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Article
10 July 2022
How Tajikistan responded rapidly to a polio outbreak
https://www.unicef.org/eca/stories/how-tajikistan-responded-rapidly-polio-outbreak
For the first time in decades, we’re witnessing a large sustained backslide in the number of children receiving routine immunizations. In many ways, that’s attributable to pandemic disruptions, but there are other factors at play, including conflict, displacement and increasing vaccine misinformation.  The consequences of this global backslide are potentially fatal. Millions of children right now are at real risk of reemerging devastating diseases, like measles and polio, that are entirely preventable. It’s UNICEF’s mission to make sure these children are reached.   How Tajikistan responded rapidly to a polio outbreak
Article
18 February 2022
Job aids on COVID-19 vaccines for healthcare workers
https://www.unicef.org/eca/job-aids-covid-19-vaccines-healthcare-workers
We have developed a set of job aids to help healthcare workers explain key facts about COVID-19 vaccines to their patients and have meaningful patient-centred conversations, boost vaccine confidence and support the patients in their decision-making process to get vaccinated against COVID-19. It primarily contains four sections: What does the…
Article
25 November 2022
Healing old wounds
https://www.unicef.org/eca/stories/healing-old-wounds
Yura, a social worker, had joined the CRWB a year earlier and was loving her work. “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,” she explained. And this was particularly vital for those fleeing from armed conflicts and humanitarian crises. Radostina Belcheva, Project Coordinator and Deputy-Chair of CRWB explained: “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 well-being.” Working directly with refugees, Yura would consult with families seeking to access health services, such as immunization. However, parents often lacked 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 required additional consultations, research and coordination, as well as testing for antibodies and immune responses when it was 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,” said Yura.  
Article
04 November 2022
Building demand for health services: the importance of health literacy
https://www.unicef.org/eca/stories/building-demand-health-services-importance-health-literacy
The success of the Initiative lies in its two-pronged approach. First, UNICEF and its partners in the five countries consulted young refugees, migrants and their caregivers on their priority health issues, as well as the gaps in health information and in their own knowledge. At every stage, their views, plus the views of UNICEF’s implementing partners on the ground, have informed health literacy packages that were rolled out in all five countries, spanning topics from the importance of immunization and the importance of breastfeeding to GBV, MHPSS and sexual and reproductive health and rights (SRHR). Second, the materials have been backed by communication plans to make sure their messages landed with their audience, and the materials produced have been culturally appropriate, gender sensitive and, where necessary, child-friendly. Cultural mediators and interpreters have helped to overcome language and cultural barriers, while materials have been made available in many languages, including Arabic, Farsi, Pashto, Tigrinya, Urdu and Wolof, as well as in large print and sign-language versions. Health literacy activities have been led by professionals who are already trusted by refugees and migrants. Materials have been shared through the channels and in the places they use most often, including asylum offices, temporary reception centres, health centres, Mother and Baby Corners, workshops and discussion sessions, during outreach activities and via social media.  
Article
29 November 2022
How a pair of spectacles changed one girl’s life
https://www.unicef.org/eca/stories/how-pair-spectacles-changed-one-girls-life
3484 refugee and migrant children accessed health checks and referrals to public healthcare services, including to immunization, with UNICEF support – almost 3 times the number targeted for the Initiative. 3338 refugee and migrant children accessed mother, and child healthcare, including infant and young child feeding counselling, with UNICEF support – more than twice as many as originally targeted. Implementing partners: Danish Refugee Council, Fenix, Medicins du Monde, Save the Children International, World Vision. An independent evaluation of the ‘RM Child-Health’ Initiative has taken stock of its impact in Bosnia and Herzegovina. [1] This impact was driven, in large part, by close collaboration between the Initiative and other UNICEF programme areas, particularly health, early childhood development and social inclusion, and by strong relationships with implementing partners: the Danish Refugee Council, Fenix, Medicins du Monde and World Vision. Refugees, migrants and service providers have valued the Initiative, with surveys carried out by UNICEF’s implementing partners finding that the activities responded to needs. The beneficiaries were highly satisfied with both the paediatric services provided and the awareness raising and training delivered. The Initiative was swift to adapt to new and emerging needs, including the COVID-19 pandemic, modifying its information and training materials and approaches to keep health services going. UNICEF and its partners obtained official approval for health workers to work in other cantons and organized transport to get them there, helping to provide cover for health workers who were infected with COVID-19. [2] Partners also held more frequent meetings with fewer participants to maintain social distancing. In response to requests from refugees and migrants, the Initiative added nutrition information as well as mental health and psychosocial support (MHPSS) services for children. Prior to the Initiative, MHPSS services had focused on adults only. Similarly, the Initiative led to the expansion of routine immunization to refugee and migrant children who had not previously been covered – with obvious benefits for the wider population as this critical immunization gap was closed. In addition, the work of the International Organization for Migration in Bosnia and Herzegovina now follows UNICEF’s protocol on the provision of baby formula milk. [3] Cantonal health institutes in Bosnia and Herzegovina are now better informed regarding the health conditions of refugees and migrants. UNICEF has also succeeded in integrating Roma and host communities in awareness-raising efforts on health delivered to refugee and migrant populations.   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 European Health and Digital Executive Agency (HaDEA) 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. *Names changed to protect identities. [1] IOD PARC , Evaluation of the UNICEF Project: Strengthening Refugee and Migrant Children’s Health Status in Southern and South-Eastern Europe. [2] UNICEF ECARO staff. [3] UNICEF CO staff.
