Statement by UNICEF Executive Director Henrietta Fore on the disruption of immunization and basic health services due to the COVID-19 pandemic
: “Around the world, the COVID-19 pandemic is overstretching health services as health workers are diverted to support the response. “Physical distancing is leading parents to make the difficult decision to defer routine immunization. “Medical goods are in short supply and supply chains are under historic strain due to transport disruptions. Flight cancellations and trade restrictions by countries have severely constrained access to essential medicines, including vaccines. “As the pandemic progresses, critical life-saving services, including immunization, will likely be disrupted, especially in Africa, Asia and the Middle East where they are sorely needed. “At the greatest risk are children from the poorest families in countries affected by conflicts and natural disasters. “We are particularly concerned about countries that are battling measles, cholera or polio outbreaks while responding to COVID-19 cases, such as Afghanistan, the Democratic Republic of Congo, Somalia, the Philippines, Syria and South Sudan. Not only would such outbreaks tax already stretched health services, they could also lead to additional loss of lives and suffering. At a time like this, these countries can ill-afford to face additional outbreaks of vaccine-preventable diseases. “The message is clear: We must not allow lifesaving health interventions to fall victim to our efforts to address COVID-19. “UNICEF is committed to supporting basic health care and immunization needs in the worst affected countries, and to doing so in a way that limits the risk of COVID-19 transmission. We are working hard to ensure adequate vaccine supplies are available in countries that need them. We are in close communication with global vaccine suppliers to ensure production is not disrupted and supply is managed in the best possible manner under these difficult circumstances. We are also providing greater support to governments to continue the supply of vaccines during this pandemic. “In the days to come, governments may have to temporarily postpone preventive mass vaccination campaigns in many places to ensure that the delivery of immunization services does not contribute to COVID-19 spread, and to follow recommendations on physical distancing. “UNICEF strongly recommends that all governments begin rigorous planning now to intensify immunization activities once the COVID -19 pandemic is under control. These vaccination activities must focus on children who will miss vaccine doses during this period of interruption and prioritize the poorest and most vulnerable children. To successfully roll-out vaccines against COVID -19 when they become available, we need to ensure that our immunization programmes remain robust and can reach those that will need these vaccines the most. “Immunization remains a life-saving health intervention. As the world's biggest buyer and supplier of vaccines, UNICEF will continue to play a pivotal role in supporting governments’ current and future immunization efforts.” Nurse Milka Babic performs immunization UNICEF/UNI218376/Pancic
More than 117 million children at risk of missing out on measles vaccines, as COVID-19 surges
“As COVID-19 continues to spread globally, over 117 million children in 37 countries may miss out on receiving life-saving measles vaccine. Measles immunization campaigns in 24 countries have already been delayed; more will be postponed. “During this challenging period, the Measles & Rubella Initiative (M&RI) expresses solidarity with families, communities, governments and emergency responders and joins our global immunization and health partners, including those within Gavi, the Vaccine Alliance and the Global Polio Eradication Initiative (GPEI) in our collective focus and fight against the threat of COVID-19. The pandemic sweeping the globe requires a coordinated effort and commitment of resources to ensure frontline health workers around the world are protected, as they face and respond to this new threat. At the same time, we must also champion efforts to protect essential immunization services, now and for the future. “The World Health Organization (WHO) has issued new guidelines endorsed by the Strategic Advisory Group of Experts on Immunization -- to help countries to sustain immunization activities during the COVID-19 pandemic. The guidelines recommend that governments temporarily pause preventive immunization campaigns where there is no active outbreak of a vaccine-preventable disease. M&RI partners, which include the American Red Cross, the U.S. Centers for Disease Control and Prevention, UNICEF, the United Nations Foundation and WHO, strongly agree with these recommendations. We also urge countries to continue routine immunization services, while ensuring the safety of communities and health workers. The recommendations also ask governments to undertake a careful risk-benefit analysis when deciding whether to delay vaccination campaigns in response to outbreaks, with the possibility of postponement where risks of COVID-19 transmission are deemed unacceptably high. “If the difficult choice to pause vaccination is made due to the spread of COVID-19, we urge leaders to intensify efforts to track unvaccinated children, so that the most vulnerable populations can be provided with measles vaccines as soon as it becomes possible to do so. While we know there will be many demands on health systems and frontline workers during and beyond the threat of COVID-19, delivering all immunization services, including measles vaccines, is essential to saving lives that would otherwise be lost to vaccine-preventable diseases. “The M&RI supports the need to protect communities and health workers from COVID-19 through a pause of mass campaigns, where risks of the disease are high. However, this should not mean that children permanently miss out. Urgent efforts must be taken now at local, national, regional and global levels to prepare to