. The film is shown to parents and families in the most vulnerable communities in Romania - people living in hard to reach areas, those affected by poverty, and Roma communities. These communities often have children with the lowest rates of immunization. The film talks about the necessity and benefits of vaccination and, at the same time, addresses the most common vaccine-related questions from parents: Is it safe to vaccinate my child? What if she/he catches another disease? What if my child gets sick after the vaccination? Is the vaccine free of charge? A girl is vaccinated at a community center in Buhuși, in Eastern Romania as part of the UNICEF and WHO supported immunization catch-up campaign. A girl is vaccinated at a community center in Buhuși, in Eastern Romania as part of the UNICEF and WHO supported immunization catch-up campaign. “In the beginning parents did not want to vaccinate their children, but then they put their trust in us. We told them vaccines are good and we encouraged them to ask the doctor all the questions they have during the campaign. So they were able to have a clear picture on the benefit of vaccination,” said Gabriela Stan, a health mediator in the town of Buhuși, in Eastern Romania. Gabriela was part of the team that went door-to-door to inform parents from vulnerable communities about the benefits of vaccination. Although there have been positive developments in reaching vulnerable children with lifesaving MMR immunizations over the past few months in Romania, until the coverage rate reaches 95 per cent, children will remain at risk.
HIV-positive… and fearless
During the first TEDxYouth event organized on 17 November in Kazakhstan, Baurzhan, age 13, and his mother Aliya spoke about living openly with HIV. This is his story. Standing before more than 100 people, Aliya asks if anyone in the audience remembers the incident in 2006 when 149 children in southern Kazakhstan were infected with the human immunodeficiency virus (HIV) at a local hospital. A few hands go up. Hesitantly. “Not too many,” sighs Aliya. “That’s 149 families facing profound pain, shock, complete lack of support and understanding.” Indeed, when the news first broke at the time, there was very little by way of public understanding and sympathy. On the contrary, the families affected have spoken about the pervasive rumors – including one suggesting that a special area would be built to quarantine the families – that they had to endure. Some families were even broken up. The sense of isolation still persists for many. “In our society,” Aliya says, “HIV is still perceived to be a ‘plague’ of the 21 st century. These families and children are hiding. They do not open up about their HIV status. These children are still invisible to society.” Then she adds, “They all live in great fear. All, but one.” A voice chimes in. “I am one of those 149 children. I am HIV-positive and today, I am the only teenager in Kazakhstan with HIV who is living openly,” says Baurzhan, age 13. Baurzhan and his mother at their home in Kazkhstan. Working towards acceptance Aliya’s son Baurzhan was just nine months old when she learned that the blood transfusion he had received for treatment was infected with HIV. When he started going to school, Baurzhan understood that there were different kinds of viruses and one of them happened to be living in him. He did not feel different, until teachers asked him not to play during recess or physical education class. “We realized that for school to be an understanding environment, we needed to organize training, raise awareness among teachers on the importance of tolerance towards children with such illnesses,” his mother says. The lanky teenager remembers crying in the school gym changing room after his classmate called him offensive names related to HIV. “I was not ready to hear it. It hurt a lot.” The incident made Aliya realize that students needed awareness training, too. She helped the school organize lessons on child rights and responsibilities explaining the universality of rights. After the first session, the boy who had offended Baurzhan apologised for what he had said. “For 11 years, I have been taking medications every day to control the amount of virus in my blood. My immunity is 900 cells. Do you know that the immunity of a healthy person is 1200 cells? So, my immunity is that of a healthy teenager,” he says. “My viral load is less than 50 copies. This means that I am just a carrier, but I cannot transmit the virus while I am taking medications.” Together with friends, Baurzhan created a self-help group called “Asian teens” where they share their experiences of living with HIV. “I want to support other kids who are living in fear because of their HIV status. I want to be a role model of living openly and without any fear.” As Baurzhan says these words, the audience erupts in standing ovation. After the TEDx talk, Baurzhan and his mother said that many people approached him and asked if they could give him a hug. “I really liked the feeling of speaking in that room – it was filled with warmth, the audience showed that they cared”, he said. “My friends who are also living with HIV cannot wait to see my video, I think they will be surprised to see the positive reaction my story received.” Baurzhan with his sibling at the family home. Baurzhan with his sibling at the family home. HIV today and steps for the future Since the outbreak in 2006, the HIV/AIDS situation has changed. By 2010, UNICEF helped decrease the rate of HIV transmission from mother to child in south Kazakhstan, which at the time had the highest number of deliveries by HIV-positive women. At country level, joint efforts of the Ministry of Health and UNICEF led to dropping the HIV transmission rate from 10.9 per cent in 2007 to 1.8 percent in 2014. Kazakhstan is now submitting a request to be certified as a country that virtually eliminated mother-to-child HIV transmission. However, more work remains, says UNICEF Health and Nutrition Officer Kanat Sukhanberdiyev. “Globally, we still see that many children are dying from HIV/AIDS. We have a long way to go until children and adolescents with HIV receive the full package of healthcare and psychosocial support.” On this World AIDS Day, UNICEF is calling on the world to increase investments in HIV prevention, testing and treatment programmes. Otherwise, by 2030, the lives of some 360,000 adolescents will be at risk of AIDS-related diseases. Find out more about UNICEF’s work on HIV in Kazakhstan.
