The Covid-19 crisis is a child rights crisis

Our Representative, Dr. Félicité Tchibindat responds to our most pressing questions on the impact of Covid-19 on children.

By Lalaina Fatratra Andriamasinoro
PM & Rep
UNICEF Niger/Islamane Abdou
01 June 2020

What’s the situation in Niger?

Niger reported its first case of Covid-19 on March 19. Two months later, as of May 19th, the country has recorded 909 confirmed cases of coronavirus disease (COVID-19) and 55 reported deaths. Out of them, 714 people already recovered and 140 are currently under treatment. While all regions are touched by the pandemic, the most affected regions remain Niamey and Zinder, the last one recently presenting a rapid increase in the number of cases. UNICEF closely works with the Government and its partners to step up the response and prevent further proliferation of the COVID-19 virus in the country, already facing the consequences of multiple crisis including malnutrition, conflicts and natural disasters. In countries facing humanitarian crises like Niger, the COVID-19 outbreak is creating significant additional pressure on an already overburdened health and social service delivery systems and exacerbating vulnerabilities in affected populations.

In countries facing humanitarian crises like Niger, the COVID-19 outbreak is creating significant additional pressure on an already overburdened health and social service delivery systems.

In your opinion why Africa, and countries like Niger, are resisting better than the rest of the world?

As of mid-May, most African countries aren’t reporting many cases and they are also reporting very few deaths. In a continent of 1.3 billion people — 17 per cent of the world’s entire population — Africa accounts for barely two per cent of the number of infections and even less than one per cent of the number of deaths. We currently do not have enough evidence to answer your question. What we can say is that African countries have a long experience in dealing with infectious diseases, like Ebola or Polio. This might, in fact, be the basis of the continent’s proactive response. In Niger, even before the country registered its first case, the Government put in place a series of restrictions and social distancing measures including school and mosque closures, movement restrictions, curfew and nationwide state of emergency. To support the government in the area of risk communication and community engagement, we, at UNICEF, have for example activated our existing polio eradication machinery, that includes thousands of town criers, social mobilizers, traditional and religious leaders, community media and youth across the country to raise awareness on Covid-19.

PM
UNICEF Niger/Islamane Abdou
UNICEF plans in the coming weeks to expand these structures both in Niamey and in regions - to reach a total of 170 additional beds.

Easing restrictions doesn’t mean danger has passed. Still, the stakes are high, we need to stay alert and we must double our vigilance. It is a path filled with extra behavioural challenges and risks.

African nations are lifting curfews and gradually returning to daily life. Is this the case of Niger and what is the risk of these measures for children?

Yes, Niger has started easing lockdown restrictions, but easing restrictions doesn’t mean danger has passed. Still, the stakes are high, we need to stay alert and we must double our vigilance. It is a path filled with extra behavioural challenges and risks. Easing the lockdown will mean people gradually getting more freedom to engage in social and economic activities, but also that they must take good care to keep a safe distance from others. Effective mitigation relies on people’s individual decisions to comply with social distancing measures. In Niger, school will reopen early June. When deciding whether to reopen schools, authorities should look at the benefits and risks across education. The best interest of every child should be paramount. Safe operational guidelines should be followed to ensure that children and their families remain protected and informed. This included thorough cleaning of classrooms and facilities, stepping up the provision of safe water, increasing good hygiene practices such as hand washing, and training teachers on how to support students’ positive behavior change and their psychological well-being in times of uncertainty.

How UNICEF and partners are helping to fight coronavirus disease in Niger?

 UNICEF is supporting the Government, and particularly the Ministry of Health (MoH), in the field of risk communication and community engagement (RCCE), infection prevention and control (IPC), supply and logistics, epidemiological surveillance and healthcare provision. We are leading on preventative actions in communities across the country with risk communication, providing hygiene and medical kits to schools and health clinics and monitoring the impact of the outbreak to support continuity of care, education and social services. UNICEF is also working to mitigate the impacts of the pandemic on protection for children and women.

Can you expand a little bit on how that works and give us some concrete examples?