close the immunity gaps that the measles virus will exploit, by ensuring that vaccines are available and that they reach children and vulnerable populations, as quickly as possible, to keep them safe. “Despite having a safe and effective vaccine for over 50 years, measles cases surged over recent years and claimed more than 140,000 lives in 2018, mostly of children and babies – all of which were preventable. Against this already dangerous backdrop, preventive and responsive measles vaccination campaigns have now been paused or postponed in 24 countries to help avert further spread of COVID-19. Campaigns expected to take place later in 2020 in an additional 13 countries may not be implemented. Together, more than 117 million children in 37 countries, many of whom live in regions with ongoing measles outbreaks, could be impacted by the suspension of scheduled immunization activities. This staggering number does not include the number of infants that may not be vaccinated because of the effect of COVID-19 on routine immunization services. Children younger than 12 months of age are more likely to die from measles complications, and if the circulation of measles virus is not stopped, their risk of exposure to measles will increase daily. “The M&RI salutes the heroism of health and emergency workers across the globe, and we recognize the vital role they play in delivering clear, trusted information, as well as preventive and supportive care within their communities. We must invest in health workers and ensure they are protected from infection and empowered as part of sustainable and functioning primary health systems. They are the first line of defense against global epidemics. We also recognize the role of parents and caregivers in ensuring their children are vaccinated by following physical distancing recommendations in line with national guidance. Finally, we call on countries and local leaders to implement effective communication strategies to engage communities, ensure supply and demand for vaccination remains strong, and help assure a healthy life for every child especially in this challenging time.” #####
As the COVID-19 pandemic begins to enter a new phase, UNICEF reminds the world that ‘the light at the end of the tunnel needs to shine for all’
“COVID-19 is the first truly global crisis we have seen in our lifetimes. No matter where we live, the pandemic affects every one of us. Children have been seriously impacted. However, with more news about promising vaccines, and as we begin to imagine a day when COVID-19 is behind us, our guiding principle must be that the light at the end of the tunnel needs to shine for all. “This is why UNICEF has enthusiastically joined the Advance Market Commitment of the COVAX Facility to allow low- and lower-middle income countries access to COVID-19 vaccines. It is the best way to make sure that, as vaccines become available, no country is pushed to the back of the line. This would not only be fundamentally unfair, it would be unwise. The whole world will remain vulnerable to the virus until countries with the weakest health systems are protected from it as well. “In order for the COVAX Facility to work and guarantee equitable and affordable access to low- and lower-middle income countries, we need a global commitment to support and capitalize it, but also to finance the delivery of vaccines and associated supplies such as syringes and safety boxes. Governments must work together to ensure that COVID-19 vaccines are affordable and accessible to all countries. High-income countries should invest financially in the Advance Market Commitment and in UNICEF’s COVID-19 vaccine delivery efforts. All countries should take a strong stand against export controls on – and unnecessary stockpiling of – commodities for the COVID-19 response. “UNICEF is also leveraging our unique strengths in community engagement and vaccine supply to make sure that countries participating in the COVAX Facility have safe, fast and equitable access to the vaccine. This is an enormous undertaking and many challenges still lay ahead. As the largest vaccine buyer in the world, procuring more than 2 billion doses annually for routine immunization and outbreak response on behalf of nearly 100 countries, UNICEF is c oordinating and supporting the procurement, international freight , and in-country distribution of COVID-19 vaccines for the COVAX Facility. “Together with WHO, PAHO, GAVI and other partners at the global and regional levels, UNICEF is also working to support countries to ‘ready’ their immunization programmes for this historic roll-out. This includes assessing capacity and helping countries to strengthen their cold and supply chains so that they have adequate infrastructure to transport and store the vaccines for delivery to the frontlines. “However, the existence of a safe and effective COVID-19 vaccine alone will not end the pandemic. We need a diverse set of tools to help slow the spread of COVID-19, including diagnostics and treatments, as well as a continuance of preventive measures such as hand washing, physical distancing and mask wearing. UNICEF is providing governments with access to personal protective equipment, validated testing approaches, and proven treatments. In addition, UNICEF continues to work with multilateral partners to support governments with infection prevention control, water, sanitation and hygiene supplies, physical distancing, surveillance, contact tracing, case identification and community referral systems to stem the pandemic. “Lastly, we continue to help countries ensure the continuity of key essential services for women, children and young people – especially the most vulnerable. COVID-19 related disruptions have had a heavy impact on children: on their safety, their well-being, their future. Even as the fight against the disease enters into a hopeful new phase, we must not forget the work ahead of us to respond, recover and reimagine a better world for children.” ###
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.”
