UNICEF reaches almost half of the world’s children with life-saving vaccines
– UNICEF procured 2.5 billion doses of vaccines to children in nearly 100 countries in 2016, reaching almost half of the world’s children under the age of five. The figures, released during World Immunization Week, make UNICEF the largest buyer of vaccines for children in the world. Nigeria, Pakistan and Afghanistan, the three remaining polio-endemic countries, each received more doses of vaccines than any other country, with almost 450 million doses of vaccines procured to children in Nigeria, 395 million in Pakistan and over 150 million in Afghanistan. UNICEF is the lead procurement agency for the Global Polio Eradication Initiative. Access to immunization has led to a dramatic decrease in deaths of children under five from vaccine-preventable diseases, and has brought the world closer to eradicating polio. Between 2000 and 2015, under five deaths due to measles declined by 85 per cent and those due to neonatal tetanus by 83 per cent. A proportion of the 47 per cent reduction in pneumonia deaths and 57 per cent reduction in diarrhea deaths in this time is also attributed to vaccines. Yet an estimated 19.4 million children around the world still miss out on full vaccinations every year. Around two thirds of all unvaccinated children live in conflict-affected countries. Weak health systems, poverty and social inequities also mean that 1 in 5 children under five is still not reached with life-saving vaccines. “All children, no matter where they live or what their circumstances are, have the right to survive and thrive, safe from deadly diseases,” said Dr. Robin Nandy, Chief of Immunization at UNICEF. “Since 1990, immunization has been a major reason for the substantial drop in child mortality, but despite this progress, 1.5 million children still die from vaccine preventable diseases every year.” Inequalities persist between rich and poor children. In countries where 80 per cent of the world’s under-five child deaths occur, over half of the poorest children are not fully vaccinated. Globally, the poorest children are nearly twice as likely to die before the age of five as the richest. “In addition to children living in rural communities where access to services is limited, more and more children living in overcrowded cities and slum dwellings are also missing out on vital vaccinations,” said Nandy. “Overcrowding, poverty, poor hygiene and sanitation as well as inadequate nutrition and health care increase the risk of diseases such as pneumonia, diarrhea and measles in these communities; diseases that are easily preventable with vaccines.” By 2030, an estimated 1 in 4 people will live in urban poor communities, mainly in Africa and Asia, meaning the focus and investment of immunization services must be tailored to the specific needs of these communities and children, UNICEF said.
Record number of infants vaccinated in 2017
: A record 123 million infants were immunized globally in 2017, according to data released today by the World Health Organization and UNICEF. The data shows that: 9 out of every 10 infants received at least one dose of diphtheria-tetanus-pertussis (DTP) vaccine in 2017, gaining protection against these deadly diseases. An additional 4.6 million infants were vaccinated globally with three doses of the diphtheria-tetanus-pertussis vaccine in 2017 compared to 2010, due to global population growth. 167 countries included a second dose of measles vaccine as part of their routine vaccination schedule and 162 countries now use rubella vaccines. As a result, global coverage against rubella increased from 35 per cent in 2010 to 52 per cent. The human papillomavirus (HPV) vaccine was introduced in 80 countries to help protect women against cervical cancer. Newly available vaccines are being added as part of the life-saving vaccination package – such as those to protect against meningitis, malaria and even Ebola. Despite these successes, almost 20 million children did not receive the benefits of full immunization in 2017. Of these, almost 8 million (40 per cent) live in fragile or humanitarian settings, including countries affected by conflict. In addition, a growing share are from middle-income countries, where inequity and marginalization, particularly among the urban poor, prevent many from getting immunized. As populations grow, more countries need to increase their investments in immunization programmes. To reach all children with much-needed vaccines, the world will need to vaccinate an estimated 20 million additional children every year with three doses of the diphtheria-tetanus-pertussis vaccine (DTP3); 45 million with a second dose of measles vaccine; and 76 million children with 3 doses of pneumococcal conjugate vaccine. In support of these efforts, WHO and UNICEF are working to expand access to immunization by: Strengthening the quality, availability and use of vaccine coverage data. Better targeting resources. Planning actions at sub-national levels and Ensuring that vulnerable people can access vaccination services.