UNICEF played a key role in the development of the Government strategy and response plan, in mobilizing partners and leveraging resources, and also provides technical support and strategic guidance in the development of standard operating procedures adapted to the country for detecting cases, treatment, contacts tracing, alert systems, the development of a supply plan (including drugs, consumables and equipment), the use of protective materials for front-line workers and for prevention and control. UNICEF supports the Government in care and surveillance, by facilitating alert mechanisms for people who present alarming symptoms, supporting the preparation of the community for the investigation of cases, monitoring the contact of people, supporting the isolation process, and managing and treating cases - including those who do not require hospital care. Alongside the Ministry of Public Health, UNICEF co-directs risk communication and community engagement actions in order to raise awareness and encourage the population to adopt barrier gestures that help contain the spread of the virus. In addition to the national campaign waged through traditional and new media - including digital and community media, UNICEF is carrying out a series of actions at the community level by mobilizing town criers and social mobilizers, traditional and religious leaders, and youth. A large part of our actions is directed towards communities In the area of infection prevention and control, support is focused on setting up handwashing facilities and the necessary supplies in health centers and other at-risk areas - both in Niamey and in the interior of the country. UNICEF supports the regular disinfection of health centers, isolation and treatment centers, public infrastructures at risk of infection, and supports compliance with the measures for the safe and dignified burial of patients who have died from COVID-19. UNICEF has started training hundreds of health workers and hygienists on infection and prevention control, aiming at ensuring the safety of health personnel and health service users and reducing the risks of infections at health facilities level. We are providing additional support to ensure the access to basic social and health services - continued care: primary health care for killer diseases, immunization, basic nutrition support, education and protection, social protection and psychosocial support to affected populations, especially women and children

PM4
UNICEF Niger/Islamane Abdou
‘‘I am confident with all the care arrangements you set up at the hospital. We are not going to give up. On my behalf, please encourage all the health personnel in this noble fight. We are looking at the situation through their eyes’’ HE Mr. Brigi Rafini, Prime Minister, when visiting the treatment center in Niamey.

Children in need of basic essential services are at risk of not receiving them. Children could face disruptions in primary care because health facilities are overwhelmed, or families are afraid to seek care due to fear of infection.

According to UNICEF, what is the greatest impact of COVID-19 on the present and future of children in countries like Niger?

The crisis is putting essential services under pressure. These are services which secure the health, education and protection of our children. The most vulnerable children are now facing even greater risks and may be cut off from existing support. Children in need of basic essential services are at risk of not receiving them. Children could face disruptions in primary care because health facilities are overwhelmed, or families are afraid to seek care due to fear of infection. Government had to temporarily postpone preventive mass vaccination campaigns and other community-based services in the country to ensure that the delivery of such services does not contribute to COVID-19 spread, and to follow recommendations on physical distancing. Likewise, the nutrition situation of children under five is expected to deteriorate with the current Covid-19 crisis. Extensive school closures are now affecting all the students across the country. Livelihoods are being threatened or lost, and parents are struggling to make ends meet. These conditions could push families to turn to negative coping mechanisms like child marriage or gender-based violence. Indeed, school closure alone implies additional protection risks for children. We are deeply worried about the next phases of the crisis and the risk of it hitting harder some of the most vulnerable children and families. The COVID-19 crisis is a child rights crisis. Extra efforts should be made to protect those most vulnerable. We will not be safe until the hardest to reach are safe too.

UNICEF
UNICEF Niger/JHARO
Equipped with a triage center, these temporary structures aim to strengthen the capacity of the hospital for the treatment of people infected with the virus and are equipped with the necessary medical equipment, including the provision of oxygen concentrators.

We are deeply worried about the next phases of the crisis and the risk of it hitting harder some of the most vulnerable children and families. The COVID-19 crisis is a child rights crisis. Extra efforts should be made to protect those most vulnerable. We will not be safe until the hardest to reach are safe too.

Can you provide some examples on how the Covid-19 has impacted on children’s social services?

