Children and COVID-19 Research Library

In lower-income countries, the economic contractions that accompany lockdowns to contain the spread of COVID-19 can increase child mortality, counteracting the mortality reductions achieved by the lockdown. To formalize and quantify this effect, this paper builds a macro-susceptible-infected-recovered model that features heterogeneous agents and a country-group-specific relationship between economic downturns and child mortality. The model is calibrated to data for 85 countries across all income levels. The findings show that in low-income countries, a lockdown can potentially lead to 1.76 children’s lives lost due to the economic contraction per COVID-19 fatality averted. The figure stands at 0.59 and 0.06 in lower-middle-income and upper-middle-income countries, respectively. As a result, in some countries, lockdowns can produce net increases in mortality. The optimal lockdowns are shorter and milder in poorer countries than in rich ones and never produce a net mortality increase.

The aim of this study is to examine trends and projections of underweight (Body Mass Index, BMI < 18.5 kg/m2) and overweight (BMI ≥ 25.0 kg/m2) in women of reproductive age in 55 low- and middle-income countries (LMICs). It used data from 2,337,855 women aged 15–49 years from nationally representative Demographic and Health Survey conducted between 1990 and 2018. Bayesian linear regression analyses were performed.

This study aims to evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents. Cross-sectional, web-based survey administered between May and June, 2020.

This report aims to support timely and context-relevant policy and programming in Bangladesh, Ethiopia, the State of Palestine (Gaza and West Bank) and Jordan by adding to the evidence base on adolescent girls’ and boys’ experiences during COVID-19. Drawing on mixed methods research it captures the risks and opportunities adolescents face across four low- and middle-income country contexts six to nine months after lockdowns in response to the pandemic were first introduced. With a focus on the intersectional challenges faced by adolescents including by gender, age, marital status, disability and context, the report covers three key domains: education and learning; violence and bodily integrity; and voice, agency and community participation. This is the companion report to a report published in August 2020, ‘I have nothing to feed my family’, which focused on the immediate, short-term effects of COVID-19 and associated lockdowns on girls and boys across the same contexts. The report concludes with key recommendations for policy and programming actors so that efforts to ‘build back better’ post-pandemic can be more effectively informed by adolescents’ experiences and voices.

This study examines the media use of children from low-income homes during school closings during the COVID-19 pandemic. Caregivers of 151 kindergarteners from low-income homes completed questionnaires as part of a larger study. Caregivers reported how much time children spent watching television/videos and using apps on the most recent weekday and weekend days. Caregivers also reported how their child's current use of media for several different purposes compared with how much the child usually uses media for that purpose.

This study aims to evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents. This study design cross-sectional, web-based survey was administered between May and June, 2020.

Vaccines developed in high-income countries have been enormously successful in reducing the global burden of infectious diseases, saving perhaps 2.5 million lives per year, but even for successful cases, like the rotavirus vaccine, global implementation may take a decade or more. For unincentivized vaccines, the delays are even more profound, as both the supply of a vaccine from developing country manufacturers and vaccine demand from countries with the high disease burdens have to be generated in order for impact to be manifest. A number of poverty-associated infectious diseases, whose burden is greatest in low-income and middle-income countries, would benefit from appropriate levels of support for vaccine development such as Group A Streptococcus, invasive non-typhoid salmonella, schistosomiasis, shigella, to name a few. With COVID-19 vaccines we will hopefully be able to provide novel vaccine technology to all countries through a unique collaborative effort, the COVAX facility, led by the World Health Organization (WHO), Gavi, and the Coalition for Epidemic Preparedness Innovations (CEPI). Whether this effort can deliver vaccine to all its participating countries remains to be seen, but this ambitious effort to develop, manufacture, distribute, and vaccinate 60–80% of the world’s population will hopefully be a lasting legacy of COVID-19.

A year after the World Health Organization declared COVID-19 a pandemic, this research takes stock of an increasingly diverse set of new studies linking violence against women and children (VAW/C) to COVID-19 and associated pandemic response measures. This fourth round up focuses exclusively on research in low- and middle-income countries (LICs and MICs) published since December 2020 to highlight dynamics in settings that previously had fewer studies. As in previous round ups, this research only include studies that have sufficient information on indicator definition and analysis methods. In total, 26 new studies from LICs and MICs are summarized, with the majority focused on identifying trends (15 studies), while others present analysis of risk factors or dynamics (an additional ten studies), and one represents an impact analysis of prevention programming.

Compounding the COVID-19 pandemic is a looming debt crisis for low- and middle-income countries where a growing debt burden threatens to crowd out social spending for children.

