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13 results
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Article
27 September 2018
Astana Global Conference on Primary Health Care
https://www.unicef.org/eca/stories/astana-global-conference-primary-health-care
What is the Astana Global Conference? On 25-26 October 2018, world leaders, government ministers, development partners, civil society and young people will meet in Astana for the Global Conference on Primary Health Care, jointly hosted by the Government of Kazakhstan, UNICEF and WHO. Participants will renew their commitment to primary health care as the means of achieving universal health coverage, SDG3 and other SDG goals to which health is a contributing factor. The Conference will mark 40 years since the first Global Conference on Primary Health Care, held in 1978 in Almaty (then Alma-Ata), Kazakhstan. The Declaration of Alma-Ata endorsed at that conference was a seminal document that founded a movement and advocacy for primary health care. The 2018 Conference will endorse a new Declaration of Astana which emphasizes the critical role of primary health care in promoting good health, social and economic development and global security. It aims to refocus efforts to ensure that everyone everywhere can enjoy their right to the highest standard of health. What is primary health care? Primary health care is an approach to designing and delivering frontline health services that lays a foundation for achieving universal health coverage. Universal health coverage is one of the targets of the third Sustainable Development Goal (SDG3): Ensure healthy lives and promote well-being for all at all ages. Primary health care includes three core elements: Affordable and accessible health services, including quality primary care, and essential public health functions that promote health and well-being, prevent illness and protect populations against outbreaks of disease. Empowered people and engaged communities, to whom health services are accountable, and who are also responsible for their own health. Inputs (policies, actions, resources) from all sectors that influence health and well-being, ranging from agriculture, manufacturing, education, water, sanitation and hygiene, transport and the media etc. A one-year-old girl is administered her first dose of the mumps, measles and rubella (MMR) vaccine at a clinic in Kyiv, Ukraine. A one-year-old girl is administered her first dose of the mumps, measles and rubella (MMR) vaccine at a clinic in Kyiv, Ukraine. How does primary health care contribute to universal health care? Universal health care is based on the principle that all individuals and communities should have access to quality essential health services without suffering financial hardship. Primary health care contributes to this by ensuring that health services are available, accessible and affordable – including services that prevent illness, cure disease and promote good health. How is UNICEF contributing to the event in Astana and to primary health care? UNICEF is working closely with WHO and the Government of Kazakhstan to support and prepare for the conference. All UNICEF offices are mobilizing government and civil society partners, and making sure the core elements of primary health care are prioritized in the allocation of funding and resources, and in follow up actions. UNICEF is coordinating a Youth Forum that will be held on the day prior to the main event to bring the voices of young people into the conference. UNICEF is also part of a core group of global and regional partners working to support primary health care at country and sub-national levels. The group, which includes UN agencies, donor governments, philanthropic foundations, multilateral agencies like the Global Fund, Gavi and others, is developing a set of operating principles that will prioritize the three core elements described above, and ensure primary health care remains in place after their support has ended. This will be reflected in UNICEF’s own programmes with governments and partners. Ahead of the Global Primary Health Care Conference in Astana, 25-56 October, UNICEF Executive Director Henrietta H. Fore shares the path to achieving “Health for all” – the vision of the SDGs. In her address, UNICEF Executive Director Henrietta H. Fore, highlights the importance of investing in the quality of primary health services and extending their reach to ensure access for the most vulnerable and underprivileged communities. #PrimaryHealthCare #HealthForAll #Astana2018 Success stories: How primary health care helps families and children In remote Kyrgyzstan simple solutions save newborn lives How visiting nurses help prevent child deaths in Kazakhstan Fathers in Turkmenistan carve out their immediate and long-term parenting roles Investing in better care during baby’s first days is saving lives in Kyrgyzstan Saving newborn lives in remote mountainous areas of Kyrgyzstan   “In Focus” reports: A healthy start in life for every child Immunization   More information about the Astana Global Conference WHO Global Conference on Primary Health Care website The Declaration of Alma-Ata Provisional conference programme
Programme
04 October 2017
Health
https://www.unicef.org/eca/health