 In the nutrition sector, UNICEF estimates that the number of children suffering from severe acute malnutrition will increase by 30% in Niger this year due to the impact of Covid-19 on the food security situation as well as on access of children and their mothers to appropriate care and basic health services. To this end, UNICEF is reinforcing capacities to respond to a possible surge in admissions for SAM and reduce mortality. UNICEF is also putting in place actions to protect the diets and nutrition services and practices of pregnant women and breastfeeding mothers during this critical period. On child health, with the arrival of COVID-19 a decrease in attendance at health facilities has been noted. Children face disruptions in primary care because families are afraid to seek care due to fear of infection. Around 19% of confirmed cases are among health workers, affecting the treatment capacity in health structures for Covid-19 and non-covid-19 diseases. The country has postponed mass immunization campaigns to ensure that the delivery of immunization services does not contribute to COVID-19 spread. In the area of child protection, border closures and other COVID-19 containment measures have put specific vulnerable groups more at risk, such as children living in the street or children from religious schools, who have been forcibly relocated with often little preparation. Due to COVID-19 economic and physical restrictions and impact on household income and security, gender-based violence has a worrying upward trend with a significant increase in March. On education, the closure of schools has affected 3.7 million children, from preprimary to secondary education. School closures in response to the COVID-19 pandemic present an unprecedented risk to children’s education, protection and wellbeing. And it’s the most marginalized children who are the hardest hit by school closures. We know from previous crises that the longer vulnerable children are out of school, the less likely they are to return.

Can you provide some examples on how the Covid-19 has impacted on children’s social services?
UNICEF Niger/JHARO
Thanks to these temporary centers, the treatment circuit was isolated and allowed the continuity of other health services in complete safety

Niger reported two new cases of circulating vaccine-derived poliovirus early this year. How the Covid-19 has impacted on Immunization services in Niger?

 The Government had to temporarily postpone preventive mass vaccination campaigns to ensure that the delivery of immunization services does not contribute to COVID-19 spread, and to follow recommendations on physical distancing. The country has reported two new cases of circulating vaccine-derived poliovirus. The two new cases of cVDPV occurred in new areas (Niamey and Tillabery), which were not covered by previous subnational immunization days in 2019 and therefore not directly linked to the COVID-19 – related suspension of vaccination campaigns (dates of onset of paralysis for the two polio cases were February 15 and 16 2020) With the arrival of COVID-19 a decrease in attendance at health facilities has been noted but it is not yet affecting the offer and utilization of routine immunization services. However, we noted through data analysis that many children have been missed in first quarter 2020 (1 child out of 3 did not receive the first dose of Polio and the same did not complete the series and 1 out of 3 children is unvaccinated for measles. As the response to COVID-19 continues, we need to act now to ensure essential health services, including routine immunizations, are protected during the pandemic. However, at the same time, we need to minimize the risk of further disease outbreaks and loss of life. This calls for adjusting the delivery of routine immunization services to ensure the safety of health workers, parents and children; strong supply chains and trained health workers; and increased communication on the safety of vaccination services in COVID-19 times.

Now more than ever, it is the time for global solidarity. The costs of the pandemic for children are immediate and, if unaddressed, may persist throughout their lives.

How COVID-19 can further exacerbate the current humanitarian crises across Niger?

Before the pandemic, already 3 million people, more than half children in Niger - were in need of humanitarian assistance, amid the risks posed by insecurity, malnutrition, recurrent disease epidemics and outbreaks, cyclical floods, droughts and displacement. Niger continues to face simultaneous emergencies that are stretching the capacities of humanitarian partners to respond adequately. The situation is exacerbated by instability in the region, including in neighboring countries, resulting in an influx of thousands of refugees, returnees, internally displaced persons and migrants, all needing access to basic social services and protection for survival. The COVID-19 outbreak is creating significant additional pressure and exacerbating vulnerabilities in affected populations. Actions taken to contain the spread of the coronavirus have slowed down the delivery of humanitarian assistance and social services for children’s care and protection in the country. Movement restrictions have greatly impacted on humanitarian access and prevented lifesaving aid from reaching the most in need. Also, humanitarian response is more expensive because of Covid-19 adaptation. Now more than ever, it is the time for global solidarity. The costs of the pandemic for children are immediate and, if unaddressed, may persist throughout their lives.