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Report
18 Июль 2023
Europe and Central Asia Regional Immunization's Snapshot
https://www.unicef.org/eca/reports/europe-and-central-asia-regional-immunizations-snapshot
New data from UNICEF and the World Health Organization (WHO) offers a snapshot of children's immunization coverage across the Europe and Central Asia region. Across the region, more than 200,000 are still not fully vaccinated. In 2022, 229,000 out of nearly 4.1 million surviving infants in the region did not receive the three…, BCG DTP1 DTP3 HepB3 Hib3 IPV1 MCV1 MCV2 PCV3 Polio3 Rota HPV - Europe and Central Asia Albania Armenia Azerbaijan Belarus Bosnia and Herzegovina Bulgaria Croatia Georgia Greece Kazakhstan Kyrgyzstan Montenegro North Macedonia Republic of Moldova Romania Serbia Tajikistan Trkiye Turkmenistan Ukraine Uzbekistan 2894789193969493949695 99 99 0 45 47…
Page
24 Апрель 2019
World Immunization Week 2019
https://www.unicef.org/eca/health/immunization/world-immunization-week-2019
Vaccines act as a shield, protecting children and newborn babies from dangerous diseases and saving up to 3 million lives each year. Yet, there are still nearly 20 million unvaccinated and under-vaccinated children in the world today. These children are at risk of serious illness, complications, and even death. Many parents want to vaccinate their children, but can’t because they don’t have access to healthcare. But increasingly, some parents are choosing not to. This reluctance often stems from misconceptions about vaccines, or complacency about the likelihood of getting infected. That’s why staying informed about the benefits of vaccines – and the risks of not getting vaccinated – is more important than ever. This World Immunization Week, UNICEF is launching a global campaign to emphasize the power and safety of vaccines among parents and social media users. From 24-30 April, the Bill & Melinda Gates Foundation will contribute US$1 to UNICEF for every like or share of social media posts using the hashtag #VaccinesWork, up to US$1 million, to ensure all children get the life-saving vaccines they need. Help protect children from deadly diseases by telling parents around the world,  #VaccinesWork !  
Page
13 Апрель 2023
A quick look: the state of routine immunization in Europe and Central Asia
https://www.unicef.org/eca/quick-look-state-routine-immunization-europe-and-central-asia
Immunization allows children everywhere to live lives free of many forms of disability and illness. UNICEF's  The State of the World’s Children 2023 highlights the current situation of immunization for children globally. UNICEF's regional brief for Europe and Central Asia demonstrate that public demand, scientific innovations and – perhaps above all – political will can drive rapid change.  Now is a time for determination. Now is a time for political will. Now is the time to protect the health of  every  child. Girl receiving a HPV vaccine. 67 million children Between 2019 and 2021, 67 million children across the world missed out on routine vaccinations. 2-month-old gets vaccinated by Nurse as part of his routine childhood immunization session. 327,400 children 327,400 are “zero-dose” and “under-vaccinated” children. That means they have not received any vaccinations or the third required dose of the diphtheria-pertussis-tetanus (DPT3) vaccine. Nurse in office 29 countries 29 countries in the region found a decrease in the perception of the importance of vaccines for children. 3-month-old gets vaccinated in Tajikistan One million Nearly one million of children who missed one or several routine vaccinations live in Europe and Central Asia.