Europe and Central Asia has surpassed global progress on child mortality, more than halving the deaths of children under five and infants since 1990. And as progress for the poorest households has accelerated, the health gap between the richest and poorest has narrowed.  However, persistent inequities reflect a continued failure to invest effectively in child-centred health systems for all. In South-East Europe, for example, child mortality among the Roma population is two to three times higher than national averages.    Problems missed at an early age can be more difficult and expensive to address later in life. Such inequities are compounded by a failure to spot problems during pregnancy and during the first 1,000 days of life, when children’s bodies and brains build the foundations for their life-long development. Problems missed at an early age can be far more difficult and expensive to address later in life.  Across the region, more than half of the children who die before their fifth birthday die in their first month of life.These deaths are often the result of conditions that are readily preventable or treatable at low cost through, for example, access to good obstetric, ante-natal and post-natal care, routine immunization and exclusive breastfeeding . The main killers of children under the age of five in the region are also preventable: pneumonia and injuries.  Emergencies have an intense impact on child health and nutrition. The impact of emergencies on children's health and nutrition can be extreme. Children on the move, such as those caught in Europe’s refugee and migrant crisis , for example, often lack adequate clothing, food, shelter or warmth. Access to health services, including immunization, has often been inadequate on their journey. The region’s existing HIV prevalence, coupled with lack of safe water and sanitation, as well as ongoing challenges related to early child development and protection all heighten the vulnerability of children during emergencies.  The region is also experiencing vaccine ‘hesitancy’ – the reluctance of some parents to immunize their children, or parental delays in immunization . This hesitancy, often fuelled by misinformation, puts children at risk of contracting, and even dying from, infectious diseases, including polio and measles.
Article
15 March 2023
UNICEF Refugee Response in the Czech Republic: Initial Results and Priorities
https://www.unicef.org/eca/stories/unicef-refugee-response-czech-republic-initial-results-and-priorities
Continued war, including recent attacks on critical infrastructure, increased humanitarian needs, nuclear threat and economic hardship are inhibiting returns and triggering new refugee movements. The situation for both refugees and host countries is complex, unpredictable and acute. Refugees struggle to access protection services and children remain at risk of violence and exploitation. Those impacted by trauma or unaccompanied, separated and/or evacuated from institutional care facilities are highly vulnerable. Rising energy prices and inflation render cash and social protection support critical. Access to education remains a challenge, with many children not yet registered in schools, while refugee health needs, including immunization, require additional capacities and investments. The Czech Republic is both a transit and a destination country for people fleeing the war in Ukraine and has welcomed over 450,000 refugees – one of countries with the highest number of registered Ukrainian refugees per capita. The Government capacities to provide critical services for refugee children and families are stretched, making it crucial to complement and strengthen national systems and child-centered responses. Host communities are also impacted by the energy crisis and high inflation, affecting solidarity and social cohesion. As part of the United Nations Regional Refugee Response Plan, UNICEF focuses on sustaining, expanding, and ensuring preparedness for protection and critical assistance to all refugee children and their families in the Czech Republic. The solidarity and support of the Government and People of the Czech Republic have been remarkable. At the same time, the sudden onset of a large refugee wave has put significant pressure and new demands on the national system. UNICEF works in close partnership with national institutions to support the delivery of refugee response, including targeted humanitarian services, policy and systems strengthening, enhancement of national and local capacities, leveraging resources and catalysing action. Strengthening national systems by partnering with ministries and other national level authorities. UNICEF established workplans with the Ministry of Education, Youth and Sports, Ministry of Labour and Social Affairs, Ministry of Health, and Ministry of the Interior Strengthening systems at local level tto provide services for refugee children and their families through partnering with regions, municipalities and other local authorities. UNICEF established a partnership with the City of Prague, which hosts the largest share of refugees, to provide comprehensive support and services for refugee children and their families. The dialogue is ongoing with other regions with high number of refugees. UNICEF is supporting cross-sectoral refugee response coordination at the regional level, through dedicated regional coordinators and linking them to the national coordination mechanisms. Strengthening outreach and services for refugee children and their families through partnering with civil society organizations (CSOs). In partnership with the Organization for Aid to Refugees (OPU), Romodrom and MRIYA non-governmental organizations, UNICEF is supporting the expansion of outreach and provision of basic services to the most vulnerable children and their families, including unaccompanied and separated children, and refugee children from the Roma community. Download the full report here