Through pandemics and epidemics, hope stays alive
For more than 70 years, we have been working to improve the lives of children and their families. Our mission is made possible by a strong network of talented and dedicated staff that includes physicians, clinicians, logistics experts and communication specialists. As the global COVID-19 pandemic unfolds, we look back at UNICEF's history of responding to health crises the world over, and look ahead to recovering from this one. Филиппины UNICEF/UN03784 Индия, 1961 год. Медицинский работник делает девочке прививку против оспы. UNICEF/UNI41906 Disease prevention Since its beginnings, UNICEF has been at the forefront of disease prevention and revolutionizing children’s health. Working closely with partners like the World Health Organization (WHO), we have seen the eradication of smallpox and the near eradication of polio. Since 1988, the number of children affected by polio has reduced by 99 per cent. Today, some of the same lessons we’ve learned in contact tracing in communities are being applied to reach vulnerable children and their families in some of the remotest parts of the world. Бангладеш, 1989 год. Посол доброй воли ЮНИСЕФ Одри Хепбёрн делает прививку от полиомиелита ребёнку в клинике. In the 1980s UNICEF led the child survival revolution — a shift from treating health issues to preventing them — helping to reduce child deaths by up to nearly 80 per cent in some countries. Our worldwide distribution of oral rehydration solution has helped reduce the number of deaths from diarrhoea — a leading killer of young children — by 60 per cent between 2000 and 2007. Mass immunization campaigns have also played a huge role in protecting children against preventable diseases. For measles alone, about 20 million young people’s lives were saved between 2000 and 2015 thanks to such efforts by UNICEF and partners. HIV and AIDS In 1987, AIDS became the first disease to be debated on the floor of the UN General Assembly. As Member States convened, UNICEF and WHO were already monitoring possible interactions between the disease and immunization and breastfeeding. As infections spread, UNICEF geared its research, policy, planning and fundraising to better understand how to prevent mother-to-child transmission. To equip the public with facts, we supported health education around the world, particularly in sub-Saharan Africa, working tirelessly to inform, educate and protect against stigma and discrimination around HIV and AIDS. Медицинский работник берёт кровь для исследования на ВИЧ Since 2010, 1.4 million HIV infections among children have been averted. The reduction in mother-to-child transmission is viewed as a public health success story. Jointly with partners, UNICEF has set ambitious targets for ending AIDS by 2030. Малыши обнимаются в приюте Swine flu In 2009, the swine flu pandemic swept across the world primarily affecting children and young adults who were otherwise in good health. UNICEF put measures in place to prepare for possible local outbreaks in 90 countries. These measures remained in place after the pandemic with an eye on future outbreaks. Mедицинские работники посещают дома Ebola Within two and a half years of the 2014 outbreak of Ebola in West Africa, more than 28,616 cases and 11,310 deaths had been recorded. During the crisis, UNICEF helped in providing care for ostracized children suspected of being infected, children who lost parents and guardians to Ebola, and the millions who were out of school. Since 2018, with the start of the second-biggest Ebola epidemic ever recorded, we have been working with partners across the region to prevent transmission and protect affected children. Within a year, UNICEF and partners had trained more than 32,400 teachers on how to teach children about Ebola prevention and how to make schools a protective environment. Медицинский работник измеряет температуру Coronavirus (COVID-19) The ongoing COVID-19 pandemic has upended family life around the world. Economic shutdowns, school closures and confinement measures are all having a heavy impact on children now and the longer-term repercussions risk their safety, their well-being and their future. UNICEF is calling for swift global action without which, this health crisis risks becoming a child-rights crisis. ЮНИСЕФ Южный Судан, 2020 год. ЮНИСЕФ располагает сетью, состоящей из 2500 социальных активистов, работающих в течение года для повышения осведомлённости людей о важности соблюдения правил гигиены, иммунизации, питания, защиты детей и образования. UNICEF is on the ground in more than 190 countries, partnering with governments, health workers and other front-line responders to keep children healthy, safe and learning, no matter who they are or where they live. COVID-19 is one of the biggest fights in our history, yet, it is a fight that together we can win. Are you with us?