A Mother and baby corner - a place of health and serenity
“Milos was born at a Reception centre, here in Serbia. We have been changing addresses ever since. We are currently staying at the Asylum centre in Belgrade. These are all difficult circumstances, where I, as a mother, don’t set the rules. And I find it very difficult.” Mother with a baby Sharife and her son Shahir Milos in the mother and baby corner in Belgrade, Serbia. That’s why Sharife is happy every time she visits the Mother and baby corner. The nearby Community centre, run by the humanitarian organization ADRA, houses just such a mother and baby corner, whose work is supported by UNICEF through the project ‘Strengthening Refugee and Migrant Children's Health Status in Southern and South-Eastern Europe’, co-funded by the Health Programme of the European Union (the ‘RM Child-Health’ initiative). Here, mothers can spend time in a safe space for women, change their babies’ clothes and nappies, access hygiene items for their children, breastfeed in privacy and put their children down for naps, as well as participate in workshops. And most importantly, because they are living in challenging circumstances, they can talk to a doctor about the nutrition, hygiene and early childhood development and immunization of their small child, but also about their own health and the health of older children. This is particularly crucial during the COVID-19 pandemic. Milos is learning through play in the Mother and baby corner. Milos is learning through play in the Mother and baby corner. The first piece of advice that mothers receive in the Mother and baby corner is always about breastfeeding – a source of food that is always available, hygienically safe and nutritious, and which boosts a child's immunity. “Breast milk provides all the nutrients a baby needs, but it also stimulates development [and] develops immunity. It helps the child to calm down, sleep better and be settled. This also helps me be calm,” explains Sharife with a smile on her face. Sharife is an experienced mother. Even so, she is very grateful for the advice she has received from the doctor at the Mother and baby corner. When Milos was six months old, she introduced solid food into his diet, while she continued to breastfeed. She recalls that Milos’s first solid food was rice cereal, and then later on vegetables, fruits and meat. The Mother and baby corner is a safe space where Milos and his mother can spend quality time together. The Mother and baby corner is a safe space where Milos and his mother can spend quality time together. “Milos likes best the carrot and apple puree I make for his snack,” explains Sharife. The needs of refugee and migrant women, according to social worker Andja Petrovic, have shaped the development of ADRA’s Community centre, where they would, as a rule of thumb, almost always come with their children. In order for women to be able to attend creative, recreational and educational workshops at the Women's centre, they needed a Child-friendly space for older children and a Mother and baby corner for women with infants. These spaces make it possible for mothers to participate in language classes, sports activities, creative workshops and, most importantly, in workshops about women's health and rights, while their children are taken care of and safe. In these challenging times, mothers really appreciate the chance to talk to a doctor about the health status of their children. “The most important thing is that all the advice from our doctor is in line with their economic circumstances and current living situation [in Reception centres],” explains Andja. “The advice is tailored to their life and I think they particularly like that, because they can see that their situation is acknowledged. Because when they go to a doctor [in other facilities], they get advice that they can’t follow because they don’t have the [living] conditions for that.” Dr Zivica Lukic explains that she talks to mothers mostly about nutrition, hygiene and how to respond to their babies’ needs. “We support mothers to establish and maintain breastfeeding, as it has not only economic benefits, but for mothers it also has emotional and physical ones. We know how healthy breastfeeding is for the child, but it is equally healthy for the mother, because it soothes and creates a strong bond between mother and child. When the baby is six months old, it’s necessary to introduce solid foods. I advise [the introduction of] vegetables that can be pureed well, such as potatoes and carrots, [as well as] rice.”
