Children and COVID-19 Research Library

This scientific brief was prepared based on results of evidence synthesis and a WHO expert consultation. The WHO COVID-19 LENS (Living Evidence Synthesis) working group consolidated available evidence, based on rapid reviews of the literature and results of a living systematic review on pregnancy and COVID-19 (up to October 7, 2020), on potential mechanisms of vertical transmission of infectious pathogens, feasibility of vertical transmission of SARS-CoV-2, data related to interpretation of positive SARS-CoV-2 virologic and serologic neonatal tests, lessons from diagnosis of other congenital infections, and existing proposed definitions to classify timing of vertical transmission of SARS-CoV-2. WHO convened a multidisciplinary, international panel of experts between October and November 2020 to review the evidence and propose a consensus initial classification system for the timing of vertical transmission of SARS-CoV-2. The panel included experts in obstetrics, neonatology, paediatrics, epidemiology, virology, infectious disease, congenital infections, and placental pathology. The selection of the panel ensured geographic representation, gender balance, and no important conflicts of interest, in accordance with WHO standard procedures.

Good nutrition during childhood and adolescence is key to ensuring optimal growth, health and well-being. Healthy dietary practices in early life have an immediate impact on healthy growth and help prevent noncommunicable diseases (NCDs) later in life and across generations. Good nutrition in childhood is also good for school performance and educational outcomes, impacting on nations’ economic and social development. Since children spend so much time in school, the school environment is an important setting for children to acquire habits, skills and knowledge related to healthy diets and physical activity. In 2016-17, the vast majority of countries (89%) reported implementation of school health and nutrition programmes although inclusion of a comprehensive set of interventions was rare and implementation of such programmes appears to have weakened since the start of the decade.

This global progress report on water, sanitation, hygiene, waste management and cleaning (WASH) in health care facilities comes at an unprecedented moment, when coronavirus disease (COVID-19) is exposing key vulnerabilities in health systems, such as inadequate infection prevention and control. WASH services in health care facilities, so often taken for granted – or as this report highlights, outright neglected – are needed more than ever to protect vulnerable health workers and patients. The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities lack basic water services, and one in 10 have no sanitation services.

The COVID-19 pandemic has created the largest disruption of education systems in history, affecting nearly 1.6 billion school-age children in more than 190 countries. Already last year, 250 million school-age children being out of school, the world was facing a “learning crisis”. But now with the COVID-19 pandemic, this crisis could turn into a generational catastrophe. While many children will continue with their education once schools reopen, others may never return to school. Current estimates indicate that 24 million children will never return to the classroom and among those, disproportional number of girls. To avert this crisis, we need to reimagine how we deliver good quality and inclusive education to the world children. Among other things, this calls for urgent investments in school health and nutrition programmes and create the conditions for children to lead healthy lives. This also includes health and nutrition literacy offered through the curriculum and through counselling in the school health services which provides young people with knowledge, skills, values, culture and behaviours they need to lead healthy, empowered lives.

There is a high risk that the COVID-19 pandemic may reverse decades-long progress on reducing child mortality and affect the number of stillbirths. This new release of the first-ever joint stillbirth estimates by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) presents the number of babies that are stillborn every year due to pregnancy and birth-related complications, the absence of health workers and basic services. The issue has become an essential part of global child survival initiatives. UNICEF calls on international organizations, governments and partners for increased and strong political will, sound policies and targeted investment along the continuum of care for every mother and child.

This brief provides guidance for governments, policymakers, UN agencies and development partners to address non-communicable diseases (NCDs) as an integral part of the COVID-19 response and in broader efforts for achieving the 2030 Agenda for Sustainable Development. NCDs, such as cardiovascular disease, cancer, diabetes and chronic respiratory disease, are amplifying the impacts of COVID-19, and COVID-19 is exacerbating the burden of NCDs, particularly in already disadvantaged communities. Almost one fourth (22%) of the global population is estimated to have an underlying condition that increases their vulnerability to COVID-19, and most of these conditions are NCDs. Urgent action across sectors is needed to address the root causes of NCDs and increase access to affordable and quality treatments and prevention.

Since the Every Woman Every Child movement was launched 10 years ago, there has been remarkable progress in improving the health of the world’s women, children, and adolescents, including reducing maternal and child mortality and improving child nutrition and education. However, conflict, climate instability, and the COVID-19 pandemic are putting all children and adolescents at risk . In particular, the COVID-19 crisis is exacerbating inequities, with reported disruptions in essential health interventions disproportionately impacting the most vulnerable women and children.
This report notes that the COVID-19 pandemic has made clear how fundamental good data are across sectors; that greater investments are needed to build resilient systems to provide high-quality and integrated services consistently; and COVID-19 recovery efforts  require multilateral action and continued investment in development.

There have been dramatic reductions in child and youth mortality over the last 29 years. Globally, under-five mortality has dropped by 59% since 1990—from 93 deaths per 1,000 live births then to 38 deaths in 2019. Initial evidence suggests that the impact of COVID-19 on direct mortality for children and youth may be small, but indirect effects can be severe. Many life-saving services have already been disrupted by COVID-19. 

Global school closures in response to the COVID-19 pandemic affect up to 1.6 billion children and present an unprecedented risk to their education and well-being. WHO and UNICEF guidelines on infection prevention in schools identify a range of measures that need to be in place for schools to reopen and operate safely, including regular hand-washing with soap and water, daily disinfection and basic drinking water and sanitation services.

Immunization is one of the most cost-effective public health interventions to date, saving an estimated 2 to 3 million lives each year. As a direct result of immunization, the world is closer than ever to eradicating polio, and deaths from measles – a major child killer – have declined by 73 per cent worldwide between 2000 and 2018, saving an estimated 23.2 million children’s lives. The emergence of COVID-19, however, threatens to reverse this progress by severely limiting access to life-saving vaccines.