Report
28 Октябрь 2020
Protecting young children from vaccine-preventable diseases
https://www.unicef.org/eca/reports/protecting-young-children-vaccine-preventable-diseases
Vaccination is one of the world’s safest and most cost-effective public health interventions. Yet growing distrust in science, coupled with misinformation, means that vaccination coverage rates are declining in some countries and communities, resulting in an upsurge of vaccine-preventable diseases. Research shows that those caring for children…, PROTECTING YOUNG CHILDREN FROM VACCINE-PREVENTABLE DISEASES MODULE 22 Disclaimer: The resource modules were authored by the individuals under the guidance of the UNICEF Regional Office for Europe and Central Asia. The text is presented in draft format and it is expected that it will be adapted and contextualized for use by interested countries.…
Statement
24 Апрель 2023
Joint statement: European Immunisation Week 2023 and beyond
https://www.unicef.org/eca/press-releases/joint-statement-european-immunisation-week-2023-and-beyond
Geneva, Brussels, Copenhagen, 24 April 2023 – Following three years with COVID-19, we are transitioning into a new normal and building on many lessons learned to create resilient health systems and stronger outbreak preparedness. Among these lessons is the powerful strength of collaboration, without which we cannot equitably reach everyone with life-saving vaccines. As we mark European Immunization Week, UNICEF, WHO and the European Commission alongside other regional and local stakeholders are committed to continue working to protect the most vulnerable through COVID-19 vaccination. Together we will continue our support to countries to ensure children and families have timely access to routine vaccinations and catch up on any missed doses, all of which are essential to prevent the return of highly contagious vaccine-preventable diseases. COVID-19 placed huge new demands on health systems and exposed existing shortages within the health workforce. Lockdowns and the fear of contracting COVID-19 while visiting health-care facilities led some families to put off vaccinating their children. Across 53 countries in Europe and Central Asia – together making up the European Region of WHO - over 1 million children missed all or some routine vaccinations since the start of the pandemic in 2020. While many of the countries in the Region quickly recovered with great effort from disruptions and delays to routine vaccinations, 16 countries saw a decline in coverage for the third dose of diphtheria-tetanus-pertussis (DTP3) vaccine in 2021 compared to pre-pandemic rates. Half of the Region’s 20 middle-income countries reported coverage below 90% for one or more vaccines in 2021, compared to less than 10% of high-income countries, which is widening the immunization equity gap among countries and their populations. War in Ukraine and earthquakes in Türkiye have caused further disruptions to health services, displaced millions of families, and made access to life-saving vaccines much harder. Vaccination is a cornerstone of public health. Every dose in the national immunisation schedule is timed to build or sustain protection from one or more diseases. Every missed or delayed dose puts a child at greater risk of infection. This can be particularly dangerous for young children and the most vulnerable in our communities. The more children who fall behind, the greater the risk of large outbreaks of measles, polio, diphtheria and other dangerous infectious diseases. Cases of measles in the European Region increased almost six-fold in a reporting year, up from 159 in 2021 to more than 900 in 2022. Cases of diphtheria increased seven-fold from 41 in 2021 to 300 in 2022. Detections of circulating vaccine-derived polioviruses were also reported in 2022 in Israel and the United Kingdom. It is in our common interest to protect each other from disease; critical to this is keeping up with national vaccine schedules, including by receiving all the recommended doses and boosters, and catching up on any that have been missed. As we continue to support countries to build resilient public health systems and infrastructures, let us remember that we have a strong foundation of public health accomplishments to preserve and build upon. Working together to bring the world closer to eradicating polio and eliminating measles, rubella, cervical and other cancers from the Region through vaccination, we will ensure better health for all and contribute to our joint commitment to regional and global health security. Signatories Ms Afshan Khan, UNICEF Regional Director for Europe and Central Asia Ms Stella Kyriakides, European Commissioner for Health and Food Safety Dr Hans Henri P. Kluge, WHO Regional Director for Europe In Krakow, Poland, Nurse prepares a Varilrix vaccine against chickenpox at the UNIMED medical center. UNICEF/U.S. CDC/UN0715410/Kasia Strek
Press release
20 Апрель 2023
Confidence in childhood vaccines declines across Europe and Central Asia – new UNICEF report
https://www.unicef.org/eca/press-releases/confidence-childhood-vaccines-declines-across-europe-and-central-asia-new-unicef