Article
01 November 2022
Building ‘muscle memory’
https://www.unicef.org/eca/stories/building-muscle-memory
EU Health programme The ‘RM Child-Health’ initiative has supported work across five European countries to strengthen the capacity of national health systems to meet the health needs of refugee and migrant children. As the programme draws to a close, we review its impact on that capacity, recognizing that a health system that works for vulnerable children is a health system that works for every child.     Support from the ‘RM Child-Health’ initiative has reinforced and enhanced health systems across five European countries (Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia), helping them to deliver the high-quality services that every child needs, regardless of where they come from. This €4.3 million initiative, launched in 2020 by the European Union Directorate-General for Health and Food Safety, has aimed to strengthen the capacity of health systems to deliver health care to refugee and migrant children so that no child is overlooked or left behind. This has been crucial for overcoming the obstacles that have confronted so many refugee and migrant families when trying to access health care. As the initiative ends, an independent evaluation has found that it has succeeded in its goal of strengthening the capacity of national authorities. In particular, the Initiative has helped to enhance access to mental health and psycho-social support (MHPSS), life-saving immunization, services to prevent and respond to gender-based violence (GBV), and services for maternal and new-born health care and nutrition.  
Article
16 November 2022
Bebbo: A Reliable Parenting Guide
https://www.unicef.org/eca/stories/bebbo-reliable-parenting-guide
Belgrade, Serbia, October 2022 - Shortly after Stasa celebrated her first birthday, the most beautiful gift arrived. Her brother Luka. Stasa is now two years old and is eagerly waiting for Luka to start walking, so they can play together in the park. Stasa loves playing with a ball, and it’s clear that Luka loves it as well. Mom Dunja and dad Stefan are the happiest when they see them playing together. Dunja and Stefan enjoy being parents, but they are also aware of the challenges, especially due to the small age gap between their children. “Being a parent is the most beautiful thing, but sometimes it’s not easy,” says Dunja. Parenting is precious, but it can also be stressful. In our case Stasa was basically a baby when we found out we were also expecting Luka, explains Stefan bebbo his photo #12 UNICEF Serbia/2022/Pancic The Bebbo app has a section titled “The Parenting Corner” where Dunja and Stefan read that it was perfectly fine for them to feel that way. It was a great relief to know that they were not alone and that other parents felt the same. The most important advice they read – is that it is important for parents to take care of themselves. “I’ve had times when I was also in a bad mood, exhausted and tired, so this is where I found explanations and recommendations about what to do. Those answers reassured me,” explains Dunja. “Children always come first, but people change through their parenting journey. It’s easier to overcome stressful situations if you have access to good advice. And the articles in the Bebbo app create a kind of interactive relationship and that’s valuable,” Stefan is convinced. The Bebbo app is a parenting guide, available at a parent’s fingertips. It interactively and safely guides moms and dads on their parenting journey – from birth up to the age of 6. Parents can get reliable advice at the right time. They can also count on receiving information and recommendations at any time about what is best for their child’s health and development, for play and learning, and for the emotional wellbeing of the family. “In this day and age, when we all have mobile phones, this app is really useful. In the past, we always used to call the HaloBeba hotline, which is very useful. But now, we can find the answers to many dilemmas at any time on our mobile phones,” Dunja believes. bebbo his photo #2 We’re very pleased with the app! When we’re worried about our children, we can really get all the answers. The app is divided into sections, and Stefan usually finds answers to his most frequent questions in the “Questions and Answers” section. “My impression is that Bebbo is well designed because there are answers to everything a parent can think of. The app takes you through a kind of filter. And you feel like you’re face to face with the person giving you advice.” Dunja found the sections on the growth and development of children were the most useful. “The application is personalized. I entered data for both children, so I can monitor whether they’ve reached the level of development expected for their age. There are also interesting and educational articles. And interesting videos showing age-appropriate games, so that we can play with them and positively influence their growth and development.” The Bebbo app really helped them keep up with the immunization calendars for Stasa and Luka. “We really have a lot on our plate, the children are young, and so they have to be revaccinated with some vaccine every month. Within the Bebbo app, there is a section, a tool called Vaccination, where we can enter the time for the next vaccine and get reminders. That’s how we schedule paediatric check-ups. It helped us a lot, to know when it’s time for which vaccine,” explains