Article
13 May 2021
Empowering refugee and migrant children to claim their right to health: Improving health literacy
https://www.unicef.org/eca/stories/empowering-refugee-and-migrant-children-claim-their-right-health-improving-health-literacy
“I have always had to behave ‘like a girl’ and I am not used to being asked for my opinion, but you ask me to say what I think during these workshops.”   A 13-year-old girl from Syria describes the impact of empowerment workshops in Serbia  Boy is drawing a picture. UNICEF-supported activities for children on the island of Lesvos, Greece The ‘RM Child-Health’ initiative has supported work across five European countries to improve health literacy among refugee and migrant children over the past year. As a result, they and their families have learned about key health issues, about the health services available to them, and how to demand health services as their right. Through its support for health literacy – the ability to find, understand and use information to take care of your own health – the initiative has helped to dismantle some key barriers to health services for refugee and migrant children and their families in Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia. This 27-month, €4.3 million co-funded initiative, which was launched in January 2020 by the European Union Directorate-General for Health and Food Safety, works alongside young refugees and migrants to ensure that they have accurate health information in their own languages – information that reaches them via the channels they use and the people they trust. Importantly, the initiative makes them more aware of their right to health care in these European countries – welcome news for those who have fled from countries where good quality health care is either unaffordable or unavailable. With support from the initiative, UNICEF and its partners first worked with young refugees and migrants to identify gaps in the information available to them and in their own knowledge. This informed the health literacy packages that have been rolled out in all five countries over the past year, spanning a wide range of topics from immunization and nutrition to sexual and reproductive health (SRH) and gender-based violence (GBV). The packages themselves have been backed by detailed plans to ensure that their messages reach their audiences and gain real traction. Great care has been taken to ensure that information materials are culturally appropriate, gender sensitive and child-friendly, and that they are suitable for the ages and backgrounds of their audiences. Cultural mediators and interpreters have helped to overcome language and cultural barriers, while materials have been made available in, for example, Arabic, Farsi and Pashto. Activities have often been led by trusted professionals, such as nurses, physicians and psychologists who are already familiar with the needs of refugee and migrant children and their families. Materials have been shared through channels and locations that are well-used by refugees and migrants, including asylum offices, temporary reception centres, health centres, Mother and Baby Corners (MBCs), workshops and discussion sessions, during outreach activities and via social media. As a result, health literacy is now embedded into existing activities with refugee and migrant children and parents across all five countries, and is based firmly on their views and needs. In Bosnia and Herzegovina, information workshops have been tailored to the needs of different groups of children, including those who are unaccompanied and separated. Topics over the past year have included personal and oral hygiene, drug and alcohol use and its impact on health, the importance of immunization, early childhood development, medical referrals and the proper use of medicines and the risks of self-medication, as well as COVID-19 risks and prevention and services for those with symptoms. Health literacy on immunization, for example, has been strengthened through close cooperation with the Institutes for Public Health and local primary health centres, helping to ensure that refugees and migrants are aware of the national immunization calendar and protocols.  In all, 1,428 refugee and migrant children and their parents have received vital information on immunization, 840 have received information on mental health and psycho-social services, and 580 (nearly double the target) have received information on maternal and child health care and nutrition.  In Bulgaria, the initiative has supported group sessions that have exceeded their targets, with 99 sessions held for refugee children and mothers – more than three times the 28 sessions envisaged. There were more than twice as many information sessions on gender-based violence as originally planned: 107 rather than 48. In all, 600 refugee and migrant children and their parents have received information on immunization, 600 on mental health and psycho-social services, and 600 on maternal and child health, with every target for these areas met or surpassed in terms of the numbers of children reached.   “Guiding 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.”    