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Children and COVID-19 Research Library

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

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Epidemiology and transmission dynamics of COVID-19 in two Indian states

AUTHOR(S)
Ramanan Laxminarayan; Shankar Reddy Dudala Dudala; Brian Wahl (et al.)

Published: November 2020   Journal: Science
Although most cases of coronavirus disease 2019 (COVID-19) have occurred in low-resource countries, little is known about the epidemiology of the disease in such contexts. Data from the Indian states of Tamil Nadu and Andhra Pradesh provide a detailed view into severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission pathways and mortality in a high-incidence setting. Reported cases and deaths have been concentrated in younger cohorts than would be expected from observations in higher-income countries, even after accounting for demographic differences across settings. Among 575,071 individuals exposed to 84,965 confirmed cases, infection probabilities ranged from 4.7 to 10.7% for low-risk and high-risk contact types, respectively. Same-age contacts were associated with the greatest infection risk. Case fatality ratios spanned 0.05% at ages of 5 to 17 years to 16.6% at ages of 85 years or more. Primary data from low-resource countries are urgently needed to guide control measures.
Cite this research | Open access | Vol.: 370 | Issue: 6517 | No. of pages: 691-697 | Language: English | Topics: Health | Tags: child health, data collection, disease control, disease transmission, COVID-19, epidemiology, low-income countries | Countries: India
The changing aspects of motherhood in face of the COVID-19 pandemic in low- and middle-income countries

AUTHOR(S)
Jennifer Prince Kingsley; Paul Kingsley Vijay; Jacob Kumaresan (et al.)

Published: November 2020   Journal: Maternal and Child Health Journal
The aim of this article is to advocate perspectives to strengthen existing healthcare systems to prioritize maternal health services amidst and beyond the COVID-19 pandemic in low- and middle income countries. COVID-19 directly affects pregnant women causing more severe disease and adverse pregnancy outcomes. The indirect effects due to the monumental COVID-19 response are much worse, increasing maternal and neonatal mortality.
Let's break silos now! Achieving disability-inclusive education in a post-COVID world
Institution: Humanity & Inclusion
Published: November 2020
This report is about the difficulties children with disabilities face in accessing education in the world’s poorest countries. The exclusion of learners with disabilities from education is due to many reasons, including inaccessible school facilities, a lack of assistive technologies, poor health, prejudice, discrimination and stigma. The interconnected and complex nature of achieving inclusive, quality education for all therefore requires stakeholders to break with siloed approaches and to work collaboratively across economic, social, cultural and protection sectors and domains.
Intersecting vulnerabilities: the impacts of COVID-19 on the psycho-emotional lives of young people in low- and middle-income countries

AUTHOR(S)
Prerna Banati; Nicola Jones; Sally Youssef

Published: November 2020   Journal: The European Journal of Development Research
Across diverse contexts, emerging evidence suggests that the COVID-19 pandemic is increasing levels of anxiety and stress. In calling for greater attention to people’s psychosocial and emotional well-being, global actors have paid insufcient attention to the realities of the pandemic in low- and middle-income countries, where millions of people are already exposed to intersecting vulnerabilities. Chronic poverty, protracted violence, confict and displacement, coupled with weak health, education and protection systems, provide the backdrop of many adolescents’ lives. Drawing on qualitative in-country telephone interviews with over 500 adolescents in Ethiopia, Côte d’Ivoire and Lebanon, this article unpacks the age and gendered dimensions of COVID-19 and its response.
A fair share for children: preventing the loss of a generation to COVID-19

As this report makes clear, it is not just COVID-19 that is exacerbating global inequality; the world’s unjust economic response to COVID-19 will deepen global inequality for at least a generation. The most marginalised and vulnerable have been left to fend for themselves and millions of children will pay the price with their lives, unless we act now. In the short term, we need immediate action to ensure the most marginalised have their fair share of the global response. At the United Nations, world leaders must review the dreadful damage done by COVID-19 to the world’s poorest communities and realise they have faced the heaviest burden. Leaders must come together and agree a global package to help low income countries and ensure the most vulnerable to the crisis receive at least some support.