Dunja. The app also helped Dunja and Stefan resolved their dilemma about the right time to enrol Stasa into preschool. “That’s where I got the information about the right time to start preschool. [I read] detailed explanations of what they do in preschool, how children learn through play. That’s how we decided that she should start preschool,” says Dunja. bebbo his photo #3 The application prototype was developed in Serbia in close cooperation between UNICEF, the Belgrade City Institute for Public Health, and the Nordeus Foundation. Then, the UNICEF Office for Europe and Central Asia Regional worked on improving the application. This new and improved version has been introduced in 10 more countries and territories in as many as 19 language variants since the beginning of 2022. The content of the application is being continuously improved and promoted with the support of the LEGO Foundation.
Article
21 November 2022
Snapshots from the ‘RM Child-Health’ initiative in Greece
https://www.unicef.org/eca/stories/snapshots-rm-child-health-initiative-greece
Over 3000 children and 2300 mothers benefited from access to services, including psychosocial support, GBV prevention and support and mother and childcare services – almost three times as many as originally targeted for the Initiative. 3600 refugee and migrant children and parents received UNICEF-supported information on GBV prevention and response, immunization, maternal and child health, and mental health and psychosocial support services – more than twice as many as originally targeted. Implementing partners: Caritas, Diotima, ELIX, Iliaktida, The Melissa Network, Metadrasi, Solidarity Now   An independent evaluation of the ‘RM Child-Health’ Initiative has taken stock of its impact in Greece since 2020. [2] It has confirmed that the Initiative’s flexibility and its focus on system strengthening has supported the expansion of capacity in situations where these systems have been over-stretched. This could be seen on the island of Lesvos, Greece, where human resources in state-run facilities have faced serious constraints in meeting the demand for health care, particularly during the COVID-19 pandemic, and where partnership with Reception and Identification Centres has proved crucial. All training delivered under the ‘RM Child-Health Initiative’ was delivered in a way that was relevant for participants and responsive to their needs. The starting point was their existing knowledge and experience, aiming to build their sense of ownership and engagement. They were also consulted to assess what kind of support to prioritize. This process revealed challenging areas that were added to the training: working with vulnerable children; professional stress and burnout; and the importance of cross-sectoral cooperation. The training was also flexible, incorporating a module on how to deliver training online during the COVID-19 pandemic. In response to the pandemic, implementing partners used a hybrid approach to reach refugees and migrants during lockdowns. They piloted community-based activities at four sites, and all service provision shifted to remote programming via telephone and internet. In camps, UNICEF’s partners complemented remote delivery with tent-to-tent visits. [3]   Partners created WhatsApp social groups for different age groups and shared ideas for coping with lockdowns. [4] Simple and engaging visuals on COVID-19 prevention and on how to maintain good nutrition during the pandemic were developed and shared. Child-friendly information posters and stickers on COVID-19 prevention are now on display wherever refugees and migrants congregate. Stakeholders have also reported greater awareness of child nutrition and the importance of breastfeeding. In Lesvos, the needs assessment for the training found that kits for mothers contained breastmilk substitutes. A set of training materials on the benefits of breastfeeding was produced, including a ‘truth or myth’ game for use with pregnant or lactating women. The training created a new network of people who have kept in touch, with some asking for more information. Implementing partners have noticed that training participants have started to collaborate in the camps, with midwives and volunteers, for example, working together. In one camp, there have been no requests for breastmilk substitutes since the training. [5] The Initiative has supported extensive work on gender-based violence, including the mapping of GBV service providers and referral mechanisms to state-run shelters and counselling centres. The work of UNICEF’s implementing partner, Melissa, has been notable: delivering mental health and psychosocial services (MHPSS) through group therapy. This approach, which built trust, proved vital during the COVID-19 pandemic because it could be transferred smoothly to online delivery to maintain women’s engagement. A separate grant provided women with tablets, which they often called ‘Melissa’s eye in their house’, saying that it made them feel safer. Melissa also developed a code women could use to ask for help. Women felt secure enough to share their experiences, knowing that they would get the right support. This resulted in a high rate of self-disclosure. Women were referred quickly without having to complete extensive questionnaires. Instead, a team of highly skilled psychologists and therapists identified GBV survivors and provided follow up.   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 European Health and Digital Executive Agency (HaDEA) 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. [1] Names changed to protect privacy. [2] IOD PARC , Evaluation of the UNICEF Project: Strengthening Refugee and Migrant Children’s Health Status in Southern and South-Eastern Europe. [3] UNICEF CO staff. [4] UNICEF CO staff. [5] IP