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
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.
Oasis of health and joy
"I want to be a photographer, and you know that the most valuable tool for any photographer is their eyes," says 17-year-old Ferhat* as he contentedly nods to his reflection in the mirror, adjusting his glasses. It has been three years since he left his home in Tehran together with his parents and younger sister in search of a better life in Europe, and after years spent crossing different borders, he is no longer sure where the most serious game for a better life will take them. Game is the word that migrants use as a synonym for an attempt of crossing the border. Ferhat is currently residing in the temporary reception centre Sedra with his family. Last year they were all staying at a reception centre in Sarajevo, and according to him: wherever life brings them, everything will be fine as long as they are together. With the support from UNICEF, the Danish Refugee Council (DRC) staff, Ferhat came to the opticians shop in Cazin. "After they took away all my personal belongings at the border, including the glasses, the doctor at the Sedra Pediatric Clinic estimated that I needed an ophthalmologist's examination and a new set of glasses. Next I was assigned an appointment, a team from DRC and UNICEF came to pick me up and took me to the ophthalmologist, and when my dioptre was determined on examination, they also took me to an optician's shop to choose the appropriate frame. Today, after a procedure that lasted several days, I received my new glasses. "Thank you to everyone who helped me and everyone who helped my family, and to others from the centre, for their work and desire to fulfil basic human needs even in such conditions," says Ferhat. Refugree and migrant children take part in a dental workshop Refugree and migrant children take part in a dental workshop Unfortunately his family members were frequent patients of the medical centres whose services are provided by UNICEF and DRC through DG Health funding: his mother's hand healed only a few days ago when her cast was removed - she had previously broken her arm while trying to cross the border and his father is a regular patient given his continuously high blood pressure. During his previous attempt to cross the border Ferhat damaged his old, precious glasses that he has worn for the last four years - ever since doctors discovered his hereditary vision problem. He still has the right to use the services of a children's clinic, which, in addition to basic pediatric care services include immunization services, systematic examinations, ophthalmological check-ups, dental services and consultations for parents. Sedra and Borići are classic family camps: at the time of our visit, 213 people were accommodated in Sedra - of which 53 were children, and 51 families with children were accommodated in Borići. To make everyday life more tolerable for children in reception centres, UNHCR cooperates with Save the Children, Médecins de Monde (MDM), Church World Service (CWS), World Vision, and centres for social work Bihać, Cazin, Velika Kladuša, Ključ and Hadžići; and there are frequent activities for the youngest that partner organizations regularly carry out with the intention of entertaining, but also educating children in the mentioned centres. The focus of this workshop is dental hygiene, where the children are learning all the practices and putting their skills to the test with a demonstration model. The focus of this workshop is dental hygiene, where the children are learning all the practices and putting their skills to the test with a demonstration model. During our stay in the reception centre in Borići, there was a dental workshop organized in partnership with the local polyclinic Muminović. Through a series of games, children had the opportunity to learn how to properly maintain oral hygiene, how to properly brush their teeth, who to contact in case of dental problems, and at the end of the workshop, they were all given hygiene packages containing basic dental hygiene supplies. Their excitement was not disturbed by the mandatory protective masks which prevented them from trying out the contents of their hygiene packages right away. Additionally, because everyone had to wear masks indoors, the associates of the Muminović polyclinic brought out demonstration models with which the children could practically test the knowledge acquired during the workshop. Families with children are accommodated in two temporary reception centres (Borići and Sedra) in the Una-Sana Canton (USC), and the Sarajevo reception centre Ušivak and unaccompanied minors are accommodated in all five reception centres (including the Bira and Miral centres). Currently, there are about 4,000 refugees/migrants accommodated in four TRCs in the USC area, including about 500 children, unaccompanied children and children separated from their parents. Thanks to funding from the EU Health Programme (DG Health), UNICEF BIH ensures that all refugee and displaced children have access to primary health care, which in BiH, includes pediatric services as well. *Name changed to protect the identity of a minor
UNICEF appeals for $3.9 billion in emergency assistance for 41 million children affected by conflict or disaster