Beyond the disease: contextualized implications of the COVID-19 pandemic for children and young people living in Eastern and Southern Africa

AUTHOR(S)
Kaymarlin Govender; Richard Gregory Cowden; Patrick Nyamaruze (et al.)

Published: October 2020   Journal: Frontiers in Public Health
The coronavirus disease 2019 (COVID-19) pandemic has created extraordinary challenges and prompted remarkable social changes around the world. The effects of COVID-19 and the public health control measures that have been implemented to mitigate its impact are likely to be accompanied by a unique set of consequences for specific subpopulations living in low-income countries that have fragile health systems and pervasive social-structural vulnerabilities. This paper discusses the implications of COVID-19 and related public health interventions for children and young people living in Eastern and Southern Africa. Actionable prevention, care, and health promotion initiatives are proposed to attenuate the negative effects of the pandemic and government-enforced movement restrictions on children and young people.
Close to contagion: the impact of COVID-19 on displaced and refugee girls and women
Institution: Plan International
Published: September 2020

Currently, as COVID-19 spreads across the world, an unprecedented 76.7 million people are living as refugees, or have been displaced inside their countries. Some 131 of the countries affected by COVID-19 have sizeable refugee populations and more than 80% of refugees are hosted in low- and middle-income countries including Uganda, Sudan, Pakistan and Turkey, with health systems that are ill-equipped to manage significant outbreaks. Refugee and IDP camps are mostly chronically overcrowded and measures to avoid community transmission of the virus, such as physical distancing and frequent handwashing, are difficult to implement. The absence of basic amenities, such as clean running water and soap, insufficient medical personnel, and poor access to health information, let alone access to masks, will make avoiding infection virtually impossible. Also, in many host countries, refugees’ entitlement to healthcare and social protection systems are restricted or non-existent, which increases their vulnerability even further.

Are child and youth population at lower risk of COVID-19 fatalities? Evidences from South-East Asian and European countries

AUTHOR(S)
Ankita Zaveri; Pradip Chouhan

Published: August 2020   Journal: Children and Youth Services Review

The coronavirus disease (COVID-19) pandemic has revealed many lacunas of public health preparedness, especially in lower and middle-income countries and fatality differentials between European and South-East Asian countries. The case fatality rate (CFR) in most of the South-East Asian countries is much lower than the European countries. The percentages of child and youth population are more in South-East countries. The study aims to show the impacts of age composition on fatality differentials in European and South-East Asian countries by age-structure, especially the percentage share of child and youth population.

Impacts of COVID-19 on childhood malnutrition and nutrition-related mortality

AUTHOR(S)
Derek Headey; Rebecca Heidkamp; Saskia Osendarp (et al.)

Published: August 2020   Journal: The Lancet
The unprecedented global social and economic crisis triggered by the COVID-19 pandemic poses grave risks to the nutritional status and survival of young children in low-income and middle-income countries (LMICs). Of particular concern is an expected increase in child malnutrition, including wasting, due to steep declines in household incomes, changes in the availability and affordability of nutritious foods, and interruptions to health, nutrition, and social protection services.
Cite this research | Open access | Vol.: 306 | Issue: 10250 | No. of pages: 519-521 | Language: English | Topics: Child Poverty, Nutrition | Tags: child care services, child nutrition, COVID-19, impact, low-income countries, multi-country
The emerging lessons on urban vulnerability and safety from Covid-19 in low- and middle-income countries

AUTHOR(S)
Jaideep Gupte

Institution: Institute of Development Studies, UN Habitat
Published: July 2020
This discussion paper sets forth the lessons on urban vulnerability and safety, relevant to the security sector, emerging from coronavirus (Covid-19) and its related socioeconomic impacts on urban societies in low- and middle-income countries.
Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study

AUTHOR(S)
Timothy Robertson; Emily Carter; Victoria Chou (et al.)