Tracking anti-vaccination sentiment in Eastern European social media networks
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…
Europe and Central Asia has surpassed global progress on child mortality, more than halving the deaths of children under five and infants since 1990. And as progress for the poorest households has accelerated, the health gap between the richest and poorest has narrowed. However, persistent inequities reflect a continued failure to invest effectively in child-centred health systems for all. In South-East Europe, for example, child mortality among the Roma population is two to three times higher than national averages. Problems missed at an early age can be more difficult and expensive to address later in life. Such inequities are compounded by a failure to spot problems during pregnancy and during the first 1,000 days of life, when children’s bodies and brains build the foundations for their life-long development. Problems missed at an early age can be far more difficult and expensive to address later in life. Across the region, more than half of the children who die before their fifth birthday die in their first month of life.These deaths are often the result of conditions that are readily preventable or treatable at low cost through, for example, access to good obstetric, ante-natal and post-natal care, routine immunization and exclusive breastfeeding . The main killers of children under the age of five in the region are also preventable: pneumonia and injuries. Emergencies have an intense impact on child health and nutrition. The impact of emergencies on children's health and nutrition can be extreme. Children on the move, such as those caught in Europe’s refugee and migrant crisis , for example, often lack adequate clothing, food, shelter or warmth. Access to health services, including immunization, has often been inadequate on their journey. The region’s existing HIV prevalence, coupled with lack of safe water and sanitation, as well as ongoing challenges related to early child development and protection all heighten the vulnerability of children during emergencies. The region is also experiencing vaccine ‘hesitancy’ – the reluctance of some parents to immunize their children, or parental delays in immunization . This hesitancy, often fuelled by misinformation, puts children at risk of contracting, and even dying from, infectious diseases, including polio and measles.
Empowering refugee and migrant children to claim their right to health: Improving health literacy
“I have always had to behave ‘like a girl’ and I am not used to being asked for my opinion, but you ask me to say what I think during these workshops.” A 13-year-old girl from Syria describes the impact of empowerment workshops in Serbia Boy is drawing a picture. UNICEF-supported activities for children on the island of Lesvos, Greece The ‘RM Child-Health’ initiative has supported work across five European countries to improve health literacy among refugee and migrant children over the past year. As a result, they and their families have learned about key health issues, about the health services available to them, and how to demand health services as their right. Through its support for health literacy – the ability to find, understand and use information to take care of your own health – the initiative has helped to dismantle some key barriers to health services for refugee and migrant children and their families in Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia. This 27-month, €4.3 million co-funded initiative, which was launched in January 2020 by the European Union Directorate-General for Health and Food Safety, works alongside young refugees and migrants to ensure that they have accurate health information in their own languages – information that reaches them via the channels they use and the people they trust. Importantly, the initiative makes them more aware of their right to health care in these European countries – welcome news for those who have fled from countries where good quality health care is either unaffordable or unavailable. With support from the initiative, UNICEF and its partners first worked with young refugees and migrants to identify gaps in the information available to them and in their own knowledge. This informed the health literacy packages that have been rolled out in all five countries over the past year, spanning a wide range of topics from immunization and nutrition to sexual and reproductive health (SRH) and gender-based violence (GBV). The packages themselves have been backed by detailed plans to ensure that their messages reach their audiences and gain real traction. Great care has been taken to ensure that information materials are culturally appropriate, gender sensitive and child-friendly, and that they are suitable for the ages and backgrounds of their audiences. Cultural mediators and interpreters have helped to overcome language and cultural barriers, while materials have been made available in, for example, Arabic, Farsi and Pashto. Activities have often been led by trusted professionals, such as nurses, physicians and psychologists who are already familiar with the needs of refugee and migrant children and their families. Materials have been shared through channels and locations that are well-used by refugees and migrants, including asylum offices, temporary reception centres, health centres, Mother and Baby Corners (MBCs), workshops and discussion sessions, during outreach activities and via social media. As a result, health literacy is now embedded into existing activities with refugee and migrant children and parents across all five countries, and is based firmly on their views and needs.