Article
18 November 2022
Reaching refugee and migrant children during COVID-19
https://www.unicef.org/eca/stories/reaching-refugee-and-migrant-children-during-covid-19
725 refugee and migrant children participated in UNICEF-supported psychosocial support sessions and referrals to specialized mental health services – almost 3 times more than the number originally targeted for the Initiative. 450 refugee and migrant children participated in UNICEF-supported gender-based violence (GBV) prevention activities and referral to national authorities’ GBV response services – 3 times more than the number originally targeted. Implementing partners: Centro Penc, INTERSOS, Medicins du Monde, Save the Children. The independent evaluation of the ‘RM Child-Health’ Initiative has taken stock of its impact in Italy since 2020. [2] It has confirmed that the Initiative’s preventive, cross-sectoral and comprehensive approach to health is helping to build long-term resilience. Italy is a prime example, as refugee flows into the country have changed in terms of their origins and arrival locations. More refugees are now arriving from Greece and Turkey, rather than via the North Africa route, and refugees are arriving in different locations, such as Calabria and Sardinia, rather than Lampedusa in Sicily. Some have landed on the shores of Roccella Ionica, for example, a small town of just 6,000 inhabitants in Calabria, where health facilities are limited. UNICEF and its partners have been able to draw on the experience of the ‘RM Child Health’ Initiative to create a resilient response by: mapping existing services at the regional level so partners can refer new arrivals setting up services at the disembarkation point as well as reception facilities, so the team at the disembarkation point can send key information to the team at the reception centre about the health needs of unaccompanied and separated refugee and migrant children, in particular. establishing networks of local authorities, service providers and non-governmental organizations to support the response drawing on the Initiative’s previous experience on psychological first aid, the information needs of refugees and migrants, and activities to reduce stress so that local partners have ‘ready-made’ solutions to offer new arrivals establishing a partnership with an association of cultural mediators that has a roster, enabling partners to mobilize mediators who speak different languages and who understand diverse cultures. The Initiative has also supported the mapping of best practices and ‘what works’ in mental health and psychosocial support (MHPSS) services for refugee and migrant children, as well as referral mechanisms. It has supported the development of materials in diverse languages that are now available for linguistic and cultural mediators, health workers, social workers and others. These include Q&As on subjects that are often sensitive and difficult for young refugees, migrants and even frontline workers to discuss, such as GBV and (in partnership with the United Nations Population Fund) sexual and reproductive health and rights. Most recently, the Initiative has supported the development, production and dissemination of clear information on menstrual hygiene. All materials have used clear, concise, user-friendly language to dispel the many myths and misconceptions around these issues. Realizing the greater difficulties faced by refugees and migrants in accessing services as a result of lockdowns, UNICEF’s partners in Italy continued to deliver remote and in-person health screenings and online psychological support and case management to those who were most vulnerable. [3] , [4] Brochures on immunization, GBV and mental health and MHPSS were disseminated during the COVID-19 pandemic, as well as short videos on all these topics, which are available through U-Report on the Move. [5] The impact often went beyond health itself: UNICEF has enhanced the capacity of partners on Protection Against Sexual Exploitation and Abuse (PSEA) [6] and shared indicators and tools to inform work with unaccompanied and separated children, strengthening the capacity of frontline staff to work with these children. [7] One partner also noted that support for documentation linked to COVID-19 resulted in more refugee and migrant children attending school (even if virtually) and a decrease in dropouts. [8]   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 European Health and Digital Executive Agency (HaDEA) 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. [1] Names of refugees and migrants have been changed to protect privacy. [2] IOD PARC , Evaluation of the UNICEF Project: Strengthening Refugee and Migrant Children’s Health Status in Southern and South-Eastern Europe [3] International Professional staff. [4] Italy: detailed Implementation Plan, revised 01062020. [5] U-Report is a digital platform that lets young migrants and refugees in Italy speak out on issues that matter to them and be heard by decision makers: U-Report On The Move | Linktree [6] International Professional staff. [7] Government representative. [8] International Professional staff.