Published: July 2020   Journal: The Lancet Global Health
While the COVID-19 pandemic will increase mortality due to the virus, it is also likely to increase mortality indirectly. This study estimates the additional maternal and under-5 child deaths resulting from the potential disruption of health systems and decreased access to food. Estimates show that if routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be substantial. 
Challenges of COVID-19 in children in low- and middle-income countries

AUTHOR(S)
Heather J. Zar; Jeanette Dawa; Gilberto B. Fischer

Published: June 2020   Journal: Paediatric Respiratory Reviews
As the coronavirus pandemic extends to low and middle income countries (LMICs), there are growing concerns about the risk of coronavirus disease (COVID-19) in populations with high prevalence of comorbidities, the impact on health and economies more broadly and the capacity of existing health systems to manage the additional burden of COVID-19. The direct effects of COVID are less of a concern in children, who seem to be largely asymptomatic or to develop mild illness as occurs in high income countries; however children in LMICs constitute a high proportion of the population and may have a high prevalence of risk factors for severe lower respiratory infection such as HIV or malnutrition. Further diversion of resources from child health to address the pandemic among adults may further impact on care for children. Poor living conditions in LMICs including lack of sanitation, running water and overcrowding may facilitate transmission of SARS-CoV-2. The indirect effects of the pandemic on child health are of considerable concern, including increasing poverty levels, disrupted schooling, lack of access to school feeding schemes, reduced access to health facilities and interruptions in vaccination and other child health programs. Further challenges in LMICs include the inability to implement effective public health measures such as social distancing, hand hygiene, timely identification of infected people with self-isolation and universal use of masks. Lack of adequate personal protective equipment, especially N95 masks is a key concern for health care worker protection. While continued schooling is crucial for children in LMICs, provision of safe environments is especially challenging in overcrowded resource constrained schools. The current crisis is a harsh reminder of the global inequity in health in LMICs. The pandemic highlights key challenges to the provision of health in LMICs, but also provides opportunities to strengthen child health broadly in such settings.
A wake-up call: COVID-19 and its impact on children's health and wellbeing.

AUTHOR(S)
Henrietta H. Fore

Institution: The Lancet
Published: May 2020   Journal: The Lancet Global Health
As cases of COVID-19 surge worldwide and threaten to overwhelm life-saving health services, the survival of mothers and children is at great risk. Henrietta Fore, Executive Director of UNICEF, highlights the risks for maternal and child health in low- and middle-income countries if essential health services are disrupted as a result of COVID-19.
Protecting children in low-income and middle-income countries from COVID-19

AUTHOR(S)
Salahuddin Ahmed; Tisungane Mvalo; Samuel Akech (et al.)

Published: May 2020   Journal: BMJ
A saving grace of the COVID-19 pandemic in high-income and upper middle-income countries has been the relative sparing of children. As the disease spreads across low-income and middle-income countries (LMICs), long-standing system vulnerabilities may tragically manifest, and we worry that children will be increasingly impacted, both directly and indirectly. Drawing on our shared child pneumonia experience globally, we highlight these potential impacts on children in LMICs and propose actions for a collective response.
Beyond handwashing: Water insecurity undermines COVID-19 response in developing areas

AUTHOR(S)
Justin Stoler; Wendy Jepson; Amber Wutich

Published: May 2020   Journal: Journal of Global Health
Water, sanitation, and hygiene (WASH) inequities are long-recognized as important contributors to the global burden of disease that inhibit sustainable development. Inadequate water quantity poses additional challenges for maintaining clean environments and sanitizing physical surfaces where COVID-19 can survive. But the problems associated with water insecurity extend well beyond issues of quantity and hygiene.
Social distancing can cause significant disruptions in people’s access to their most basic necessity. One of the most underappreciated coping strategies for dealing with water insecurity is water sharing between households. The ubiquitous, but often invisible, practice of household water sharing occurs in a variety of socio-cultural settings, and may serve as a transmission pathway for many communicable diseases. 
Water insecurity also complicates people’s ability to participate in social distancing if they have to fetch their own water. About a billion people globally collect their own water from sources outside of their home such as public standpipes, wells, or surface water bodies, and often at great distances. Water fetching in groups contributes to building social capital among women and children, while offering a mechanism of protection from physical dangers like injuries, accidents, harassment, and assaults. Thus, when social distancing measures are in place, vulnerable groups (especially women and girls) experience greater risks by having to fetch water alone. 
Under-resourced regions that already suffer economic losses from lack of adequate water supplies are on the verge of an enormous additional burden from COVID-19. 
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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.