With financial support from the European Union UNICEF launches the ‘RM Child-Health’ project to strengthen vulnerable refugee and migrant children’s health
– Under the Health Programme of the European Union, the Directorate General for Health and Food Safety has committed a project grant to UNICEF to support work ensuring refugee and migrant children and their families have access to quality health care and accurate health information in Bulgaria, Greece, Italy, Spain, Bosnia Herzegovina and Serbia. Refugee and migrant children and their families often have more health-related risks and face a number of barriers accessing quality health care. Many children and families also live with severe emotional distress due to the trauma of fleeing home, undertaking dangerous journeys and experiencing abuse and exploitation, including sexual and gender-based violence. The global COVID19 pandemic further exacerbates these health challenges. “With the ongoing pandemic, protecting every child and adult’s right to health care and accurate heath information is paramount. This collaboration with the EU Health Programme will help ensure the most vulnerable refugee and migrant children will have better access to primary healthcare services, psychosocial support as well as violence prevention and response services,” said UNICEF Regional Director for Europe and Central Asia and Special Coordinator for the Refuge and Migrant Response in Europe, Ms. Afshan Khan. The project ‘RM Child-Health’ will help improve the health of refugee and migrant children by improving their access to life-saving immunizations, mental health and psychosocial support, gender-based violence prevention and response activities as well as maternal and newborn health care and nutrition support. Information materials on health-related risks and services available for refugee and migrant populations will be created and shared. Medical interpreters and cultural mediators will be deployed to support communication between children and families and health care providers. The project ‘RM Child-Health’ will also support training programmes so frontline health care workers can better respond to the specific needs of refugee and migrant children and their families. In parallel, national health authorities will benefit from technical support to develop, update and improve the implementation of health policies and address bottlenecks in national health systems that currently prevent refugee and migrant children from accessing services. Refugee mother feeding her baby at ADRA community centre in Belgrade. UNICEF/UNI220342/Pancic
Addressing double burden of malnutrition must be prioritized in Eastern Europe and Central Asia – UNICEF
– The new State of the World’s Children Report: Children, Food and Nutrition was launched at a special event in Kazakhstan to promote nutrition and raise awareness about unhealthy diets among children in Central Asia. The event included more than one thousand child participants and was organized by the Foundation of the First President of Kazakhstan. The new report shows that at least 1 in 3 children under five globally – or over 200 million – is either undernourished or overweight. Almost 2 in 3 children between six months and two years of age are not fed food that supports their rapidly growing bodies and brains. This puts them at risk of poor brain development, weak learning, low immunity, increased infections and, in many cases, death. In Eastern Europe and Central Asia, 18 per cent of the poorest children under 5 years old are stunted, which means they have low height for their age. While at the same time, 15 per cent of children under five years old in the Region are overweight, which is the highest rate globally. “In Central Asia and Eastern Europe children face a double burden of malnutrition – undernutrition found alongside obesity,” said Amirhossein Yarparvar, Health & Nutrition Specialist for UNICEF’s Regional Office for Europe and Central Asia. “Ensuring all children have adequate nutrition must be an urgent priority for policy makers, communities and families.” The report found that the Region has made gains in exclusive breastfeeding, with the percentage of infants breastfed rising from 20 per cent in 2005 to 33 per cent in 2018. But even with this increase, 65 percent of newborns are deprived of the recommended 6 months of exclusive breastfeeding. The report lists several recommendations to improve child nutrition, including: • National food systems must put children’s nutrition at the heart of their work because their nutritional needs are unique and meeting them is critical for sustainable development. • Financial incentives should be used to reward actors who increase the availability of healthy and affordable foods in markets and other points of sale especially in low-income communities. • Financial disincentives on unhealthy foods can improve children’s diets. For example, taxes on sugary foods and beverages can reduce their consumption by children and adolescents. • Fortification of complementary foods and staple foods with micronutrients can be a cost-effective intervention to combat hidden hunger in children, young people and women. family eating at home in a low-income neighbourhood_Alimzhan Jorobayev Bektur Zhanibekov A family of seven people eats at home in a low-income neighbourhood in rural Kyrgyzstan on 18 March 2012.
