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Children and COVID-19 Research Library

UNICEF Innocenti's curated library of COVID-19 + Children research

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Disruptions to routine childhood vaccinations in low- and middle-income countries during the COVID-19 pandemic: a systematic review

AUTHOR(S)
Alexandra M. Cardoso Pinto; Lasith Ranasinghe; Peter J. Dodd (et al.)

Published: August 2022   Journal: Frontiers in Pediatrics

The COVID-19 pandemic has disrupted routine childhood vaccinations worldwide with low- and middle-income countries (LMICs) most affected. This study aims to quantify levels of disruption to routine vaccinations in LMICs.  A systematic review (PROSPERO CRD42021286386) was conducted of MEDLINE, Embase, Global Health, CINAHL, Scopus and MedRxiv, on the 11th of February 2022. Primary research studies published from January 2020 onwards were included if they reported levels of routine pediatrics vaccinations before and after March 2020. Study appraisal was performed using NHLBI tool for cross-sectional studies. Levels of disruption were summarized using medians and interquartile ranges.

Assessing the prevalence of young children living in households prepared for COVID-19 in 56 low- and middle-income countries

AUTHOR(S)
Chunling Lu; Yiqun Luan; Sara N. Naicker (et al.)

Published: June 2022   Journal: Global Health Research and Policy

The COVID-19 pandemic and governments’ attempts to contain it are negatively affecting young children’s health and development in ways we are only beginning to understand and measure. Responses to the pandemic are driven largely by confining children and families to their homes. This study aims to assess the levels of and associated socioeconomic disparities in household preparedness for protecting young children under the age of five from being exposed to communicable diseases, such as COVID-19, in low- and middle-income countries (LMICs). Using data from nationally representative household surveys in 56 LMICs since 2016, we estimated the percentages of young children under the age of five living in households prepared for communicable diseases (e.g., COVID-19) and associated residential and wealth disparities at the country- and aggregate-level. Preparedness was defined on the basis of space for quarantine, adequacy of toilet facilities and hand hygiene, mass media exposure at least once a week, and phone ownership. Disparities within countries were measured as the absolute gap in two domains—household wealth and residential area - and compared across regions and country income groups.

Evidence and gap map research brief: UNICEF strategic plan 2018–2021: COVID-19 special evidence brief
Institution: *UNICEF
Published: June 2022
This research brief is one of a series of six briefs, which provide an overview of available evidence shown in the Campbell-UNICEF Mega-Map of the effectiveness of interventions to improve child well-being in low- and middle-income countries. Five of these briefs summarize evidence as mapped against the five goal areas of UNICEF’s 2018–2021 Strategic Plan. A sixth special brief was added to focus specifically on COVID-19 and other epidemics and major crises. It is anticipated that the briefs will also be useful for others working in the child well-being space.
Let Us Learn: Making education work for the most vulnerable in Afghanistan, Bangladesh, Liberia, Madagascar and Nepal

AUTHOR(S)
Marco Valenza; Thomas Dreesen

Institution: *UNICEF
Published: May 2022

Learning remains largely out of reach for many of the most vulnerable children around the world. In low- and middle-income countries, an estimated 56% of children cannot read a simple text by the age of 10. This share is projected to rise to 70% after the pandemic. The school closures imposed by the COVID-19 outbreak, coupled with an enduring tendency in low-income countries to allocate a limited share of the national education budget to the most vulnerable, are further widening inequalities in the global learning crisis landscape. The Let Us Learn (LUL) initiative implements innovative education programmes to improve learning for the most vulnerable children in five countries with high levels of out-of-school children: Afghanistan, Bangladesh, Liberia, Madagascar and Nepal. This report documents the outcomes, lessons learned and recommendations based on the experience of the initiative across four types of learning programmes spanning the education lifecycle: (1) pre-primary education; (2) accelerated learning pathways; (3) programmes to reduce barriers to access and stay in formal school; and (4) vocational training.

Factors associated with hospitalization or intensive care admission in children with COVID-19 in Latin America

AUTHOR(S)
Eduardo López-Medina; German Camacho-Moreno; Martin E. Brizuela (et al.)

Published: April 2022   Journal: Frontiers in Pediatrics

Limited data is available from low-middle and upper-middle income countries of the factors associated with hospitalization or admission to pediatric intensive care unit (PICU) for children with COVID-19. This study aims to describe the factors associated with hospitalization or PICU admission of children with COVID-19 in Latin America. Multicenter, analytical, retrospective study of children reported from 10 different Latin American countries to the Latin-American Society of Pediatric Infectious Diseases (SLIPE-COVID) research network from June 1, 2020, and February 28, 2021. Outpatient or hospitalized children <18 years of age with COVID-19 confirmed by polymerase chain reaction or antigen detection from the nasopharynx were included. Children with multisystem inflammatory syndrome in children (MIS-C) were excluded. Associations were assessed using univariate and multivariable logistic regression models.