NEW YORK, 20 April 2023 – The public perception of the importance of childhood vaccines has declined across Europe and Central Asia since the onset of the COVID-19 pandemic, according to a new analysis of data from 55 countries worldwide – 29 of which are in Europe and Central Asia. The analysis is featured in a new report published today by UNICEF. The State of the World’s Children 2023: For Every Child, Vaccination is the most comprehensive assessment of routine immunization ever produced by UNICEF. It notes that in the 29 countries in Europe and Central Asia featured in the analysis, the perception of the importance of vaccines for children has declined by more than 10 percentage points. In the majority of countries analysed, people under 35-years-old and women were most likely to have reported less confidence in childhood vaccines. “The decline in confidence in childhood vaccines is deeply concerning. Immunization is one of humanity’s most remarkable success stories. Too many lives are at stake to let it fall prey to a wave of fear and misinformation fuelled by the pandemic.” “The decline in confidence in childhood vaccines is deeply concerning. Immunization is one of humanity’s most remarkable success stories. Too many lives are at stake to let it fall prey to a wave of fear and misinformation fuelled by the pandemic,” said Philippe Cori, UNICEF Deputy Regional Director for Europe and Central Asia. The decline in confidence comes amid the largest sustained backslide in childhood immunisation in 30 years . The pandemic interrupted childhood vaccination almost everywhere, largely due to intense demands on health systems, the diversion of immunization resources to COVID-19 vaccination, health worker shortages and stay-at-home measures. As a result, 67 million children globally missed out on routine vaccinations between 2019 and 2021, with vaccination coverage levels decreasing in 112 countries. Nearly one million of children who missed one or several routine vaccinations live in Europe and Central Asia. Among whom, 327,400 are “zero-dose” – children who have not received any vaccinations, and “under-vaccinated” children – those who have not received the third required dose of the diphtheria-pertussis-tetanus (DPT3) vaccine – critical markers in immunization coverage. Bosnia and Herzegovina, Kyrgyzstan, Moldova, North Macedonia and Ukraine have among the highest rates of zero-dose children in the region. Bosnia and Herzegovina, Georgia, Montenegro, Romania and Ukraine have among the highest rates of under-vaccinated children. The pandemic also exacerbated existing inequities. Vast gaps in immunization coverage exist among Roma children, one of Europe’s largest and most marginalised minority groups. UNICEF is calling on governments to double-down on their commitment to increase financing for immunization and to work with stakeholders to unlock available resources, including leftover COVID-19 funds, to urgently implement and accelerate catch-up vaccination efforts to protect children and prevent disease outbreaks. The report features a set of recommendations for governments including: Urgently identify and reach all children, especially those who missed vaccinations during the COVID-19 pandemic Strengthen confidence in and demand for vaccines, including by working closely with communities to address their vaccination needs and concerns Prioritise funding to immunization services and primary health care Build resilient health systems through investment in female health workers, innovation and local manufacturing “Immunization is central in protecting children’s health and well-being. To minimize outbreaks of vaccine-preventable disease, and unnecessary suffering, we urge governments and donors to redirect leftover COVID-19 funds to strengthen immunization services and ensure that routine immunization reach all children, wherever they are,” said Cori. A small child gets vaccinated. UNICEF/U.S. CDC/UN0749657/Christina Pashkina
Flagship report
20 Апрель 2023
The State of the World’s Children 2023: For every child, vaccination
https://www.unicef.org/eca/reports/sowc2023-eca
For every child, vaccination, Immunization is one of humanity’s most remarkable success stories. It has saved countless lives. Many more lives will be saved if the goals of the Immunization Agenda 2030 are achieved. This global strategy aims for a world where “everyone, everywhere, at every age, fully benefits from vaccines for good health and…, For Every Child, Vaccination R E G I O N A L B R I E F : E U R O P E A N D C E N T R A L A S I AT H E S TAT E O F T H E W O R L D S C H I L D R E N 2 0 2 3 1 THE STATE OF THE WORLDS CHILDREN 2023: FOR EVERY CHILD, VACCINATION For every child, vaccination Immunization is one of humanitys most remarkable success stories. It has…
Document
06 Июль 2023
500 days of war for Ukraine’s children
https://www.unicef.org/eca/documents/500-days-war-ukraines-children
Ukraine’s children and their families have endured 500 days of forced displacement, unthinkable loss, and relentless violence since the escalation of war in February 2022. At least 535 children have been killed – the equivalent of a child dying every day since the war escalated, mostly from bombardment. At least 1,095 children have been injured.…, UNICEF's response, UNICEF continues to respond to children’s urgent humanitarian needs and ensure children have access to health care, immunization, nutrition, education, water and sanitation, and mental health and psychosocial support. In refugee hosting countries, UNICEF continues to work with governments, municipalities, and local partners to…, Ukraines children and their families have endured 500 days of forced displacement, unthinkable loss, and relentless violence since the escalation of war in February 2022. At least 535 children have been killed the equivalent of a child dying every day since the war escalated, mostly from bombardment. At least 1,095 children have been injured.1…
