Global Annual Results Report 2021: Every child survives and thrives
Goal Area 1: Progress, results achieved and lessons from 2021
As UNICEF marks its seventy-fifth year of service, it faces the sobering reality of multiple and overlapping threats to the health and well-being of children, their families and their communities. These threats - including the effects of climate changes and climate-related disasters, an increase in numbers of children living in conflict zones. and a dramatic increase in multidimensional poverty - compound already significant vulnerabilities and deprive children of access to health care and adequate nutrition, as well as many other rights essential to their growth and development. It is within this troubling and complicated global environment that UNICEF and its broad range of national and international partners continued to push forward, with a steady focus on reaching all children, everywhere, with high quality, equitable rights-based support.
This commitment is based on the Convention on the Rights of the Child, the Convention on the Elimination of All Forms of Discrimination against Women and the Convention on the Rights of Persons with Disabilities, through which UNICEF strives to address inequalities, abuses and discriminatory practices that prevent children from accessing their full human rights.
UNICEF’s work in health is focussed on reaching the most vulnerable children, the so called ‘zero-dose children’ who often face multiple deprivations. With a focus on these children, informed by human rights approaches and principles, UNICEF uses primary health care as a foundation to deliver results at-scale, through integrated and multisectoral programming, so that children can survive and thrive.
Maternal and newborn health
UNICEF works with partners to help countries in saving the lives of newborns by supporting high-quality, low-cost care and services at health facilities and at home and by working towards the elimination of maternal and neonatal tetanus. UNICEF supports 52 high-burden countries in the provision of antenatal and postnatal care, skilled attendance at birth and deliveries in health-care facilities.
38.9 million live births
were delivered in health facilities through UNICEF-supported programmes
strengthened the quality of maternal and newborn care with UNICEF support in 52 UNICEF high-burden countries
80 per cent of live births
were attended by skilled health personnel in 52 UNICEF high-burden countries
3,618 health care facilities
in UNICEF-supported programmes were supported with WASH facilities
8 million women of reproductive age
were reached through UNICEF supported supplementary immunization activities in four countries – CAR, Nigeria, Pakistan and South Sudan – with more than 80 per cent vaccination coverage to prevent maternal and newborn tetanus
Quality of maternal and newborn care is critical, especially for sick newborns
The quality of care before, during and after childbirth is critical for healthy outcomes for mothers and newborns.
Sick Newborn Care Units are special newborn units in large hospitals, generally at district level that aim to reduce the case fatality among sick newborns.
Kangaroo mother care (KMC) is a practice that uses skin-to-skin contact to warm and nurture a new-born baby in particular pre-term and low birth weight newborns: KMC can substantially increase a preterm or low-birthweight baby’s chances of survival.
In Ethiopia: High risk mother giving birth to a high-risk newborn
In the Dominican Republic: Skin-to-skin contact has been a gift of life for little Nellys
Working towards maternal and neonatal tetanus elimination
UNICEF and partners remain committed to the elimination of maternal and neonatal tetanus, and are working to reduce the incidence of maternal and neonatal tetanus to 1 in every 1,000 births. UNICEF remains the flagbearer of the Maternal and Neonatal Tetanus Elimination (MNTE) Initiative and, together with WHO, augments technical assistance to countries for steering planning, implementation, and monitoring processes.
25 years of success: Achievements that are saving and improving lives
Children’s survival and thriving was and will continue to be guiding principles behind UNICEF’s work. Throughout the 2018–2021 Strategic Plan period, UNICEF continued to be the voice for children and adolescents and provided direct service provision to ensure access to rights-based, equity-focused HIV prevention and treatment services and intensified global advocacy.
UNICEF provided efficient and tireless technical support and policy advocacy to drive strong results in two main areas that focus on treatment and care of pregnant and breastfeeding women, children and adolescents living with HIV and adolescent HIV prevention in in 35 HIV priority countries experiencing the highest burden of disease. Despite these efforts however, the global 2020 target of reducing new HIV infections in children to fewer than 20,000 was not reached, with 160,000 new child infections reported that year. Results for children are, however, slightly better in UNICEF 35 Strategic Priority countries.
It is clear that the AIDS epidemic is not over. The pace of progress is too slow to meet the 2030 SDG targets. To promote faster and more consistent improvement, the new UNICEF Strategic Plan emphasizes differentiation, integration, partnership and innovation to address barriers to inequalities.
Reasons for stalled progress in 2021: Inequalities that are leaving too many behind
335.9 million children
were reached with services to prevent stunting and other forms of malnutrition - a 38 per cent increase from 2020
67.4 million adolescents
benefited from services and support to prevent anaemia and other forms of malnutrition – a 90 per cent increase from 2020
5.4 million children
received treatment for life-threatening wasting – a 10 per cent increase from 2020
Children and their families need access to nutritious diets, essential services and positive practices that set them on the path to survive and thrive. UNICEF prioritizes interventions to prevent all forms of malnutrition – including stunting, wasting, micronutrient deficiencies and overweight. Where prevention falls short, the early detection and treatment of wasting and other forms of life-threatening malnutrition are critical to save lives and return children to healthy growth and development.