Safeguarding the health of refugee and migrant children during COVID-19
, the initiative has supported UNICEF’s efforts to improve the immunization process for refugee children and migrants by strengthening the assessment and monitoring process. As a result of such efforts, refugees and migrants have been included in the national COVID-19 Immunization Plan.
Navigating pregnancy during the COVID-19 pandemic
Many expectant mothers are fearful of going to appointments while they are taking precautions, such as staying home and practicing physical distancing when outside. “You do see a lot of adaptation happening at the moment in the world where midwives are doing clinics or certain appointments by phone, so that the actual looking at the baby and the growth of the baby appointment can be short,” says Cadée. “I expect that pregnant women will find they’re seeing their healthcare professional less, to protect them and the healthcare professional from getting infected and that they will be seen live when it’s necessary.” Modifications may also be tailored for individual patients depending on their respective conditions, for example lower vs. higher-risk pregnancies. Cadée advises mothers to find out what options are available to them from their healthcare professional and in their communities. “The person who’s taking care of you is perfectly geared to you and your own needs, so your midwife or obstetrician will know best.” After your child is born, it is also important to continue receiving professional support and guidance, including routine immunizations. Speak to your healthcare provider about the safest way to have these appointments, for you and your baby. >> How to get routine childhood vaccinations during COVID-19
Poor diets damaging children’s health worldwide, warns UNICEF
– An alarmingly high number of children are suffering the consequences of poor diets and a food system that is failing them, UNICEF warned today in a new report on children, food and nutrition. The State of the World’s Children 2019: Children, food and nutrition finds that at least 1 in 3 children under five – or over 200 million – is either undernourished or overweight. Almost 2 in 3 children between six months and two years of age are not fed food that supports their rapidly growing bodies and brains. This puts them at risk of poor brain development, weak learning, low immunity, increased infections and, in many cases, death. “Despite all the technological, cultural and social advances of the last few decades, we have lost sight of this most basic fact: If children eat poorly, they live poorly,” said Henrietta Fore, UNICEF Executive Director. “Millions of children subsist on an unhealthy diet because they simply do not have a better choice. The way we understand and respond to malnutrition needs to change: It is not just about getting children enough to eat; it is above all about getting them the right food to eat. That is our common challenge today.” The report provides the most comprehensive assessment yet of 21 st century child malnutrition in all its forms. It describes a triple burden of malnutrition: Undernutrition, hidden hunger caused by a lack of essential nutrients, and overweight among children under the age of five, noting that around the world: 149 million children are stunted, or too short for their age, 50 million children are wasted, or too thin for their height, 340 million children – or 1 in 2 – suffer from deficiencies in essential vitamins and nutrients such as vitamin A and iron, 40 million children are overweight or obese. The report warns that poor eating and feeding practices start from the earliest days of a child’s life. Though breastfeeding can save lives, for example, only 42 per cent of children under six months of age are exclusively breastfed and an increasing number of children are fed infant formula. Sales of milk-based formula grew by 72 per cent between 2008 and 2013 in upper middle-income countries such as Brazil, China and Turkey, largely due to inappropriate marketing and weak policies and programmes to protect, promote and support breastfeeding. As children begin transitioning to soft or solid foods around the six-month mark, too many are introduced to the wrong kind of diet, according to the report. Worldwide, close to 45 per cent of children between six months and two years of age are not fed any fruits or vegetables. Nearly 60 per cent do not eat any eggs, dairy, fish or meat. As children grow older, their exposure to unhealthy food becomes alarming, driven largely by inappropriate marketing and advertising, the abundance of ultra-processed foods in cities but also in remote areas, and increasing access to fast food and highly sweetened beverages. For example, the report shows that 42 per cent of school-going adolescents in low- and middle-income countries consume carbonated sugary soft drinks at least once a day and 46 per cent eat fast food at least once a week. Those rates go up to 62 per cent and 49 per cent, respectively, for adolescents in high-income countries. As a result, overweight and obesity levels in childhood and adolescence are increasing worldwide. From 2000 to 