Blog post
19 Май 2021
Frontline social workers provide vital support to improve health
https://www.unicef.org/eca/stories/frontline-social-workers-provide-vital-support-improve-health
Yura has been a social worker for many years. “When I started working in social services, I was mainly interested in family therapy,” she says . “In time, I found out that supporting communities to become resilient and self-reliant is an extremely rewarding experience.” A year ago, she joined the Council of Refugee Women in Bulgaria (CRWB) – a civil society organization created in 2003 to support the integration of refugees and migrants. “Guiding through people from refugee and migrant backgrounds on health-related procedures in their host country is a way to empower them to find solutions to health issues,” explains Yura. And this is particularly vital for those fleeing from armed conflicts and humanitarian crises. As they search for safety and better life opportunities, both adults and children go through many traumatic experiences as a result of often prolonged stays in refugee camps, limited access to health care, and the dangers they face as they travel through volatile areas. By the time they finally reach a safe destination, they are often in very bad physical and psychological shape. “In Bulgaria, refugee children arrive with their parents or – in some cases – unaccompanied. Psychological problems, infectious diseases, medically unobserved pregnancies and, in particular, a lack of immunization, are common problems that have a negative impact on their health and wellbeing.” Radostina Belcheva, Project Coordinator and Deputy-Chair of CRWB The CRWB partners with UNICEF Bulgaria to provide general health checks and referrals, as well as life-saving vaccines in line with children’s immunization schedules, and equips parents with information on health risks, entitlements and how to access medical services. “As part of the ‘Strengthening Refugee and Migrant Children’s Health Status in Southern and South-Eastern Europe’ (RM Child-Health) project co-funded by the European Union’s Health Programme, we work with our partners to ensure that children can follow immunization plans and that their vaccination status is updated in their immunization documents. These are crucial steps in ensuring good health . ” Diana Yovcheva, Programme Officer with UNICEF Bulgaria Working directly with refugees, Yura consults families that want to access health services. “Some cases are easier than others”, she says, recalling a consultation with Ahmed*, a 45-year-old father of six children, who fled Syria in 2020 and received humanitarian status in Bulgaria. A chef by profession, Ahmed settled quite well in the host country, found a job in a restaurant and, after some time, managed to reunite with his wife, his four sons and two daughters. “Ahmed was referred to the CRWB by friends and he came in for a consultation on the immunization process with his youngest baby girl, Yasmina, only one year old” explains Yura. During their meeting, the social worker provided information about the health system in Bulgaria, the role of a general practitioner, and how people with refugee status can access medical services including vaccinations for their children. Although Ahmed’s baby girl had been vaccinated before her arrival in Bulgaria and had an immunization passport, the father urgently needed to update her vaccination status to synchronize her vaccinations with the recommendations of the national immunization calendar. “I contacted the Regional Health Inspectorate and helped Ahmed to provide the necessary documents and find a translator, as the documents were in Turkish”, says Yura. Subsequently, she helped Ahmed schedule an appointment with a medical doctor and Yasmina received her next vaccine. Parents often lack the necessary vaccination documents. According to Yura, “Sometimes children have not had any vaccinations, or they have been vaccinated in their country of origin, but their immunization cards have been lost or destroyed.”    Such cases require additional consultations, research and coordination, as well as testing for antibodies and immune responses when it is not clear whether the child has been vaccinated. “By empowering parents to familiarize themselves with the immunization plans and procedures we help them become proactive in following up on their children’s health." Yura, Social worker To address the COVID-19 restrictions and keep active communication with refugees and migrants, the CRWB and UNICEF developed leaflets in Bulgarian, Arabic and Farsi with details about the health system in Bulgaria and the importance of vaccinations, and regularly provide health-related information via social media. “The role of communication in immunization is essential.  Our frontline staff interact on a daily basis with beneficiaries, but we have also used other means [such as a Facebook group dedicated to health-related topics] to keep the information flow going, particularly during the COVID-19 pandemic . ” Radostina Belcheva, Project Coordinator and Deputy-Chair of CRWB Logo - Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe 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). The content of this story 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 European Health and Digital 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 .
Article
30 Ноябрь 2018
HIV-positive… and fearless
https://www.unicef.org/eca/stories/hiv-positive%E2%80%A6-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.