Article
08 November 2022
From curiosity to confidence
https://www.unicef.org/eca/stories/curiosity-confidence
An independent evaluation of the Initiative has captured its impact on health policy implementation by frontline workers. The training of government officials and the staff of implementing partners has, for example, generated noticeable behaviour change in health service providers and the way in which they deliver services. [1] Importantly, it has also helped public health workers to develop more effective ways to cope with their own stress. [2] Feedback from pre- and post-training assessments has confirmed that knowledge has improved. [3] Services have been mapped out across the five countries, Standard Operating Procedures (SOPs) have been improved, and referral services that connect children and their caregivers to specialized health care have been enhanced. [4] ; [5] With support from the Initiative, public health officials interacted (often for the first time) with cultural mediators, resulting in greater appreciation for their vital work. The Initiative has also increased health professionals’ understanding of the importance of immunization and treatment of mental health issues, as well as raising awareness and understanding of substance abuse among children and adolescents. [6] ; [7] National partners now have greater capacity on key issues. In Bosnia and Herzegovina, for example, the International Organization for Migration now follows UNICEF’s protocol on the provision of baby formula milk. [8] In Italy, UNICEF was able to enhance the capacity of partners on Protection Against Sexual Exploitation and Abuse (PSEA) [9] and disseminate indicators, tools and protocols to inform work with unaccompanied and separated children, which has strengthened the capacity of frontline staff to work with these children. [10] The Project also helped to increase the knowledge of public health institutions. In Bosnia and Herzegovina, cantonal health institutes are now better informed on refugee and migrant health conditions. [11] Targets for this aspect of the ‘RM Child-Health Initiative’ have often been exceeded. In Bulgaria, for example, the Initiative aimed to ensure that 30 health authorities, service providers and other frontline workers (disaggregated by authority) completed UNICEF-supported training on health issues for refugee and migrant children and international best practice. In all, 170 completed this training – more than five times the original target. In Serbia, around twice as many professionals were reached as originally intended, with workshops reaching a wide range of professionals, including educators, trainers, guardians from centres for social work, Commissariat staff, and frontline health staff such as doctors and psychologists. [12] This training is continuing to reach staff, even though the Initiative itself has come to an end. Training was delivered in a way that was relevant to participants and responsive to their needs. In Greece, for example, the starting point for the training was the existing knowledge and experience of participants, aiming to build their sense of ownership and engagement, and the training built on an assessment of their training needs. The communities participating in the training were also consulted to assess what kind of support to prioritize. This process revealed challenging areas that needed to be added to the training: working with vulnerable children; professional stress and burnout; and the importance of cross-sectoral cooperation. The training was also flexible, incorporating a module on how to deliver training online during the COVID-19 pandemic. In Lesvos, Greece, the needs assessment for the training found that kits for mothers contained breastmilk substitutes. A set of training materials was produced for a wide range of participants, including staff from non-governmental organizations, the state-run health provider and site management organizations as well as volunteers in the camps and other professional in Lesvos, such as teachers. These materials included a ‘truth or myth’ game for use with pregnant or lactating women. The training created a new network of people who have kept in touch, with some asking for more information on how to deal with specific cases. Implementing partners have noticed that training participants have started to collaborate in the camps, with midwives and volunteers, for example, working together. In one camp, there have been no requests for breastmilk substitutes since this initiative. [13]  