Improving health literacy among refugee and migrant children
UNICEF has worked with partners and with young refugees and migrants on the ground to identify information gaps – work that has, in turn, guided the development of health literacy packages across all five countries on a range of crucial health issues, from immunization and nutrition to sexual and reproductive health (SRH) and gender-based violence (GBV). The assessment has shaped the development of detailed plans on how to ensure that health messages reach their audience and have an impact. The health literacy packages have also drawn on existing materials, including Facts for Life , My Safety and Resilience Girls Pocket Guide and an adapted version of the UNFPA curriculum: ‘Boys on the Move’. Refugees and migrants face a chronic lack of health information in their own languages, and a lack of information that reaches them through the channels or people they trust health navigation Some common priorities have been identified by refugees and migrants across all five countries, including access to immunization and other primary health care services, breastfeeding and young child feeding, and the prevention of GBV. They have also flagged up the pressing need for more mental health and psychological services. Other issues have emerged as priorities in specific countries, including cyberbullying and online safety in Italy, and substance abuse among young people In Serbia – the focus of a new in-depth UNICEF study. Not surprisingly, the COVID-19 pandemic is a new and urgent priority for refugee and migrant communities – and one that has heightened the health risks they already face by curtailing their movements and their access to health services. A consultation with refugee and migrant adolescents and young people living in Italy has revealed major gaps in their knowledge about sexual and reproductive health, drawing on an online survey, a U-Report poll and a series of focus group discussions. It has highlighted some common misunderstandings, such as the myth that masturbation causes infertility, and continued perceptions around the importance of a woman’s virginity at marriage, as well as knowledge gaps around menstruation, pregnancy and sexually transmitted infections. The consultation also found, however, that the young participants want to know far more about this crucial area of health. As one young man from Guinea noted during a focus group discussion: “often young people do not want to know if they have an infection, also because they are not aware that these can be treated. It is so critical to raise awareness on STIs tests and treatment options.”
Tackling sexual exploitation and abuse of children: Actions and commitments
– “Sexual exploitation and abuse of children under any circumstances is reprehensible. No organization is immune from this scourge and we are continuously working to better address it. When it comes to the protection of children, we are determined to act. There is no room for complacency. “As UNICEF’s Executive Director, I have put this issue at the top of our agenda and we are committed to strong action and transparency within UNICEF. “To make sure we are doing everything possible, we are commissioning an independent review of our procedures and I will make its recommendations public. “My team is also exploring ways to use technology to quickly assess the risks of sexual exploitation of abuse, and facilitate safe and confidential reporting by the victims. “Starting in locations where the risk of sexual exploitation and abuse is higher, we are implementing more stringent vetting of all personnel and improving safety and protection around children in our operations. “These new measures add to the strong and determined actions we have taken over the years to prevent the abuse of children and respond to the needs of those affected, building on the lessons we have learned and a regular assessment of our approaches: We have made the reporting of sexual exploitation and abuse mandatory, through a notification alert that reports information to me within 24 hours. We have scaled up our assistance to victims and are providing them with safe and confidential support; We are rolling-out community-based complaint mechanisms; We have strengthened our investigations unit; and We have made training on the prevention of sexual exploitation and abuse mandatory. “We have zero tolerance for sexual exploitation and abuse, and we remain committed to continually learning and improving. We want justice for the child victims and are determined to work with all partners to achieve it.” Statement by UNICEF Executive Director Henrietta H. Fore.
Precious support in the game of life
Thanks to funding from the European Union ‘RM Child-Health’ initiative, UNICEF works to ensure that all refugee and migrant children in Bosnia and Herzegovina have access to primary health care, including paediatric services and, in the case of 10-year old Maisa, a vital pair of glasses. “I will wear these glasses all the time. I hope I won't lose them during the next ‘game’", says 10-year-old Maisa.* In Maisa’s world, the word "game" does not mean playing with her friends. It is the slang she uses to describe the attempts she and her family – originally from Iran – have made to cross the border from Bosnia and Herzegovina into the European Union in search of a more a promising future. To date, all of their attempts have failed. But they will keep trying. Maisa is at the opticians in Cazin, trying to decide which eyeglasses suit her best, having been brought here previously by a team from UNICEF and the Danish Refugee Council (DRC), with funding from the EU’s ‘RM Child-Health’ initiative, to have her eyes tested by an ophthalmologist. Trying on glasses while wearing protective face masks to prevent the spread of COVID-19 is an additional challenge, making it difficult for her to judge how the glasses look. Her dad, Zerin*, helps her choose and she is delighted with the purple-framed glasses that will come ‘home’ with her to the Sedra reception centre in Bihać. A pair of glass might seem like a small thing, but for Maisa, this is a joyous moment that will enhance her view of the world around her. Human lives are at stake in the game played by Maisa and her family. She has endured so many challenges since she left her native Tehran a year ago. At the time, she still had multifocal glasses that were suitable for treating her strabismus. However, the unpredictable life on the migrant route meant that Maisa lost her glasses long before the family arrived in Bosnia and Herzegovina. Her new glasses will allow her to