Millions of children living in countries affected by conflict and disaster lack access to vital child protection services, putting their safety, well-being and futures at risk, UNICEF warned today as it appealed for $3.9 billion to support its work for children in humanitarian crises . UNICEF’s Humanitarian Action for Children sets out the agency’s 2019 appeal and its efforts to provide 41 million children with access to safe water, nutrition, education, health and protection in 59 countries across the globe. Funding for child protection programmes accounts for $385 million of the overall appeal, including almost $121 million for protection services for children affected by the Syria crisis. “Today millions of children living through conflict or disaster are suffering horrific levels of violence, distress and trauma,” said UNICEF Executive Director Henrietta Fore. “The impact of our child protection work cannot be overstated. When children do not have safe places to play, when they cannot be reunited with their families, when they do not receive psychosocial support, they will not heal from the unseen scars of war.” UNICEF estimates that more than 34 million children living through conflict and disaster lack access to child protection services, including 6.6 million children in Yemen, 5.5 million children in Syria and 4 million children in the Democratic Republic of the Congo (DRC ). Child protection services include all efforts to prevent and respond to abuse, neglect, exploitation, trauma and violence. UNICEF also works to ensure that the protection of children is central to all other areas of the organisation’s humanitarian programmes, including water, sanitation and hygiene, education and other areas of work by identifying, mitigating and responding to potential dangers to children’s safety and wellbeing. However, funding constraints, as well as other challenges including warring parties’ growing disregard for international humanitarian law and the denial of humanitarian access, mean that aid agencies’ capacity to protect children is severely limited. In the DRC, for example, UNICEF received just a third of the $21 million required for child protection programmes in 2018, while around one-fifth of child protection funding for Syrian children remained unmet. “Providing these children with the support they need is critical, but without significant and sustained international action, many will continue to fall through the cracks,” said Manuel Fontaine, UNICEF Director of Emergency Programmes. “The international community should commit to supporting the protection of children in emergencies.” 2019 marks the 30th anniversary of the landmark Convention on the Rights of the Child and the 70th anniversary of the Geneva Conventions, yet today, more countries are embroiled in internal or international conflict than at any other time in the past three decades, threatening the safety and wellbeing of millions of children. UNICEF’s appeal comes one month after the children’s agency said that the world is failing to protect children living in conflict around the world, with catastrophic consequences. Children who are continuously exposed to violence or conflict, especially at a young age, are at risk of living in a state of toxic stress – a condition that, without the right support can lead to negative life-long consequences for their cognitive, social and emotional development. Some children impacted by war, displacement and other traumatic events – such as sexual and gender-based violence – require specialized care to help them cope and recover. The five largest individual appeals are for Syrian refugees and host communities in Egypt, Jordan, Lebanon, Iraq and Turkey (US$ 904 million); Yemen (US$ 542.3 million); The Democratic Republic of the Congo (US$ 326.1 million); Syria (US$ 319.8 million) and South Sudan (US$ 179.2 million). ### Notes to editors: In total, working alongside its partners, UNICEF aims to: Provide 4 million children and caregivers with access to psychosocial support; Provide almost 43 million people with access to safe water; Reach 10.1 million children with formal or non-formal basic education; Immunize 10.3 million children against measles; Treat 4.2 million children with severe acute malnutrition. In the first 10 months of 2018, as a result of UNICEF’s support: 3.1 million children and caregivers received psychosocial support; 35.3 million people had access to safe water; 5.9 million children accessed some form of education; 4.7 million children were vaccinated against measles; 2.6 million children were treated for severe acute malnutrition. Photos and multimedia materials are available for download here: https://weshare.unicef.org/Package/2AMZIFI7QW8B Humanitarian Action for Children 2019 and individual appeals can be found here: https://uni.cf/HAC_2019 On 23 September 2018 in Ukraine, Masha Khromchenko, 11, stands in the kindergarten class room that took a direct hit from a shell Novotoshkivske in the Luhansk region. The shell caused massive damage to the facility and surrounding residential area. UNICEF/UN0243152/Morris VII Photo On 23 September 2018 in Ukraine, Masha Khromchenko, 11, stands in the kindergarten class room that took a direct hit from a shell Novotoshkivske in the Luhansk region. The shell caused massive damage to the facility and surrounding residential area.