Yura, a social worker with the Council of Refugee Women in Bulgaria (CRWB) In Greece, support from the initiative has enabled UNICEF and its partners to equip refugee and migrant children with information on health risks, entitlements and services through its non-formal education programme in urban areas and on the islands. In the first full year of the initiative, 1,796 children and 464 parents have received crucial information to help them safeguard their own health.   In addition, information on mental health risks, entitlements and services has been shared with 587 refugee and migrant children on Lesvos through existing psychosocial support activities at the Child and Family Support Hub (CFSH), including counselling, information sessions, parent sessions and more. Refugee and migrant women and children using the UNICEF-supported Safe Space in Athens and the CFSH on Lesvos have had access to information on GBV, with 1,313 women and 687 children reached to date. Another 1,183 mothers and 596 children have received information on maternal and child health via the CFSH on Lesvos and at child-friendly spaces within the Asylum Service Offices in Athens and Thessaloniki.  In Italy, there has been an emphasis on peer-to-peer health literacy over the past year. Young refugees and migrants have shared critical health messages through, for example, the U-Report on the Move platform – a user-friendly, cost-effective and anonymous digital platform with more than 6,000 subscribers, where they speak out on the issues that matter to them. Brochures on immunization, mental health and GBV have been translated into seven languages, and a live chat on reproductive health and the concept of ‘consent’ has been conducted in partnership with the United Nations Population Fund (UNFPA). ‘Q&A’ publications have provided clear answers to burning questions on immunization, mental health and GBV, with short videos explaining, for example, what to do if someone you know has been subjected to violence, and how to protect yourself from online abuse. In the first full year of the ‘RM Child-Health’ initiative, more than 10,887 refugees and migrants in Italy have benefited from critical information on health-related risks and services. The health literacy package supported by the initiative is being shared beyond refugee and migrant communities to reach local communities and key stakeholders, with human interest stories aiming to increase public awareness of the lives of refugees and migrants. The initiative’s targets for health literacy in Serbia have also been exceeded, with 1,094 refugee and migrant children and parents receiving information on mental health (original target: 500) and 722 receiving information on GBV (original target: 600). Looking beyond the sheer numbers of beneficiaries, those taking part in health literacy workshops, in particular, have voiced their appreciation. One woman from Syria who took part in a GBV workshop commented: “I think that women, especially in our culture, do not recognize violence because they think it’s normal for men to be louder, to yell, that they have the right to have all their whims fulfilled even if their wife wants or needs something different. It is a form of inequality we are used to. That is why it is important to talk about it, as you do, to have more workshops on these topics with women from our culture, so that we realize we should not put up with anything that is against our will or that harms us and our health.”   Another woman from Syria, who participated in a workshop on mental health and psychosocial support, said:  “If it weren't for these workshops you’re organizing, our stay in the camp would be so gloomy. I notice that women are in a much better mood and smiling during the workshops, more than in our spare time. You have a positive impact on us.”   Materials have been available in six languages and have covered access to health services, mental health issues, GBV, breastfeeding and infant and young child feeding, breastfeeding during the COVID-19 pandemic, recommendations for parents of children aged 1-6 months, recommendations for children aged 7-24 months, and substance abuse. To reach key stakeholders beyond refugee and migrant communities, a project information sheet and human-interest stories have been widely shared via social media and other well-used channels. Work is now underway in Serbia, with support from the ‘RM Child-Health’ initiative, to develop a new information package and tools to prevent and respond to sexual violence against boys. This will be rolled out in 2021 in close partnership with key actors in child protection, including those who work directly with boys from refugee and migrant communities. The first full year of support from the ‘RM Child-Health’ initiative shows what can be achieved when refugee and migrant children, women and parents are all treated as champions for their own health, rather than the passive recipients of health care. Once equipped with the right information, including the knowledge of their fundamental right to health services, they are more likely to demand the health care to which they are entitled. Logo - Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe This story is part of the Project ‘Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe’, co-funded by the Health Programme of the European Union (the ‘RM Child-Health’ initiative). 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 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. 
