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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

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

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.
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

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

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.
Two years of COVID-19 is threatening progress towards the sustainable development goals: emerging policy recommendations to support young people in developing countries

Kath Ford; Richard Freund

Institution: Young Lives
Published: March 2022

After two years of the COVID-19 pandemic, our four study countries are each facing significant economic and social challenges, and rapidly changing circumstances. But COVID-19 is not the only global crisis; our evidence from Ethiopia reflects unprecedented times, as vulnerable families grapple with the compounding effects of civil conflict and climate change. This policy brief summarises key findings from the fifth call in the Young Lives phone survey, conducted between October and December 2021, and draws on previous COVID-19 calls, as well as longitudinal data collected since 2001 through regular in-person surveys. The brief builds on previous policy recommendations from our phone survey, highlights how the pandemic, alongside climate change and conflict, is continuing to have an adverse impact on the lives of young people in low- and middle-income countries, and presents emerging policy recommendations in response to this impact. Our analysis demonstrates that urgent action is required if we are to get progress towards the SDGs back on track.

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

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

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.

Political prioritization of early childhood education during the COVID-19 pandemic: a comparative policy analysis of low- and middle-income countries

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

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

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.
Impact of the COVID-19 pandemic on adolescents’ sexual and reproductive health in low- and middle-income countries

Salima Meherali; Bisi Adewale; Sonam Ali (et al.)

Published: December 2021   Journal: International Journal of Environmental Research and Public Health
Adolescents living in low- and middle-income countries (LMICs) are struggling with accessing sexual and reproductive health (SRH) services, and COVID-19 has escalated the problem. The purpose of this review was to identify and assess the existing literature on the impact of the pandemic on SRH needs and access to services by adolescents in LMICs. A scoping review was conducted to collate findings on the topic. Searches were performed on eight databases. Data were extracted and categorized into various themes.
Decline in uptake of childhood vaccinations in a tertiary hospital in Northern Ghana during the COVID-19 pandemic

Kingsley Appiah Bimpong; Benjamin Demah Nuertey; Anwar Sadat Seidu (et al.)

Published: December 2021   Journal: BioMed Research International
At the beginning of the COVID-19 pandemic, early modelling studies estimated a reduction in childhood vaccinations in low- and middle-income countries. Regular provision of both curative and preventive services such as antenatal care and childhood immunizations has been negatively affected since the onset of the pandemic. This study was aimed at examining the impact that the pandemic had on childhood vaccination services at the Tamale Teaching Hospital (TTH). A mixed methods study design was employed for the study, which was conducted at the Child Welfare Clinic (CWC) of the TTH.
Systems thinking in COVID-19 recovery is urgently needed to deliver sustainable development for women and girls

Jessica Omukuti; Matt Barlow; Maria Eugenia Giraudo (et al.)

Published: December 2021   Journal: The Lancet Planetary Health
In low-income and middle-income countries, such as those in sub-Saharan Africa and Latin America, the COVID-19 pandemic has had substantial implications for women's wellbeing. Policy responses to the COVID-19 pandemic have highlighted the gendered aspect of pandemics; however, addressing the gendered implications of the COVID-19 pandemic comprehensively and effectively requires a planetary health perspective that embraces systems thinking to inequalities. This Viewpoint is based on collective reflections from research done by the authors on COVID-19 responses by international and regional organisations, and national governments, in Latin America and sub-Saharan Africa between June, 2020, and June, 2021. A range of international and regional actors have made important policy recommendations to address the gendered implications of the COVID-19 pandemic on women's health and wellbeing since the start of the pandemic. However, national-level policy responses to the COVID-19 pandemic have been partial and inconsistent with regards to gender in both sub-Saharan Africa and Latin America, largely failing to recognise the multiple drivers of gendered health inequalities.
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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.