COVID-19 could reverse decades of progress toward eliminating preventable child deaths, agencies warn
– The number of global under-five deaths dropped to its lowest point on record in 2019 – down to 5.2 million from 12.5 million in 1990, according to new mortality estimates released by UNICEF, the World Health Organization (WHO), the Population Division of the United Nations Department of Economic and Social Affairs and the World Bank Group. Since then, however, surveys by UNICEF and WHO reveal that the COVID-19 pandemic has resulted in major disruptions to health services that threaten to undo decades of hard-won progress. “The global community has come too far towards eliminating preventable child deaths to allow the COVID-19 pandemic to stop us in our tracks,” said Henrietta Fore, UNICEF Executive Director. “When children are denied access to health services because the system is overrun, and when women are afraid to give birth at the hospital for fear of infection, they, too, may become casualties of COVID-19. Without urgent investments to re-start disrupted health systems and services, millions of children under five, especially newborns, could die.” Over the past 30 years, health services to prevent or treat causes of child death such as preterm, low birthweight, complications during birth, neonatal sepsis, pneumonia, diarrhea and malaria, as well as vaccination, have played a large role in saving millions of lives. Now countries worldwide are experiencing disruptions in child and maternal health services, such as health checkups, vaccinations and prenatal and post-natal care, due to resource constraints and a general uneasiness with using health services due to a fear of getting COVID-19. A UNICEF survey conducted over the summer across 77 countries found that almost 68 per cent of countries reported at least some disruption in health checks for children and immunization services. In addition, 63 per cent of countries reported disruptions in antenatal checkups and 59 per cent in post-natal care. A recent WHO survey based on responses from 105 countries revealed that 52 per cent of countries reported disruptions in health services for sick children and 51 per cent in services for management of malnutrition. Health interventions such as these are critical for stopping preventable newborn and child deaths. For example, women who receive care by professional midwives trained according to internationals standards are 16 per cent less likely to lose their baby and 24 per cent less likely to experience pre-term birth, according to WHO . "The fact that today more children live to see their first birthday than any time in history is a true mark of what can be achieved when the world puts health and well-being at the centre of our response,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Now, we must not let the COVID-19 pandemic turn back remarkable progress for our children and future generations. Rather, it’s time to use what we know works to save lives, and keep investing in stronger, resilient health systems.” Based on the responses from countries that participated in the UNICEF and WHO surveys, the most commonly cited reasons for health service disruptions included parents avoiding health centers for fear of infection; transport restrictions; suspension or closure of services and facilities; fewer healthcare workers due to diversions or fear of infection due to shortages in personal protective equipment such as masks and gloves; and greater financial difficulties. Afghanistan, Bolivia, Cameroon, the Central African Republic, Libya, Madagascar, Pakistan, Sudan and Yemen are among the hardest hit countries. Seven of the nine countries had high child mortality rates of more than 50 deaths per 1000 live births among children under five in 2019. In Afghanistan, where 1 in 17 children died before reaching age 5 in 2019, the Ministry of Health reported a significant reduction in visits to health facilities. Out of fear of contracting the COVID-19 virus, families are de-prioritizing pre- and post-natal care, adding to the risk faced by pregnant women and newborn babies. Even before COVID-19, newborns were at highest risk of death. In 2019, a newborn baby died every 13 seconds. Moreover, 47 per cent of all under-five deaths occurred in the neonatal period, up from 40 per cent in 1990. With severe disruptions in essential health services, newborn babies could be at much higher risk of dying. For example, in Cameroon, where 1 out of every 38 newborns died in 2019, the UNICEF survey reported an estimated 75 per cent disruptions in services for essential newborn care, antenatal check-ups, obstetric care and post-natal care. In May, initial modelling by Johns Hopkins University showed that almost 6,000 additional children could die per day due to disruptions due to COVID-19. These