Programme
29 January 2021
Improving health literacy among refugee and migrant children
https://www.unicef.org/eca/stories-region/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.”  
Article
30 November 2018
HIV-positive… and fearless
https://www.unicef.org/eca/stories/hiv-positive%E2%80%A6-and-fearless
During the first TEDxYouth event organized on 17 November in Kazakhstan, Baurzhan, age 13, and his mother Aliya spoke about living openly with HIV.  This is his story. Standing before more than 100 people, Aliya asks if anyone in the audience remembers the incident in 2006 when 149 children in southern Kazakhstan were infected with the human immunodeficiency virus (HIV) at a local hospital. A few hands go up.  Hesitantly. “Not too many,” sighs Aliya. “That’s 149 families facing profound pain, shock, complete lack of support and understanding.” Indeed, when the news first broke at the time, there was very little by way of public understanding and sympathy.  On the contrary, the families affected have spoken about the pervasive rumors – including one suggesting that a special area would be built to quarantine the families – that they had to endure.  Some families were even broken up.  The sense of isolation still persists for many. “In our society,” Aliya says, “HIV is still perceived to be a ‘plague’ of the 21 st century. These families and children are hiding.  They do not open up about their HIV status. These children are still invisible to society.” Then she adds, “They all live in great fear. All, but one.” A voice chimes in.  “I am one of those 149 children.  I am HIV-positive and today, I am the only teenager in Kazakhstan with HIV who is living openly,” says Baurzhan, age 13. Baurzhan and his mother at their home in Kazkhstan. Working towards acceptance Aliya’s son Baurzhan was just nine months old when she learned that the blood transfusion he had received for treatment was infected with HIV.  When he started going to school, Baurzhan understood that there were different kinds of viruses and one of them happened to be living in him.  He did not feel different, until teachers asked him not to play during recess or physical education class. “We realized that for school to be an understanding environment, we needed to organize training, raise awareness among teachers on the importance of tolerance towards children with such illnesses,” his mother says. The lanky teenager remembers crying in the school gym changing room after his classmate called him offensive names related to HIV.  “I was not ready to hear it.  It hurt a lot.” The incident made Aliya realize that students needed awareness training, too. She helped the school organize lessons on child rights and responsibilities explaining the universality of rights.  After the first session, the boy who had offended Baurzhan apologised for what he had said. “For 11 years, I have been taking medications every day to control the amount of virus in my blood. My immunity is 900 cells. Do you know that the immunity of a healthy person is 1200 cells? So, my immunity is that of a healthy teenager,” he says.  “My viral load is less than 50 copies. This means that I am just a carrier, but I cannot transmit the virus while I am taking medications.” Together with friends, Baurzhan created a self-help group called “Asian teens” where they share their experiences of living with HIV. “I want to support other kids who are living in fear because of their HIV status. I want to be a role model of living openly and without any fear.”  As Baurzhan says these words, the audience erupts in standing ovation. After the TEDx talk, Baurzhan and his mother said that many people approached him and asked if they could give him a hug. “I really liked the feeling of speaking in that room – it was filled with warmth, the audience showed that they cared”, he said. “My friends who are also living with HIV cannot wait to see my video, I think they will be surprised to see the positive reaction my story received.” Baurzhan with his sibling at the family home. Baurzhan with his sibling at the family home. HIV today and steps for the future Since the outbreak in 2006, the HIV/AIDS situation has changed. By 2010, UNICEF helped decrease the rate of HIV transmission from mother to child in south Kazakhstan, which at the time had the highest number of deliveries by HIV-positive women. At country level, joint efforts of the Ministry of Health and UNICEF led to dropping the HIV transmission rate from 10.9 per cent in 2007 to 1.8 percent in 2014. Kazakhstan is now submitting a request to be certified as a country that virtually eliminated mother-to-child HIV transmission. However, more work remains, says UNICEF Health and Nutrition Officer Kanat Sukhanberdiyev. “Globally, we still see that many children are dying from HIV/AIDS. We have a long way to go until children and adolescents with HIV receive the full package of healthcare and psychosocial support.” On this World AIDS Day, UNICEF is calling on the world to increase investments in HIV prevention, testing and treatment programmes.  Otherwise, by 2030, the lives of some 360,000 adolescents will be at risk of AIDS-related diseases. Find out more about UNICEF’s work on HIV in Kazakhstan.
