‘RM Child-Health’: safeguarding the health of refugee and migrant children in Europe
More than 1.3 million children have made their way to Europe since 2014, fleeing conflict, persecution and poverty in their own countries. They include at least 225,000 children travelling alone – most of them teenage boys – as well as 500,000 children under the age of five. In 2019 alone, almost 32,000 children (8,000 of them unaccompanied or separated) reached Europe via the Mediterranean after perilous journeys from Syria, Afghanistan, Iraq and many parts of Africa – journeys that have threatened their lives and their health. Many have come from countries with broken health systems, travelling for months (even years) with no access to health care and facing the constant risks of violence and exploitation along the way. Many girls and boys arriving in Europe have missed out on life-saving immunization and have experienced serious distress or even mental health problems. They may be carrying the physical and emotional scars of violence, including sexual abuse. The health of infants and mothers who are pregnant or breastfeeding has been put at risk by a lack of pre- and post-natal health services and of support for child nutrition. Two girls wash a pot in the common washing area of the Reception and Identification Centre in Moria, on the island of Lesvos, in Greece. Two girls wash a pot in the common washing area of the Reception and Identification Centre in Moria, on the island of Lesvos, in Greece. Child refugees and migrants also face an increased health risk as a result of crowded and unhygienic living conditions during their journeys and at their destinations. Even upon their arrival in Europe, refugee and migrant children and families often face continued barriers to their health care, such as cultural issues, bureaucracy, and a lack of information in their own language. Southern and South East European countries are at the heart of this challenge, struggling to meet the immediate needs of vulnerable refugee and migrant children. And now, an already serious problem is being exacerbated by the COVID-19 pandemic. Refugee checks on his son
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.
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.
Refugee and migrant children in Europe
People have always migrated to flee from trouble or to find better opportunities. Today, more people are on the move than ever, trying to escape from climate change, poverty and conflict, and aided as never before by digital technologies. Children make up one-third of the world’s population, but almost half of the world’s refugees: nearly 50 million children have migrated or been displaced across borders. We work to prevent the causes that uproot children from their homes While working to safeguard refugee and migrant children in Europe, UNICEF is also working on the ground in their countries of origin to ease the impact of the poverty, lack of education, conflict and insecurity that fuel global refugee and migrant movements. In every country, from Morocco to Afghanistan, and from Nigeria to Iraq, we strive to ensure all children are safe, healthy, educated and protected. This work accelerates and expands when countries descend into crisis. In Syria, for example, UNICEF has been working to ease the impact of the country’s conflict on children since it began in 2011. We are committed to delivering essential services for Syrian families and to prevent Syria's children from becoming a ‘ lost generation ’. We support life-saving areas of health , nutrition , immunization , water and sanitation, as well as education and child protection . We also work in neighbouring countries to support Syrian refugee families and the host communities in which they have settled.