This policy brief explores whether the current support from the international community is enough to maintain spending on basic services during COVID-19. It highlights countries that are most at risk due to high levels of poverty, as well as those less likely to benefit from the G20 Debt Standstill (DSSI). It concludes that a new international debt restructuring architecture, which encompasses the needs of poorer countries, is crucial to protecting children’s rights in the wake of COVID-19. 

This paper presents a new estimate that pre-primary school closures in 2020 may cost today’s young children US$1.6 trillion in lost earnings over their lifetimes. Children in middle-income countries will be most greatly affected. However, most low- and middle- income countries are leaving pre-primary education out of their responses to COVID-19. This paper also draws lessons from evaluations of accelerated, bridging and remedial programmes on how introducing or expanding these transition programmes in the early years can mitigate the long-term impact on learning from pre-primary school closures.

The aim of this study was to quantify the changes that occurred in the surgical services of children during the COVID-19 pandemic from the perspective of a low/middle-income country. Design A case–control study was conducted at a large referral centre in Bangladesh among patients aged ≤12 years. Comparisons were made between cases admitted during a period of ‘April to September 2020’ (Pandemic period) and controls during a similar period in 2019 (Reference period). The number of admissions and outpatient department (OPD) attendances, age and sex distribution, diagnosis, number and types of surgeries performed (elective vs emergency), variations in treatment of acute appendicitis, types of anaesthesia and mortality were compared

Global response to COVID-19 pandemic has inadvertently undermined the achievement of existing public health priorities and largely overlooked local context. Recent evidence suggests that this will cause additional maternal and childhood mortality and morbidity especially in low- and middle-income countries (LMICs). This paper has explored the contextual factors influencing maternal, neonatal and children health (MNCH) care in Bangladesh, Nigeria and South Africa amidst the pandemic.

The emergence of SARS-CoV-2 and attempts to limit its spread have resulted in a contraction of the global economy. This study documents the socioeconomic impacts of the pandemic among households, adults and children in low-income countries. To do so, it relies on longitudinal household survey data from Ethiopia, Malawi, Nigeria and Uganda, originating from pre-COVID-19 face-to-face household surveys plus phone surveys implemented during the pandemic. 256 million individuals—77% of the population—are estimated to live in households that have lost income during the pandemic. Attempts to cope with this loss are exacerbated by food insecurity and an inability to access medicine and staple foods. Finally, this study finds that student– teacher contact has dropped from a pre-COVID-19 rate of 96% to just 17% among households with school-aged children. These findings can inform decisions by governments and international organizations on measures to mitigate the effects of the COVID-19 pandemic.

Compounding the COVID-19 pandemic is a looming debt crisis for low- and middle-income countries where a growing debt burden threatens to crowd out social spending for children.

This policy brief explores whether the current support from the international community is enough to maintain spending on basic services during COVID-19. It highlights countries that are most at risk due to high levels of poverty, as well as those less likely to benefit from the G20 Debt Standstill (DSSI). It concludes that a new international debt restructuring architecture, which encompasses the needs of poorer countries, is crucial to protecting children’s rights in the wake of COVID-19. 

13 years after the first Lancet Series on maternal and child undernutrition, we reviewed the progress achieved on the basis of global estimates and new analyses of 50 low-income and middle-income countries with national surveys from around 2000 and 2015. The prevalence of childhood stunting has fallen, and linear growth faltering in early life has become less pronounced over time, markedly in middle-income countries but less so in low-income countries. Stunting and wasting remain public health problems in low-income countries, where 4·7% of children are simultaneously affected by both, a condition associated with a 4·8-times increase in mortality. New evidence shows that stunting and wasting might already be present at birth, and that the incidence of both conditions peaks in the first 6 months of life. Global low birthweight prevalence declined slowly at about 1·0% a year. Knowledge has accumulated on the short-term and long-term consequences of child undernutrition and on its adverse effect on adult human capital. Existing data on vitamin A deficiency among children suggest persisting high prevalence in Africa and south Asia. Zinc deficiency affects close to half of all children in the few countries with data. New evidence on the causes of poor growth points towards subclinical inflammation and environmental enteric dysfunction. Among women of reproductive age, the prevalence of low body-mass index has been reduced by half in middle-income countries, but trends in short stature prevalence are less evident. Both conditions are associated with poor outcomes for mothers and their children, whereas data on gestational weight gain are scarce. Data on the micronutrient status of women are conspicuously scarce, which constitutes an unacceptable data gap. Prevalence of anaemia in women remains high and unabated in many countries. Social inequalities are evident for many forms of undernutrition in women and children, suggesting a key role for poverty and low education, and reinforcing the need for multisectoral actions to accelerate progress. Despite little progress in some areas, maternal and child undernutrition remains a major global health concern, particularly as improvements since 2000 might be offset by the COVID-19 pandemic.