Article
27 October 2021
“I’d settle for a year being sick, as long as it’s not her, not for a single day”
https://www.unicef.org/eca/stories/id-settle-year-being-sick-long-its-not-her-not-single-day
Little Varya was 3 years old when Alexei and Nastya Naumov adopted her from an orphanage.   They had long dreamed of children, when they found this girl who looked so much like Alexei Naumov. Nothing could stop them: neither difficulties, nor Varyusha's diagnosis – HIV, which the orphanage told them about right away.  Varya Varya at the New Year celebration Nastya and Alexei decided that they wouldn’t conceal their now 9 year old daughter’s diagnosis. It is better to put all the cards on the table, than constantly have to look over their shoulder, they say. The parents always emphasize: they have never regretted their decision.  In November 2018, when Varya was in the first grade, she fell ill with scarlet fever. The family had just moved to Almaty from Atyrau. Nastya Naumova brought her daughter to two pediatricians, but they did not suspect anything. And then their infectious disease specialist at the AIDS center confirmed the diagnosis. ‘Guys, you have scarlet fever,’ she said.  “It seemed to me that this was a forgotten disease, that it is simply impossible. Varya has recovered, but I was still afraid. And as it turned out, not in vain,” says Nastya.  The Naumovs were warned that live vaccines are contraindicated for a child with HIV.   “I was afraid that Varya would get infected,” Anastasia says. “I didn’t know how the virus would work with her diagnosis, how it would affect the body. And, thank God, for a long time she was able to avoid infection. But, as it turned out, not measles.”  In Kazakhstan all children diagnosed with HIV usually receive a medical contraindication for vaccination, which applies to the so-called live vaccines against measles, mumps and rubella. Although in accordance with the WHO clinical protocol, a vaccine against measles, mumps, and rubella (MMR) and other measles-containing vaccines (MCV) should be considered for HIV-infected patients who are asymptomatic or mildly immunosuppressed, as per the routine national schedule. For infants with high risk of exposure to the measles virus, an additional dose of single-antigen measles vaccine administered at 6–11 months of age is recommended, followed by a first dose of routine MMR or another MCV at age 12 months or older (with a minimum interval of 1 month between doses).1 Parents can learn more about each vaccine, included into the National Vaccination Calendar, at a special website dedicated to children routine vaccination:  EGU.kz    In February 2019, when Varya was preparing to go to school, she noticed red dots on her legs: hemorrhagic vasculitis. Nastya and Varya were immediately taken to the hospital; they thought it was an allergy. For 3 weeks the child was not diagnosed, doctors had not realised that it was measles.  Anastasia Naumova shares her story Anastasia Naumova shares her story Later, it turned out that hemorrhagic vasculitis was Varya’s body's reaction to measles. The incubation period was already in progress. But the doctors the Naumovs visited did not understand this. Their infectious disease specialist arrived at the hospital only after Varya's temperature rose to 40 degrees, and diagnosed her with measles. Varya and her mother were taken to the infectious diseases hospital. Varya at the hospital with measles Varya at the hospital with measles “I will never forget the following 10 days…,”  Nastya says.  