2016, the proportion of overweight children between 5 and 19 years of age doubled from 1 in 10 to almost 1 in 5. Ten times more girls and 12 times more boys in this age group suffer from obesity today than in 1975. The greatest burden of malnutrition in all its forms is shouldered by children and adolescents from the poorest and most marginalized communities, the report notes. Only 1 in 5 children aged six months to two years from the poorest households eats a sufficiently diverse diet for healthy growth. Even in high-income countries such as the UK, the prevalence of overweight is more than twice as high in the poorest areas as in the richest areas. The report also notes that climate-related disasters cause severe food crises. Drought, for example, is responsible for 80 per cent of damage and losses in agriculture, dramatically altering what food is available to children and families, as well as the quality and price of that food. To address this growing malnutrition crisis in all its forms, UNICEF is issuing an urgent appeal to governments, the private sector, donors, parents, families and businesses to help children grow healthy by: Empowering families, children and young people to demand nutritious food, including by improving nutrition education and using proven legislation – such as sugar taxes – to reduce demand for unhealthy foods. Driving food suppliers to do the right thing for children, by incentivizing the provision of healthy, convenient and affordable foods. Building healthy food environments for children and adolescents by using proven approaches, such as accurate and easy-to-understand labelling and stronger controls on the marketing of unhealthy foods. Mobilizing supportive systems – health, water and sanitation, education and social protection – to scale up nutrition results for all children. Collecting, analyzing and using good-quality data and evidence to guide action and track progress. “We are losing ground in the fight for healthy diets,” said Fore. “This is not a battle we can win on our own. We need governments, the private sector and civil society to prioritize child nutrition and work together to address the causes of unhealthy eating in all its forms.” Children eating UNICEF/UN0339621/Darkhan Zhagiparov
Strengthening the implementation of health policies
The initiative also promotes and supports multi-disciplinary approaches and teams to address the complex causes of health problems among refugee and migrant children – from trauma, anxiety and over-crowded conditions, to lack of hygiene facilities and immunization. As a result, support from the ‘RM Child-health’ initiative builds trust between refugee and migrant families and health providers. At the Centre for refugees and migrants near Bela Palanka in south-eastern Serbia, for example, the needs of refugee and migrant women have shaped the development of the Community Centre run by ADRA, with its Mother and Baby Corner for women with infants. Here, women can take part in language classes, sports activities and, crucially, in workshops about their own health and rights. “ The most important thing is that all the advice from our doctor is in line with their economic circumstances and current living situation [in Reception centres],” explains social worker Andja Petrovic. “The advice is tailored to their life and I think they particularly like that, because they can see that their situation is acknowledged. Because when they go to a doctor [in other facilities], they get advice that they can’t follow because they don’t have the living conditions for it.” Also in Serbia, funding from the ‘RM Child-health Initiative’ supports work by UNICEF and the Institute of Mental Health that looks beyond the provision of basic health care to assess the scale and nature of substance abuse among refugee and migrant communities. This cutting-edge field research will guide the development of materials and capacity building specifically for health and community workers who are in regular contact with young refugees and migrants, helping these workers to identify and tackle substance abuse by connecting children and youth to support services. As one researcher involved in the research commented: “Most of those children have spent several years without a home or any sense of stability. They can't make a single plan about the future since everything in their life is so uncertain. I can't begin to imagine how frightening that is.” By building greater rapport between frontline workers and children, and by equipping those workers with the support, skills and resources they need, the ‘RM Child-health’ initiative is helping to transform health policies into health practice. This vital work has been particularly crucial in 2020, as frontline workers have had to confront – and adapt to – the greatest public health crisis in living memory: the COVID-19 pandemic. Logo This story is part of the Project ‘Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe’, Co-funded by the Health Programme of the European Union (the ‘RM Child-Health’ initiative).It represents the views of the author only and is her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.