Reaching refugee and migrant children during COVID-19
How funding from the EU ‘Refugee and Migrant Child-Health Initiative’, has enabled UNICEF and its partners to improve refugee and migrant children’s health status in Italy.
With funding from the European Union (EU) ‘RM Child-Health Initiative’, UNICEF and its partners have been supporting the health and wellbeing of refugee and migrant children in Italy, even at the height of the COVID-19 pandemic and the country’s strict lockdowns. As the initiative draws to a close, we look back at some highlights since its launch in 2020.
2020: Support for frontline health care during the COVID-19 pandemic
At the height of the COVID-19 pandemic in Italy and the resulting restrictions, health teams reached out to vulnerable refugee and migrant children and families who have limited access to services, with co-funding from the ‘RM Child-Health Initiative’. In 2020, Italy was one of the countries hit hardest by the global COVID-19 pandemic. Even without a pandemic, refugee and migrant children and families struggled to access healthcare, accurate health information and preventive services like proper sanitation facilities. COVID-19 made everything worse, especially for those in crowded living conditions and limited access to services.
As the country ground to a halt, the INTERSOS health outreach team continued to provide vulnerable children and families with vital health screenings, hygiene supplies and factual information on how to prevent the spread of coronavirus. From June 2020, the team’s activities were supported by co-funding from the ‘RM Child-Health’ initiative and UNICEF. From the beginning of Italy’s national lockdown, the team conducted outreach missions five days a week, every week to provide health screenings.
Abdoul Bassite, originally from Togo, was an INTERSOS outreach worker living in Rome. Abdoul ensured that children and families understood what was happening and how the team could support them.
“The main problem we face is that migrants and refugees are not aware of the risks of COVID-19,” he said. “My job is to meet them and to explain what the virus is, how they can protect themselves and the rules they have to follow in order to be safe."
The other member of the outreach team was Dr. Antonella Torchiaro. She explained:
“We measure their temperature, ask if they have had any respiratory or flu symptoms and, together with the measurement of temperature and oxygen saturation, this helps us to have an overview of the overall situation and therefore to identify what can be defined as a suspected case of coronavirus.”
Abdoul Bassite was well aware of the risks he faces doing this work but was determined to keep helping children and families. “Yes, we are aware of the risks,” he said. “But we are taking all of the precautions to prevent ourselves from getting sick. You know we are very happy doing this work because we know that the small things that we are doing can save lives,” he says.
2021: The community that defended itself against COVID-19
In 2021 we met Josy, a refugee living in an overcrowded building in an informal settlement on the edge of Rome. Around 500 people from all over the world were living there, with families sharing bathrooms. Not surprisingly, they had reacted to the arrival of the COVID-19 with real trepidation. In a cramped place like this, the impact of COVID-19 would be devastating for people’s emotional, as well as physical, health.
"When COVID arrived here, I thought: it's over, it will spread throughout the building,” said Josy. “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 received by INTERSOS and UNICEF."
With support from the ‘RM Child-Health’ Initiative, INTERSOS and UNICEF had selected and trained volunteers from this informal settlement to work with the health authorities to manage suspected cases of COVID-19. These volunteer health promoters proved to be critical in raising awareness and sharing information among the families in Josy’s building.
As a result, when the first cases of COVID-19 appeared in the building, this community was prepared and ready for action. Thanks to the work of the INTERSOS mobile team and the health promoters, people already knew how to protect themselves and others against the risk of infection. They worked in shifts to clean and disinfect all rooms. They set aside part of the building to isolate and care for those who had tested positive for COVID-19, supporting their emotional, as well as physical wellbeing.
The results exceeded every expectation. Infections were contained and people emerged from the pandemic with a new feeling of strength, and a growing awareness of the power of their own community.
2022: Periods do not stop for girls on the move
Menstruation is an entirely natural process, yet it often remains a cultural taboo. The problems faced by women and adolescent girls during their periods are compounded when they are on the move. Periods do not stop for refugees and migrants, and finding information, services and menstrual products can be a real challenge.
Responding appropriately to women and girls’ menstrual health needs while they are on the move and during a crisis should be always a key priority. Now, with support from the ‘RM Child-Health’ Initiative, migrant and refugee women and girls in Italy can access information on sexual and reproductive health rights (SRHR), including information on menstruation through the digital platform U-Report on the Move. Through the platform, UNICEF provides refugee and migrant women and girls in Italy with information on SRHR, including information on how to manage their menstruation. The platform has adapted its activities to meet the needs of these girls and women for information, including many Ukrainians who have arrived in Italy since February 2022. Relevant information on SRHR is available in adolescent-friendly formats and in different languages.