Varya fell seriously ill. She was burning with a fever, crying from pain at night. There was nothing Nastya could do to help her child. “I have hardly slept these ten days. I would lean on the table, doze off, the timer would go off - I set Varya's temperature to be measured every hour. And you can't do anything - the treatment is symptomatic,”  Nastya says.  The complications were the worst. Varya had right-sided pneumonia, so severe that she could not swallow saliva. How would Nastya give her pills? Water? Food?  “I was almost shoving this pill into her mouth, and Varya cried and shouted: ‘Mom, it hurts! Mom, don't!’ Almost two years have passed since that moment, and I am still shaking. I’d settle for a year being sick, as long as it’s not her, not for a single day. When you see that your child suffers so much simply because someone did not give her the vaccine, how would you feel about it? I have no words,” Nastya says.    In total, they spent about 6.5 weeks in the hospital. During their stay the hospital was full. Children and many adults - all with measles.   Fortunately, Varya pulled through. Emaciated, she weighed 17 or 18 kilograms, weak, but alive. Varya does not mention her illness.   Nastya noticed that after the illness Varya started having problems studying. Apparently, this ten day long fever affected her cognitive abilities.  “I believe if opponents of vaccination ever saw how people bear measles, they would think about it. It's a shame that children who have medical contraindication are at risk,” Nastya says.   The Naumovs then vaccinated their daughter (with those vaccines that are not contraindicated for her) in an ordinary district hospital.   “The child has HIV infection, an incurable disease, but even she did not have a reaction to the vaccine,” Nastya says.  In 2019, there was an outbreak of measles in Kazakhstan with 16,871 cases, of which 13,326 (78.9%) were laboratory confirmed.2 19 children and two adults dies from the disease. Among the victims of measles, 8 children were not vaccinated due to medical contraindications. In 2020, 3,270 cases of measles were registered, of which 2,265 were children under 14 years of age. False contraindications and medical exemptions have been identified as one of the main causes of missed opportunities to vaccinate against measles during the root cause analysis conducted by UNICEF Kazakhstan. The analysis was the part of the UNICEF Kazakhstan Measles Outbreak Prevention Program funded by the US Agency for International Development (USAID).   “We sincerely thank USAID for partnering in such an important program for children's lives to prevent a measles outbreak in the future and strengthen the immunization programme in Kazakhstan. We believe that this project will help save and preserve the lives and health of Kazakhstani children and families," said the UNICEF Representative in Kazakhstan Arthur van Diesen.  The Program provided technical support to analyze the causes of the measles outbreak, study parents' views on vaccination and awareness campaigns, as well as recommendations for improving the supply of vaccines and building the capacity of healthcare workers for immunization. For example, UNICEF is providing a series of trainings to address false contraindications in cooperation with the Association of Family Doctors of Kazakhstan in Aktobe, Atyrau, Eastern-Kazakhstan, Kyzylorda, Turkestan, Karaganda oblasts, Almaty and Shymkent.  
Article
16 September 2020
Precious support in the game of life
https://www.unicef.org/eca/stories/precious-support-game-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.