In 2021, UNICEF supported countries to recover from pandemic-related service disruptions, helping them regain – and at times accelerate – progress towards targets. Despite the setbacks of the last two years, UNICEF achieved or exceeded nearly all nutrition targets in its Strategic Plan 2018–2021.
Prevention of stunting and other forms of malnutrition
The primary objective of UNICEF nutrition programmes is to prevent maternal and child malnutrition in all its forms. UNICEF works with governments to:
- improve access to nutritious, safe and affordable diets
- support good-quality nutrition, health, water and sanitation services
- promote optimal feeding, hygiene and care practices.
These foundations of good nutrition fuel children’s growth, development and learning in childhood, with benefits that endure across generations.
UNICEF support from 2018 to 2021 allowed more countries to improve children’s diets and strengthen policies and programmes to prevent malnutrition in early childhood:
Fed to fail? Tackling the crisis of children’s diets
Most children are not being fed enough of the right foods at the right time in their development. This crisis of child diets has been compounded by the COVID-19 pandemic, which left many families facing significant barriers to accessing nutritious, safe and affordable diets in 2020 and 2021. UNICEF is working to change this. Read the Fed to fail? report.
Do you eat lunch in the restroom?of children’s diets
In Mexico, UNICEF is supporting an innovative campaign to promote breastfeeding-friendly policies in the workplace. UNICEF worked with the Government and partners to: issue a series of recommendations to support breastfeeding; foster dialogue with national companies; produce a national guide to promote nursing rooms in businesses; and develop communication materials to raise awareness about breastfeeding support in the workplace.
1.6 million children
accessed stimulation, care, play and learning in humanitarian settings in 2021
Early childhood remains one of the most crucial periods for children’s holistic development, given the profound, lifelong impact of early experiences on children’s future learning, health and earning potential. Early childhood development (ECD) interventions that integrate across health, nutrition, education, child protection, social policy and other sectors are key accelerators towards programme impact. Throughout the 2018–2021 Strategic Plan period, UNICEF drove strong results in three output areas: enhancing ECD policy environments, institutionalizing multisectoral ECD programme packages and integrating ECD interventions into humanitarian action.
Generating demand for services and improving service delivery at scale
Countries have increasingly adopted, implemented and institutionalized multisectoral ECD packages integrating responsive caregiving, early stimulation, and other essential services across sectors.
In 2021, a total of 128 countries had government-owned multisectoral ECD packages, including 61 countries with costed action plans, paving the way for a sustainable scale-up of packages. ECD intervention packages include
In Serbia: Caring for the Caregiver pilot
UNICEF is empowering mothers and fathers to nurture playful interactions with their children in Serbia. Preschool teachers, visiting nurses and social workers teach parents ways in which to engage their children in play and early learning and support them in coping with the stresses that are inherent to parenthood. Serbia is one of eight countries that piloted UNICEF's Caring for the Caregiver approach, with support from the LEGO Foundation.
Enhancing enabling policy environments for implementation at scale
Throughout the Strategic Plan period, UNICEF and partners continued to work in country to strengthen ECD policy environments. Ninety-nine countries had established ECD national policy or action plans in 2021, and the number of countries reporting having two or more family-friendly policies (FFPs) – on parental leave, support for breastfeeding, access to good-quality childcare and child benefits – has more than doubled. Yet, even as upward trends are expected to continue, policy gains must be protected amid potential loss of political will and investment in the ECD agenda.
In Rwanda: Supporting working mothers
A mother leaves her children at a day care centre during the hours she works on a tea estate in Rwanda. The children receive care and meals and have opportunities to play and learn with other children. The mother is more productive at work, and she has more time for herself and her family. FFPs help parents balance work and family life by increasing their access to time, resources and services
Renewed focus on ECD in emergencies – Action in humanitarian settings
Armed and violent conflict, natural disasters and chronic emergencies have acute impact on young children's development, and the effects of prolonged exposure to violence and insecurity in early childhood can last a lifetime. UNICEF's priorities for children under 5 in humanitarian action are to ensure they have safe and equitable access to ECD and early learning interventions and support their parents and caregivers in providing nurturing care. Over the Strategic Plan period, more countries began incorporating ECD into their humanitarian responses.
ECD in humanitarian action
UNICEF reached 1.6 million children under 5 years in 76 countries affected by humanitarian situations with early stimulation, care, play and learning interventions in 2021.
This report highlights the achievements made possible by the generous contributions of softly earmarked thematic funding received from various partners. UNICEF would like to express it's sincere appreciation for these contributions.
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Throughout 2021 countries around the world continued to combat and recover from the COVID-19 pandemic. And while notable progress has been made in some of the results areas since the adoption of the Sustainable Development Goals in 2015, the world remains significantly off-track towards meeting many of them. Despite significant global challenges, UNICEF is deeply committed to reaching the SDGs through high quality and targeted programming, robust partnerships at the country, regional and international levels, and passionate advocacy on a global scale to keep the rights of children at the forefront of the development agenda.
This report covers progress made for children and their communities during 2021 through UNICEF’s Goal Area 1, which feeds directly into SDGs 2, 3, 4 and 5 by bringing together four interconnected programmes – health, nutrition, HIV/AIDS and early childhood development (ECD) – with the aim of ensuring that all children survive and thrive.