This matters, because if the needs of women and girls for SRHR are not met it will have an impact on their personal choices. For example, menstrual hygiene management is not only about sanitation: it has a fundamental role in enabling women and girls to reach their full potential. Without it, they may face discomfort, shame and limits on their movement, as well as risks of infection. Lack of access to menstrual products may also affect their school attendance and participation in community life.
With support from the ‘RM Child-Health’ Initiative, UNICEF has also worked with the United Nations Population Fund (UNFPA) to produce a booklet on SRHR, based on consultations with young people and experts. This provides basic information on SRHR for refugee and migrant adolescents and young people in Italy.
Taking stock of the ‘RM Child-Health’ Initiative in Italy
- 725 refugee and migrant children participated in UNICEF-supported psychosocial support sessions and referrals to specialized mental health services – almost 3 times more than the number originally targeted for the Initiative.
- 450 refugee and migrant children participated in UNICEF-supported gender-based violence (GBV) prevention activities and referral to national authorities’ GBV response services – 3 times more than the number originally targeted.
- Implementing partners: Centro Penc, INTERSOS, Medicins du Monde, Save the Children.
The independent evaluation of the ‘RM Child-Health’ Initiative has taken stock of its impact in Italy since 2020. It has confirmed that the Initiative’s preventive, cross-sectoral and comprehensive approach to health is helping to build long-term resilience. Italy is a prime example, as refugee flows into the country have changed in terms of their origins and arrival locations. More refugees are now arriving from Greece and Turkey, rather than via the North Africa route, and refugees are arriving in different locations, such as Calabria and Sardinia, rather than Lampedusa in Sicily. Some have landed on the shores of Roccella Ionica, for example, a small town of just 6,000 inhabitants in Calabria, where health facilities are limited. UNICEF and its partners have been able to draw on the experience of the ‘RM Child Health’ Initiative to create a resilient response by:
- mapping existing services at the regional level so partners can refer new arrivals
- setting up services at the disembarkation point as well as reception facilities, so the team at the disembarkation point can send key information to the team at the reception centre about the health needs of unaccompanied and separated refugee and migrant children, in particular.
- establishing networks of local authorities, service providers and non-governmental organizations to support the response
- drawing on the Initiative’s previous experience on psychological first aid, the information needs of refugees and migrants, and activities to reduce stress so that local partners have ‘ready-made’ solutions to offer new arrivals
- establishing a partnership with an association of cultural mediators that has a roster, enabling partners to mobilize mediators who speak different languages and who understand diverse cultures.
The Initiative has also supported the mapping of best practices and ‘what works’ in mental health and psychosocial support (MHPSS) services for refugee and migrant children, as well as referral mechanisms. It has supported the development of materials in diverse languages that are now available for linguistic and cultural mediators, health workers, social workers and others. These include Q&As on subjects that are often sensitive and difficult for young refugees, migrants and even frontline workers to discuss, such as GBV and (in partnership with the United Nations Population Fund) sexual and reproductive health and rights. Most recently, the Initiative has supported the development, production and dissemination of clear information on menstrual hygiene. All materials have used clear, concise, user-friendly language to dispel the many myths and misconceptions around these issues.
Realizing the greater difficulties faced by refugees and migrants in accessing services as a result of lockdowns, UNICEF’s partners in Italy continued to deliver remote and in-person health screenings and online psychological support and case management to those who were most vulnerable., Brochures on immunization, GBV and mental health and MHPSS were disseminated during the COVID-19 pandemic, as well as short videos on all these topics, which are available through U-Report on the Move.
The impact often went beyond health itself: UNICEF has enhanced the capacity of partners on Protection Against Sexual Exploitation and Abuse (PSEA) and shared indicators and tools to inform work with unaccompanied and separated children, strengthening the capacity of frontline staff to work with these children. One partner also noted that support for documentation linked to COVID-19 resulted in more refugee and migrant children attending school (even if virtually) and a decrease in dropouts.
This story is part of the Project ‘Strengthening Refugee and Migrant Children’s Health Status in Southern and South Eastern Europe’, Co-funded by the Health Programme of the European Union (the ‘RM Child-Health’ initiative). It represents the views of the author only and is her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the European Health and Digital Executive Agency (HaDEA) or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.
 IOD PARC, Evaluation of the UNICEF Project: Strengthening Refugee and Migrant Children’s Health Status in Southern and South-Eastern Europe
 International Professional staff.
 Italy: detailed Implementation Plan, revised 01062020.
 U-Report is a digital platform that lets young migrants and refugees in Italy speak out on issues that matter to them and be heard by decision makers: U-Report On The Move | Linktree
 International Professional staff.
 Government representative.
 International Professional staff.