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
21 September 2020
Oasis of health and joy
https://www.unicef.org/eca/stories/oasis-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
Article
01 February 2021
Strengthening the implementation of health policies
https://www.unicef.org/eca/stories/strengthening-implementation-health-policies
The initiative also promotes and supports multi-disciplinary approaches and teams to address the complex causes of health problems among refugee and migrant children – from trauma, anxiety and over-crowded conditions, to lack of hygiene facilities and immunization. As a result, support from the ‘RM Child-health’ initiative builds trust between refugee and migrant families and health providers. At the Centre for refugees and migrants near Bela Palanka in south-eastern Serbia, for example, the needs of refugee and migrant women have shaped the development of the Community Centre run by ADRA, with its Mother and Baby Corner for women with infants. Here, women can take part in language classes, sports activities and, crucially, in workshops about their own health and rights. “ The most important thing is that all the advice from our doctor is in line with their economic circumstances and current living situation [in Reception centres],” explains social worker Andja Petrovic. “The advice is tailored to their life and I think they particularly like that, because they can see that their situation is acknowledged. Because when they go to a doctor [in other facilities], they get advice that they can’t follow because they don’t have the living conditions for it.” Also in Serbia, funding from the ‘RM Child-health Initiative’ supports work by UNICEF and the Institute of Mental Health that looks beyond the provision of basic health care to assess the scale and nature of substance abuse among refugee and migrant communities. This cutting-edge field research will guide the development of materials and capacity building specifically for health and community workers who are in regular contact with young refugees and migrants, helping these workers to identify and tackle substance abuse by connecting children and youth to support services. As one researcher involved in the research commented: “Most of those children have spent several years without a home or any sense of stability. They can't make a single plan about the future since everything in their life is so uncertain. I can't begin to imagine how frightening that is.” By building greater rapport between frontline workers and children, and by equipping those workers with the support, skills and resources they need, the ‘RM Child-health’ initiative is helping to transform health policies into health practice. This vital work has been particularly crucial in 2020, as frontline workers have had to confront – and adapt to – the greatest public health crisis in living memory: the COVID-19 pandemic. Logo This story is part of the Project ‘Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe’, Co-funded by the Health Programme of the European Union (the ‘RM Child-Health’ initiative).It represents the views of the author only and is her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.
Article
29 January 2021
Strengthening national health capacity for refugee and migrant children
https://www.unicef.org/eca/stories/strengthening-national-health-capacity-refugee-and-migrant-children
“This collaboration is helping to stimulate public demand for strong national health systems that work for everybody and that rise to new challenges, such as disease outbreaks.” Afshan Khan, UNICEF Regional Director The ‘RM Child-Health’ initiative has supported work across five European countries to enhance and strengthen the capacity of national health systems to meet the health needs of refugee and migrant children. This work recognizes that a health system that works for such vulnerable children is a health system that works for every child. At first glance, helping a 10-year girl from Iran, now living in Bosnia and Herzegovina, get a new pair of glasses might seem a simple thing. For Maisa, however, this is the end result of a continuum of intensive support, from identifying a girl who struggles with an eye condition, to connecting her to a skilled ophthalmologist. And now Maisa stands in front of a mirror, trying on the glasses that will enhance her life, learning and play. Such a momentous day is only possible when an established health system is equipped to accommodate and respond to the complex needs of refugee and migrant children. Support from the ‘RM Child-Health’ initiative aims to reinforce and enhance health systems across five European countries (Bosnia and Herzegovina, Bulgaria, Greece, Italy and Serbia) so that these systems can deliver the high-quality services that are the right of every child – and that every child needs, regardless of their origins. The aim: to ensure that health systems catch every refugee and migrant child who is in danger of slipping through the gaps. And there are additional benefits: a health system that works for these vulnerable and excluded children is a health system that works for every child, and that can reach those who are so often the very hardest to reach. This 24-month, €4.3 million initiative, which was launched in January 2020 by the European Union Directorate-General for Health and Food Safety, aims to strengthen the capacity of health systems to deliver health care to refugee and migrant children. That means ensuring access to life-saving immunization, to mental health and psycho-social support, and services to prevent and respond to gender-based violence, as well as maternal and new-born health care and nutrition. Stronger health systems are needed to overcome the bottlenecks that confront so many refugee and migrant families when they try to access health care. “ The profound challenges that often confront populations – especially children – on the move can include cultural and language barriers, stigma and discrimination on the part of health providers, and a lack of detailed medical records or paperwork,” says Dr. Basil Rodriques, UNICEF Regional Health Advisor. “They may also have their own reasons to distrust state-provided services, including fears of deportation.”
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