Health care in pregnancy during the COVID-19 pandemic and pregnancy outcomes in six low-and-middle-income countries: evidence from a prospective, observational registry of the global network for women’s and children’s health

AUTHOR(S)
Seemab Naqvi; Farnaz Naqvi; Sarah Saleem (et al.)

Published: April 2022   Journal: BJOG : an International Journal of Obstetrics and Gynaecology

On a population basis, this study assessed medical care for pregnant women in specific geographic regions of six countries before and during the first year of the COVID-19 pandemic in relationship to pregnancy outcomes. It is a prospective, population-based study. Its setting are communities in Kenya, Zambia, the Democratic Republic of the Congo, Pakistan, India, and Guatemala.

Young lives, interrupted: short-term effects of the COVID-19 pandemic on adolescents in low- and middle-income countries

AUTHOR(S)
Marta Favara; Richard Freund; Catherine Porter (et al.)

Published: March 2022   Journal: The Journal of Development Studies
This study examines the situation of adolescents during the COVID-19 pandemic in four low- and middle-income countries using data from a large-scale phone survey conducted in 2020. The survey was part of Young Lives, a 20-year longitudinal study of two cohorts of young people born in 1994 and 2001 in Ethiopia, India (Andhra Pradesh and Telangana), Peru and Vietnam. It focuses on the Younger (19-year-old) Cohort, describing their experiences along multiple dimensions, and assessing how their lives have changed since an earlier survey in 2016. It also compares these young people with an Older Cohort (surveyed at the same age in 2013), using a cross-cohort comparison in the spirit of a difference-in-differences approach. Compared to 2016, and compared with the Older Cohort, the increase in the probability of a loss of household livelihood (income or employment) is both large and significant in all countries.
School closures and educational attainment in Ethiopia: can extra classes help children to catch up?

AUTHOR(S)
Fiona Carmichael; Christian K. Darko; Shireen Kanji (et al.)

Published: March 2022   Journal: British Educational Research Journal
School closures impact children's attainment adversely, but understanding the effects of closures on children's attainment in lower-income countries is still limited. Addressing this deficit, this study examines how past school closures have impacted children's educational attainment in Ethiopia. The study uses individual student-level data from the Young Lives School Survey and standardised test scores in mathematics and language recorded at the start and end of the school year to model children's attainment. Multiple regression with propensity score matching is used to analyse how attainment over the school year is impacted by school closures for a matched sub-sample of 4842 students.
Knowledge, attitude and practices of pregnant women related to COVID-19 infection: a cross-sectional survey in seven countries from the Global Network for Women’s and Children’s Health

AUTHOR(S)
Farnaz Naqvi; Seemab Naqvi; Masum Billah (et al.)

Published: February 2022   Journal: BJOG : an international journal of obstetrics and gynaecology

This study sought to understand knowledge, attitudes and practices (KAP) regarding COVID-19 in pregnant women in seven low and middle-income countries (LMIC). Population-based prospective, observational study SETTINGS: Study sites in DRC, Kenya, Zambia, Bangladesh, India (two sites), Pakistan, and Guatemala. Pregnant women in the Global Network's Maternal and Neonatal Health Registry (MNHR). A KAP questionnaire was administered in face-to-face interviews with pregnant women from September 2020 through October 2021 in the MNHR.

Shortfalls in social spending in low- and middle-income countries: COVID-19 and shrinking finance for social spending
Institution: *UNICEF
Published: February 2022

Financing quality social services will require increased public investment and greater mobilization of both domestic and international resources in the post-COVID era. Currently, low- and middle-income countries invest, on average, just one third of their total government expenditure in social spending on education, health and social protection. However, the fiscal space to enhance social spending remains constrained in many parts of the world. Given the scale of the challenge facing many countries, a renewed focus on financing social spending is needed to address widening inequalities. This policy brief is the second in a series that assesses key issues affecting social spending as part of UNICEF’s work on Public Finance for Children. The brief examines how recent trends are impacting on the financing available for, and directed to, social spending in low- and middle-income countries in different regions, using secondary analysis of public expenditure data collected by international organizations. It calculates median spending figures by region and income group, using World Bank regional aggregates for domestic spending.

The evolution of young people’s mental health during COVID-19 and the role of food insecurity: evidence from a four low-and-middle-income-country cohort study

AUTHOR(S)
Catherine Porter; Annina Hittmeyer; Marta Favara (et al.)

Published: February 2022   Journal: Public Health in Practice

This study aimed to provide evidence on how young people’s mental health has evolved in Low-and-Middle-Income-Countries (LMICs) during the progression of the COVID-19 pandemic. Identify particularly vulnerable groups who report high and/or continuously high rates of mental health issues. Two consecutive phone-surveys (August–October and November–December 2020) in Ethiopia, India, Peru and Vietnam interviewed around 9000 participants of a 20-year cohort study who grew up in poverty, now aged 19 and 26. Rates of at least mild anxiety/depression measured by GAD-7/PHQ-8 were each compared across countries; between males/females, and food secure/food insecure households.