Article
13 May 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.  
Article
13 May 2021
Support for frontline workers: Implementation of health policies for refugee and migrant children
https://www.unicef.org/eca/stories/support-frontline-workers-implementation-health-policies-refugee-and-migrant-children
“I find the tool for identification of unaccompanied and separated girls [UASGs] very useful since the indicators included are clear and help us recognise UASGs more quickly.”   A frontline worker in Serbia welcomes a new tool to identify refugee and migrant girls Two girls are talking to each other. The ‘RM Child-Health’ initiative has supported work across five European countries over the past year to equip those who work directly with refugee and migrant children and adolescents with all the skills and resources they need to turn health policies into concrete action. In its first full year, this 27-month, co-funded €4.3 million initiative, which was launched in January 2020 by the European Union Directorate-General for Health and Food Safety, has enhanced the knowledge and skills of frontline workers to maximize the impact of their work with young refugees and migrants. The initiative 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 a wide range of frontline workers, including health service providers. In Bosnia and Herzegovina, for example, 34 national service providers and other frontline workers have completed pre- and in-service training on health issues for refugee and migrant children and international best practice. Country-specific policy packages for health policy implementation have been made available on standard operating procedures (SOPs) for paediatric infirmaries, the use of breastmilk substitutes in temporary reception centres (TRCs) and referrals for specialized health care. Links have been strengthened across different disciplines, with skills-based training offered to psychologists working with children on the move, psychologists working at Centres for Mental Health, social workers and school pedagogists. UNICEF has also worked with Médecins du Monde (MdM) to organize a peer-to-peer session for 23 child protection frontline workers – legal guardians, caseworkers, as well as child protection officers – in Una-Sana Canton, enhancing their ability to support the mental health of child refugees and migrants. In Bulgaria, the past year has seen a strong focus on the training of frontline workers to identify, manage and refer children with physical and mental health problems, and on embedding child protection standards into health provision. In all, 36 frontline workers have been trained to work effectively with children who have mental health issues – far exceeding the original target of 25. UNICEF and two of its key partners in the ‘RM Child-Health’ initiative – the Council of Refugee Women in Bulgaria (CRWB) and the Mission Wings Foundation (MWF) – have also raised awareness on gender-based violence (GBV) among community-based professionals who work with refugees and asylum seekers. More than 70 frontline workers, including cultural mediators and interpreters, have received information and/or training on GBV prevention and response, more than twice as many as the 30 originally envisaged.    In Italy, UNICEF has worked with MdM, reception sites, local health authorities and others to enhance the knowledge and skills of frontline workers from different sectors – health, child protection, education and reception services – on health risks for migrant and refugee children, with a focus on mental health and GBV prevention and response. Training materials have aimed to address the potential biases, attitudes and beliefs that might prevent frontline workers from delivering quality services that are sensitive to gender and culture. A November 2020 training session on the impact of the COVID-19 pandemic on risks and services related to violence showed first responders how to handle GBV disclosures and support survivors through, for example, a psychological first aid (PFA) approach. To date, more than 150 service providers and other frontline workers have been reached by such interventions. In Serbia, UNICEF and the University of Belgrade (Faculty of Political Sciences) have developed and piloted the interdisciplinary university Course Protection of Children Affected by Mixed Migration over the past year. The course has reached 40 students of social work and active frontline workers to date – well on track to reach the 50 planned for the whole duration of the ‘RM Child-Health’ initiative. “The course was very comprehensive and useful for me. The lectures where we discussed the political context were useful to know more about the reasons for migration.”   Student UNICEF has also produced Making the Invisible Visible – an analysis and toolkit to help frontline practitioners identify unaccompanied and separated girls (UASGs). These girls may easily be overlooked and might not receive the support they need unless frontline workers know what to look for, as they may not seem to be unaccompanied at first glance. The toolkit includes a 10-point tip-sheet for frontline workers, alerting them to, for example, look out for girls whose stories seem ‘rehearsed’ or who do not speak the same language or share the same dialect as their travelling companions. A roll-out of the analysis and toolkit was organized for 47 frontline practitioners in 2020, with one commenting: “I like the tool for identification of unaccompanied and separated girls [UASGs] you’ve developed. It is especially good that many of the indicators do not require an interview with a potential UASGs, given that the conditions for a confidential interview in the field are not always achievable, such as a safe space and cultural mediators, especially female ones. So, it’s important we know what the red flags are, even prior to speaking with the girl.” 
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