Page
02 Июль 2020
‘RM Child-Health’: safeguarding the health of refugee and migrant children in Europe
https://www.unicef.org/eca/rm-child-health-safeguarding-health-refugee-and-migrant-children-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
Article
13 Май 2021
Safeguarding the health of refugee and migrant children during COVID-19
https://www.unicef.org/eca/stories/safeguarding-health-refugee-and-migrant-children-during-covid-19
"When COVID arrived here, I thought: ‘It's over, it will spread throughout the building’. I didn't think it was possible to avoid the spread of the outbreak. Instead, we have had very few cases and we owe this, above all, to the support we received from INTERSOS and UNICEF."  Josehaly (Josy), a refugee living in Rome A field worker from Intersos fastens a mask for a young refugee girl in Rome. A field worker from Intersos fastens a mask for a young refugee girl in Rome. The ‘RM Child-Health’ initiative is funding work across five European countries to keep refugee and migrant children connected to health services. While the COVID-19 pandemic was not foreseen when the initiative was first launched, the strategic principles underpinning the ‘RM Child-Health’ initiative – flexibility, responsiveness to real needs, and building on what works – meant that UNICEF and partners could swing into action to safeguard the health and wellbeing of refugee and migrant children and overcome intensified and unprecedented challenges. Since the launch of the 27-month ‘RM Child-Health’ initiative in January 2020, activities were adapted quickly to address access to health services during the COVID-19 crisis in Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia. This €4.3 million initiative, co-funded by the European Union Directorate-General for Health and Food Safety, has shown refugee and migrant children and families how to protect themselves and others, and that they have every right to health care – even in a pandemic. The rapid escalation of the COVID-19 pandemic in Europe in 2020 exacerbated the already worrying state of health and wellbeing of the region’s most vulnerable people, including refugee and migrant children, and has had a protracted impact on their access to health and other vital services. The situation has been particularly dire for refugees and migrants who are not in formal reception sites, and who are, therefore, harder to reach and monitor. Refugee and migrant families living in over-crowded conditions with limited access to sanitation are at high risk of infection. These communities have often had to face a ‘double lockdown’, confined to their settlements and camps and having little or no access to accurate information on protecting themselves and others.  The additional pressures have been severe. UNICEF and its partners in Bulgaria have seen appeals for support double from 30 to 60 cases per day. Far more refugees and asylum-seekers have been in urgent need of financial and material support, having lost their incomes because of the pandemic. There have been increased requests for support to meet the cost of medical care for children, which is not covered by the state budget, and more requests for psychosocial support. This increase in demand has, of course, coincided with serious challenges for service delivery. Restrictions on movement have curtailed in-person services, and partners have had to adapt the way in which they connect with refugees and migrants. The pandemic has had a direct impact on the provision of group sessions to share health-related information, as well as on the timely identification of children and women suffering from or at risk of health-related issues. The impact on vital services for timely and quality maternal and child health care, psychosocial support, recreational and non-formal services, and on services to prevent and respond to gender-based violence (GBV) has been profound. In Bulgaria, UNICEF and its partners were able to take immediate measures with support from the ‘RM Child-Health’ initiative to alleviate the impact, including online awareness raising and information sessions and the use of different channels for communication, including social media. UNICEF’s partners, the Council of Refugee Women in Bulgaria (CRWB) and the Mission Wings Foundation (MWF) adapted service delivery to allow both face-to-face interaction (while maintaining social distancing for safety) as well as assistance online and by telephone. Partners were able to continue to provide direct social services support while also delivering online consultations to refugees and migrants on cases of violence, as well as referral to specialized services. In Greece, the initiative supported the development of child-friendly information posters and stickers for refugee and migrant children and their families on critical preventive measures and on what to do and where to go if they experience any COVID-19 symptoms. In Italy, the initiative has supported outreach teams and community mobilization, providing refugee and migrant families with the information and resources they need to keep the pandemic at bay. In Rome, for example, health promoters from Intersos continued to work directly with refugee and migrant communities in informal settlements, not only to prevent infection but also to keep their spirits high, as one health promoter explained: "We have organized housing modules that are not only designed to keep the community safe, but also to stop loneliness overwhelming the people forced into isolation. The entire community has assisted people affected by the virus by cooking, washing clothes and offering all possible support, particularly to the children."  UNICEF and its partners in Italy, as in other countries, have aimed to maintain continuity and unimpeded access to key services. Child protection, for example, has been mainstreamed into all project activities, and additional measures have been introduced, with a ramping up of activities to raise awareness and share information. UNICEF partners adapted quickly to the pandemic, with Médecins du Monde (MdM) activating a hotline number to provide remote counselling and psychological first aid (PFA). Centro Penc shifted to remote case management and individual psychological support, strengthening the capacity of cultural mediators to support GBV survivors, with UNICEF’s support. Young people were consulted and engaged through UNICEF’s online platform U-Report on the Move, with young U-reporters sharing information on the increased risks of GBV, as well as on available services. In Serbia, the initiative has supported UNICEF’s efforts to improve the immunization process for refugee children and migrants by strengthening the assessment and monitoring process. As a result of such efforts, refugees and migrants have been included in the national COVID-19 Immunization Plan.  
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