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.”
Students in Armenia explore a healthy lifestyle with Healthy Buddy
It’s 11 o'clock on a hot summer Sunday morning, but Achajur village school in Tavush marz is full of students. Over 120 children have come to school to take part in UNICEF’s “Healthy Buddy” session , organized in partnership with the Ministry of Health and Family Academy NGO. Healthy Buddy is a special session about health nutrition and lifestyle designed for each age group that helps children of different ages to understand the importance of proper nutrition for their life and development and to become Healthy Buddy advocates themselves. Vahe, 7, is a new Healthy Buddy advocate, who walked for exactly 40 minutes from home to school today to take part in the session. “I have heard of words like ‘carbohydrates’ or ‘protein’ a lot, but I didn’t know that our immune cells are made up of protein, and carbohydrates are like fuel for people․ They give us energy to move and do other things. I also did not know that sugar is a carbohydrate, but it is a bad fuel.” Boy is listening to the Healthy Buddy session. UNICEF Armenia/2021/Margaryan Vahe prides himself of the little garden that he has at home, full of fruit trees - a big mulberry tree, a pomegranate tree, apple trees. He promised to take care of them and make sure to get his daily intake of fruit during the day. This extraordinarily smart, extremely active and quite mature 7-year-old is very caring for his family members, admires his brother, and dreams of creating a safe and positive environment in his community. “I want to become a lawyer and defend my community from criminals, so that we can all live in a better world.” Vahe glues the HEalthy plate magnet to their refrigerator. Vahe already knows that his health and success in the future depend on him eating healthy every day. Meanwhile, thousands of children in Armenia go through what experts call the triple burden of malnutrition. First, insufficient food intake threatens the survival, growth and development of children. Then there is micronutrient deficiency - a hidden form of malnutrition - in which case children do not get enough vitamins and micronutrients, necessary for a normal immune response, bone growth and brain development. On the other hand, there is also the issue of overweight or obesity due to excess calories and sedentary lifestyle. UNICEF, the Ministry of Health and other partners work to prevent this. “We want to create an environment where all children and young people enjoy their right to a healthy diet. Where children and their parents know exactly what is needed for healthy development and know that it is linked to children’s academic wellbeing at school and in the future. You need to eat healthy not only to have a healthy body, but also to have a healthy mind,” explains Liana Hovakimyan, UNICEF Health Specialist and shares facts. Liana Hovakimyan, Health Specialist at UNICEF Armenia UNICEF Armenia/2021/Galstyan “In the first two years of life, 75% of each spoon is spent on building the child’s brain. As the child grows, his or her nutritional needs also grow. We all must act urgently to have a healthier generation and society.” At the Achajur school session, we met with three girlfriends - all three honors students, full of dreams, and super excited for the session to start. Three girlfriends - all three honors students, full of dreams, and super excited for the session to start. The girls were most surprised when nutritionist Lidia Ayvazyan listed the ingredients of carbonated drinks, chips, cookies and ice cream, while presenting the repercussions of consuming junk food. “Actually, I used to eat both healthy and junk food, but now I’ve made up my mind. I will definitely eat healthier and do my best to put together a ‘healthy plate’ with the help of veggies and fruits. I will put this ‘healthy plate’ sticker on our fridge, and it will always remind me of the secret to proper nutrition,” shared Anahit, 10, after the session. Nutritionist asks questions to the girl who participates in sessions, UNICEF Armenia/2021/Margaryan Anahit’s friend Narine added that they have already learned about proteins, carbohydrates and fats during their “Me and the environment” course at school. “But I didn’t know that healthy eating is also linked to learning well at school. I love school very much, so I have to eat well in order to study well.” Boy and a girl ate laying chess. Narine, who loves chess and dancing, dreams of becoming a writer. She has already authored her first four fairy tales, one of which is entitled The Chess Queen, where a little boy plays chess with the Queen and mates her in one move. And just like the little boy in Narine’s fairy tale, ever child has the potential to “check” and “mate” to reach their full potential. But first, they must be equipped with the necessary knowledge and opportunities to achieve their dreams. After Achajur, Healthy Buddy team is on the road again, set to reach to over 4200 girls and boys in Shirak, Kotayk, Aragatsotn, Lori, Tavush and Yerevan.
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.
Strengthening national health capacity for refugee and migrant children
At first glance, helping a 10-year girl from Iran, now living in Bosnia and Herzegovina, get a new pair of glasses might seem a simple thing. For Maisa, however, this is the end result of a continuum of intensive support, from identifying a girl who struggles with an eye condition, to connecting her to a skilled ophthalmologist. And now Maisa stands in front of a mirror, trying on the glasses that will enhance her life, learning and play. Such a momentous day is only possible when an established health system is equipped to accommodate and respond to the complex needs of refugee and migrant children. Support from the ‘RM Child-Health’ initiative aims to reinforce and enhance health systems across five European countries (Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia) so that these systems can deliver the high-quality services that are the right of every child – and that every child needs, regardless of their origins. The aim: to ensure that health systems catch every refugee and migrant child who is in danger of slipping through the gaps. And there are additional benefits: a health system that works for these vulnerable and excluded children is a health system that works for every child, and that can reach those who are so often the very hardest to reach. This 24-month, €4.3 million initiative, which was launched in January 2020 by the European Union Directorate-General for Health and Food Safety, aims to strengthen the capacity of health systems to deliver health care to refugee and migrant children. That means ensuring access to life-saving immunization, to mental health and psycho-social support, and services to prevent and respond to gender-based violence, as well as maternal and new-born health care and nutrition. Stronger health systems are needed to overcome the bottlenecks that confront so many refugee and migrant families when they try to access health care. “ The profound challenges that often confront populations – especially children – on the move can include cultural and language barriers, stigma and discrimination on the part of health providers, and a lack of detailed medical records or paperwork,” says Dr. Basil Rodriques, UNICEF Regional Health Advisor. “They may also have their own reasons to distrust state-provided services, including fears of deportation.”
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State Secretary, Ministry of Labour, the Pension System, the Family and Social Policy European Union Margareta Mađerić was born on 2 July 1977 in Zagreb. After finishing high school, she enrolled in Zagreb School of Business where she obtained her bachelor’s degree in Marketing and Communication and worked as a marketing and communications manager before entering into politics. In 2005, as a member of Croatian Democratic Union (HDZ), Mađerić was elected to the Zagreb City Assembly, where she served three consecutive terms and served as president of the Deputy Club of the Croatian Democratic Union. In the 2013 local elections in Zagreb, she ran as the HDZ candidate for mayor, and in the 2015 Croatian parliamentary elections, Mađerić ran as a candidate for the Patriotic Coalition, led by the HDZ. She was a member of the Croatian Parliament and was named president of the Parliamentary committee for mandates and immunity, before she assumed the position of State Secretary in the Ministry for Demography, Family, Youth and Social policy. Following the 2020 parliamentary elections she continued to serve as State Secretary in the new Ministry of Labour, Pension system, Family and Social Policy. SAILA RUUTH Personal archive