Impact of Covid-19 on maternal health seeking in Ghana

AUTHOR(S)
Patrick Opoku Asuming; Deborah Aba Gaisie; Caesar Agula (et al.)

Published: January 2022   Journal: Journal of International Development
The Covid-19 pandemic is widely speculated to have disrupted the delivery of primary health care in low-income countries. Yet, there is little rigorous empirical research identifying this effect. This paper estimates the impact of Covid-19 on facility and skilled delivery and utilisation of antenatal care (ANC) services by comparing these outcomes for women who were pregnant/delivered before and during the Covid-19 period. The results show that Covid-19 led to 23% and 25% reductions, respectively, in the likelihood of facility delivery and four or more ANC visits during pregnancy. These findings highlight the need to build more resilient health systems in low-income settings.
Political prioritization of early childhood education during the COVID-19 pandemic: a comparative policy analysis of low- and middle-income countries

AUTHOR(S)
Michelle J. Neuman; Shawn Powers

Published: January 2022   Journal: Early Childhood Research Quarterly
Despite strong evidence of its importance to the welfare of children and societies, early childhood education has been comparatively neglected as a policy priority both before and during the COVID-19 pandemic. This paper seeks to understand what factors have contributed to the relative lack of priority for early childhood education in distance learning and school reopening plans by applying a political prioritization framework to the pandemic context in four low- and middle-income countries: Ethiopia, Jamaica, Liberia, and Pakistan (Punjab Province). Some aspects of the pre-COVID-19 status quo which disfavored early childhood education have continued, including a lack of cohesive support from civil society and a greater focus by international partners on norm promotion and technical assistance than financing. In other respects, the pandemic put early childhood education at an even greater disadvantage. These include perceptions that early childhood education is less suited to distance delivery than other levels of education, concerns about young children's ability to comply with health protocols, and competition with high-stakes examinations for education ministries’ attention. Previous country experience with pandemics (in Liberia) and a strong coordinating entity (in Jamaica) were mitigating factors.
Scaling education innovations for impact in low- and middle-income countries during COVID

AUTHOR(S)
Brad Olsen

Published: December 2021

Interest in scaling promising innovations to effect systemic change in education around the world has grown over the last decade. Scaling has become fashionable because the modern landscape of educational improvement is littered with short-term projects that temporarily succeeded only to later dissipate, isolated pursuits that never crossed into broad adoption, or specialized policy programs that floundered. Moving beyond 20th-century technical-rational implementation and acknowledging the mixed history of global development in low-and middle-income countries, newer iterations of scaling have sought to collaboratively embed promising education ideas and technologies into whole systems. Increased recognition of the interconnectedness of culture, governments, global development architecture, and the learning sciences has reframed education scaling as a holistic process of mutual adaptation and collective transformation. Lasting impact has replaced size or scope as the goal. As a result, this past decade of scaling and research has offered hope and possibility—even as it has also underscored the sometimes maddening complexity of this work.

Adults’ acceptance of COVID-19 vaccine for children in selected lower- and middle-income countries

AUTHOR(S)
Suzanna Awang Bono; Ching Sin Siau; Won Sun Chen (et al.)

Published: December 2021   Journal: Vaccines
Since emergency approval of COVID-19 vaccines for children aged between 12 and 15 years old was recently obtained in the United States and Europe, we aimed to assess the willingness to vaccinate children with a COVID-19 vaccine in lower- and middle-income countries (LMICs). Therefore, we launched an online cross-sectional survey in several LMICs. Questions relating to socio-demographic information, knowledge of COVID-19, level of fear/worry of being infected with COVID-19, and willingness to vaccinate children with the COVID-19 vaccine at 50%, 75% and 95% effectiveness levels, were asked. Of the 6571 participants (mean age = 39 ± 14 years), 64.0%, 72.6%, and 92.9% were willing to vaccinate children at 50%, 75%, and 95% effectiveness levels, respectively. Respondents who were undergraduates, who were more worried/fearful about COVID-19, had higher knowledge scores regarding COVID-19, and a higher belief that COVID-19 vaccination is important to protect others, were more willing to accept COVID-19 vaccination of children. COVID-19 vaccination of children will limit the spread of the virus, especially in schools; it may decrease the need for school closures which has a negative effect on child development.
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UNICEF Innocenti's Children and COVID-19 Library is a database collecting research from around the world on COVID-19 and its impacts on children and adolescents.

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Check our quarterly thematic digests on children and COVID-19

Each quarterly thematic digest features the latest evidence drawn from the Children and COVID-19 Research Library on a particular topic of interest.
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COVID-19 & Children: Rapid Research Response

UNICEF Innocenti is mobilizing a rapid research response in line with UNICEF’s global response to the COVID-19 crisis. The initiatives we’ve begun will provide the broad range of evidence needed to inform our work to scale up rapid assessment, develop urgent mitigating strategies in programming and advocacy, and preparation of interventions to respond to the medium and longer-term consequences of the COVID-19 crisis. The research projects cover a rapid review of evidence, education analysis, and social and economic policies.