continue her treatment for strabismus and help repair her damaged vision. Maisa at the pediatric clinic Maisa at the pediatric clinic of the Sedra Reception Center, her medical examination before heading off to the optical shop to get new eyeglasses. Back at the Sedra reception centre, Maisa talks about her hopes. She can't explain exactly why she wants her wanderings on the European continent to end happily in England, but maybe the staff of the reception centre are partly responsible for that: "They teach me English and thanks to them, I speak better because I want to be able to express myself clearly” she says to her Farsi translator, who helps to enhance communication between children like Maisa and local health services. The family’s attempts to cross the border to find a better life somewhere in the north of Europe have taken their toll on Maisa’s education. Nevertheless, her English flows with such ease and eloquence that one almost forgets she is sitting in the reception centre’s modest and crumbling paediatric clinic. She could be doing her medical examination before enrolling in a prestigious international school. The healthcare professionals at the Sedra clinic cannot estimate exactly how many children it is serving at the moment, as children so often go to ‘games’ with their families. Some return, some don’t, and new children arrive, with different health issues, of different ages and from different backgrounds. The reception centre is occupied mostly by families with children, so there has been a clear need for paediatric services for a long time. Maisa entering the pediatric clinic Maisa entering the pediatric clinic of the Sedra Reception center, where along with her medical check-ups she is practicing her English skills and conversing with the medical workers. According to its team of paediatricians, children most often come to the clinic for general health examinations, or because of respiratory and gastrointestinal infections. Babies are also taken care of, in addition to examinations, therapies and dressing services. If the outpatient clinic can’t provide the care that is needed, children are referred to the Bihać Cantonal Hospital or the Cazin Health Center. And it is thanks to this referral system, supported by the ‘RM Child-Health’ initiative, that Maisa was referred to the ophthalmologist. In total, more than 750 children were helped by the paediatric clinic between January and September 2020. "Thanks to the support of the EU ‘RM Child-Health’ initiative, and the work of the DRC and our partners working within reception centres, the quality and number of services provided to children in need of health care have increased significantly since we founded the pediatric units in Sedra and Borići”, says Amila Madžak, Education officer at the UNICEF office in Bihać. “This has had a positive impact on individuals and families, and on migrant communities, as well as on wider public health. Help is also provided for unaccompanied children living in the reception centres in Bira and Miral. In addition to basic services, the paediatric care on offer also includes immunization services, systematic examinations, ophthalmological and dental services, consultations, training and coaching for children and adults. We also went through the first cycle of immunization with 500 children in the USC, and we are continuing with the next cycle in the Una Sana Canton, as well as in Sarajevo Canton." Fortunately, Maisa's problem was much easier to solve than many other health problems faced by the children of migrants, refugees and by unaccompanied minors. For many of them, this is the end of the road, with no prospect of going any further. And going further is what Maisa has been dreaming of since embarking on this unpredictable journey: the London rain, the British accent and the ability to use her eyes to their full potential. *Names changed to protect identities. 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). Logo The content of this article represents the views of the author(s) only and is his/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.
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
UNICEF seeks $3.3 billion in emergency assistance for 48 million children caught up in conflict and other crises
– 48 million children living through some of the world’s worst conflicts and other humanitarian emergencies will benefit from UNICEF’s 2017 appeal, which was launched today. From Syria to Yemen and Iraq, from South Sudan to Nigeria, children are under direct attack, their homes, schools and communities in ruins, their hopes and futures hanging in the balance. In total, almost one in four of the world’s children lives in a country affected by conflict or disaster. “In country after country, war, natural disaster and climate change are driving ever more children from their homes, exposing them to violence, disease and exploitation,” said UNICEF Director of Emergency Programmes, Manuel Fontaine. UNICEF’s Humanitarian Action for Children sets out the agency’s 2017 appeal totaling $3.3 billion, and its goals in providing children with access to safe water, nutrition, education, health and protection in 48 countries across the globe. An estimated 7.5 million children will face severe acute malnutrition across the majority of appeal countries, including almost half a million each in northeast Nigeria and Yemen. “Malnutrition is a silent threat to millions of children,” said Fontaine. “The damage it does can be irreversible, robbing children of their mental and physical potential. In its worst form, severe malnutrition can be deadly.” The largest single component of the appeal is for children and families caught up in the Syria conflict, soon to enter its seventh year. UNICEF is seeking a total of $1.4 billion to support Syrian children inside Syria and those living as refugees in neighbouring countries. In total, working alongside its partners, UNICEF’s other priorities in 2017 are: - Providing over 19 million people with access to safe water; - Reaching 9.2 million children with formal or non-formal basic education; - Immunizing 8.3 million children against measles; - Providing psychosocial support to over two million children; - Treating 3.1 million children with severe acute malnutrition. In the first ten months of 2016, as a result of UNICEF’s support: - 13.6 million people had access to safe water; - 9.4 million children were vaccinated against measles; - 6.4 million children accessed some form of education; - 2.2 million children were treated for severe acute malnutrition.
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.