reports and surveys highlight the need for urgent action to restore and improve childbirth services and antenatal and postnatal care for mothers and babies, including having skilled health workers to care for them at birth. Working with parents to assuage their fears and reassure them is also important. “The COVID-19 pandemic has put years of global progress to end preventable child deaths in serious jeopardy,” said Muhammad Ali Pate, Global Director for Health, Nutrition and Population at the World Bank. “It is essential to protect life-saving services which have been key to reducing child mortality. We will continue to work with governments and partners to reinforce healthcare systems to ensure mothers and children get the services they need.” "The new report demonstrates the ongoing progress worldwide in reducing child mortality,” said John Wilmoth, Director of the Population Division of the United Nations Department of Economic and Social Affairs. “While the report highlights the negative effects of the COVID-19 pandemic on interventions that are critical for children’s health, it also draws attention to the need to redress the vast inequities in a child's prospects for survival and good health.” ###### A child and his mother while waiting to receive medical care UNICEF/UNI347480/Poveda
World's richest countries grappling with children’s reading and math skills, mental well-being and obesity
On average 40 per cent of children across all OECD and EU countries do not have basic reading and mathematics skills by age 15. Children in Bulgaria, Romania and Chile are the least proficient in these skills. Estonia, Ireland and Finland the most proficient. In most countries, at least 1 in 5 children lack confidence in their social skills to make new friends. Children in Chile, Japan and Iceland are the least confident in this area. The report also contains data on clear areas of progress in child well-being. On average, 95 per cent of pre-school aged children are now enrolled in organized learning programmes, and the number of young people aged 15-19 not in education, employment or training has declined in 30 out of 37 countries. Yet, these important gains are at risk of falling back due to the impact of COVID-19. Countries are also ranked based on their policies that support child well-being and other factors including the economy, society and environment. Norway, Iceland and Finland have the highest-ranking policies and context to support child well-being. On average, countries spend less than 3 per cent of their GDP on family and child policies. “In times of crisis and calm, families need supportive governments and workplaces in order to raise the next generation of happy and healthy citizens,” said Fayaz King, Deputy Executive Director at UNICEF. “An investment in children is a direct investment in our future.” Due to the COVID-19 outbreak, in the first half of 2020 most of the countries covered in the report kept schools closed for more than 100 days while strict stay-at-home policies were also implemented. The report notes that loss of family members and friends, anxiety, stay-at-home restrictions, lack of support, school closures, the balancing of work and family life, poor access to healthcare, combined with the economic loss caused by the pandemic are catastrophic for children’s wellbeing, affecting their mental and physical health, and their development. Before the COVID-19 outbreak the average relative child poverty rate across the 41 countries was 20 per cent. With GDP expected to fall over a two-year period in almost all of these countries, unless governments take immediate remedial actions child poverty will rise. “As the economic, educational and social fallout of the pandemic continues to take hold, without concerted effort, there will be a worsening, devastating impact on the well-being of today’s children, their families and the societies they live in,” said Olsson. “But these risks do not have to become the reality, if governments take decisive action now to protect children’s well-being.” On the basis of the report and these recent developments UNICEF is calling for the following steps to protect and improve child wellbeing: Take decisive action to reduce income inequality and poverty and ensure that all children have access to the resources they need. Rapidly address the serious gap in mental health services for children and adolescents. Expand family-friendly policies to improve work-family balance, especially access to high-quality, flexible and affordable early-years childcare. Strengthen efforts to protect children from preventable diseases, including reversing recent falls in measles immunization. Improve COVID-19 policies that support families with children and ensure budgets that support child well-being are protected entirely from austerity measures. ###