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Children and COVID-19 Research Library

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

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A systematic review of acute and emergency care interventions for adolescents and adults with severe acute respiratory infections including COVID-19 in low- and middle-income countries

AUTHOR(S)
Stephanie Chow Garbern; Pryanka Relan; Gerard M. O’Reilly (et al.)

Published: November 2022   Journal: Journal of Global Health

Severe acute respiratory infections (SARIs) remain a leading cause of death globally, particularly in low- and middle-income countries (LMICs). Early intervention is critical, considering the potential for rapid decompensation in patients with SARIs. We aimed to evaluate the impact of acute and emergency care interventions on improving clinical outcomes in patients >10 years old with SARIs in LMICs. A systematic literature search was performed in PubMed, Global Health, and Global Index Medicus databases to identify peer-reviewed studies containing SARI, LMICs, and emergency care interventions. Studies published prior to November 2020 focusing on patients >10 years old were included. A narrative synthesis was performed due to the heterogeneity of identified articles. Risk of bias was assessed using the Risk of Bias 2 and Risk of Bias In Non-Randomized Studies of Interventions tools.

Assessment of disruption of routine childhood immunization in developing countries due to pandemic

AUTHOR(S)
Riddhi S. Poshattiwar; Ashish Anjankar

Published: October 2022   Journal: Medical Journeys
The COVID-19 pandemic, also known as the coronavirus pandemic, began in March 2020 and was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pandemic impacted the global healthcare system. It caused the biggest threat to the global routine immunization system. Routine childhood immunization was disrupted globally, particularly in the early pandemic period. This review discusses the severity of disruptions to routine immunization, their root causes, and remedial measures to lessen these disruptions. It is essential to maintain routine medical care, especially routine immunization, to avert morbidity and death from several diseases that vaccines can prevent, including a pandemic. The healthcare system's reaction to a pandemic must include catch-up vaccinations because missed vaccines increase the population's and children's health risks.
Confirming—and testing—bonds of trust: A mixed methods study exploring community health workers’ experiences during the COVID-19 pandemic in Bangladesh, Haiti and Kenya

AUTHOR(S)
Pooja Sripad; Ann Gottert; Timothy Abuya (et al.)

Published: October 2022   Journal: Plos Global Public Health
Amidst the COVID-19 pandemic and national responses, trust (one’s belief that a system acts in one’s best interest) is important to consider. In community health systems, trust is embedded in relationships between clients, CHWs, and health system stakeholders. This mixed-methods study explores trust through the evolving COVID-19 crisis in Bangladesh, Haiti, and Kenya, where multi-country community health research was underway. It investigates the extent and ways trust between communities, community health workers (CHWs), and health system actors shift, including its relation to community fear and hostility, through self-reported positive and negative experiences of CHWs and policy/program stakeholders on a phone-based survey with 2,025 CHWs and 72 key informant interviews, including CHWs, in late 2020.
Effects of COVID-19 pandemic on nutritional status, feeding practices, and access to food among infants and children in lower and middle-income countries: a narrative review

AUTHOR(S)
Paola Hong Zhu; Susan Nita Mhango; Anirudh Vinnakota (et al.)

Published: October 2022   Journal: Current Tropical Medicine Reports
The COVID-19 pandemic has affected children across the planet and the consequences on their health, nutritional status, and social structure have been more pronounced in low- and middle-income countries (LMICs). This review will focus on the effects of the COVID-19 pandemic on infant growth and feeding practices and access to food and obesity prevalence among children in LMICs. An electronic search was performed on MEDLINE and Embase to identify relevant articles in the English language.
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.

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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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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.