Children and COVID-19 Research Library

The UNICEF, WHO and the World Bank inter-agency team update the joint global and regional estimates of malnutrition among children under 5 years of age each year. These estimates of prevalence and numbers affected for child stunting, overweight, wasting and severe wasting are derived for the global population as well as by regional groupings of United Nations (UN) regions and sub-regions, Sustainable Development Goals (SDG), UNICEF, WHO and World Bank regions, as well as World Bank country-income group classifications.

The World Health Organization (WHO) acknowledged that, as health services divert their attention to the COVID-19 pandemic, the delivery of essential nutrition services may be compromised. This impact may be more pronounced in the context of humanitarian crises, such as the one currently unfolding in Yemen. In line with Pillar 9 of the WHO’s COVID-19 Strategic Preparedness and Response Plan, this paper reports on the nutrition program adaptations in Yemen to maintain the delivery of essential nutrition services to under-five children. The process of adaptation focused on the services provided within the nutrition surveillance system (NSS), therapeutic feeding centers (TFC), and isolation units (IU).

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.

This publication by the United Nations World Food Programme (WFP) provides an analysis of the State of School Feeding Worldwide in 2020. A report on the State of School Feeding Worldwide was first published by WFP in 2013. This 2020 version follows a similar format and uses the best available data sources to describe key aspects of coverage, implementation practices and costs of school-based health and nutrition programmes worldwide. In addition, the 2020 version seeks to analyse the direction and scale of change between 2013 and 2020, and to provide an update on advances in evidence and understanding of school feeding programmes.

Good nutrition during childhood and adolescence is key to ensuring optimal growth, health and well-being. Healthy dietary practices in early life have an immediate impact on healthy growth and help prevent noncommunicable diseases (NCDs) later in life and across generations. Good nutrition in childhood is also good for school performance and educational outcomes, impacting on nations’ economic and social development. Since children spend so much time in school, the school environment is an important setting for children to acquire habits, skills and knowledge related to healthy diets and physical activity. In 2016-17, the vast majority of countries (89%) reported implementation of school health and nutrition programmes although inclusion of a comprehensive set of interventions was rare and implementation of such programmes appears to have weakened since the start of the decade.

The COVID-19 pandemic has deteriorated key determinants of health and caused major upheavals around the world. Children, although less directly affected by the virus, are paying a heavy price through the indirect effects of the crisis, including poor diet, mental health impact, social isolation, addiction to screens and lack of schooling and health care, particularly among vulnerable groups. This paper is aimed at discussing the potential impact of this pandemic on children’s nutrition and lifestyle. Preliminary data from the literature and from our survey show significant disruptions in nutrition and lifestyle habits of children. While undernutrition is expected to worsen in poor countries, obesity rates could increase in middle- and high-income countries especially among precarious groups widening the gap in health and social inequalities. The real impact of the COVID-19 pandemic on children extends well beyond that of a viral infection. This crisis has public health implications that could have life-long consequences on children. It requires effective and targeted measures mainly for vulnerable children and households to guarantee children’s basic rights for optimal nutrition, health and development.

If maternal milk is unavailable, the World Health Organization recommends that the first alternative should be pasteurised donor human milk (DHM). Human milk banks (HMBs) screen and recruit milk donors, and DHM principally feeds very low birth weight babies, reducing the risk of complications and supporting maternal breastfeeding where used alongside optimal lactation support. The COVID‐19 pandemic has presented a range of challenges to HMBs worldwide. This study aimed to understand the impacts of the pandemic on HMB services and develop initial guidance regarding risk limitation.

Indigenous communities continue to be under-resourced, under-funded, and overly managed and policed (Greenwood et al., 2012), which has only been exacerbated by COVID-19. Our ability to choose our own path has been gated, leaving only a singular paved road toward the center; toward assimilation. For many, this is not a choice at all.

Over 20 million children under 5 years old in the WHO Eastern Mediterranean Region have stunted growth, as a result of chronic malnutrition, with damaging long-term consequences for individuals and societies. This review extracted and analyzed data from the UNICEF, WHO and the World Bank malnutrition estimates to present an overall picture of childhood stunting in the region. The number of children under 5 in the region who are affected by stunting has dropped from 24.5 million (40%) in 1990 to 20.6 million (24.2%) in 2019. The reduction rate since the 2012 baseline is only about two fifths of that required and much more rapid progress will be needed to reach the internationally agreed targets by 2025 and 2030. Prevalence is highest in low-income countries and those with a lower Human Development Index. The COVID-19 pandemic threatens to undermine efforts to reduce stunting, through its impact on access and affordability of safe and nutritious foods and access to important health services.

In Kenya, millions of children have limited access to nurturing care. With the Coronavirus disease 2019 (COVID-19) pandemic, it is anticipated that vulnerable children will bear the biggest brunt of the direct and indirect impacts of the pandemic. This review aimed to deepen understanding of the effects of COVID-19 on nurturing care from conception to four years of age, a period where the care of children is often delivered through caregivers or other informal platforms. The review has drawn upon the empirical evidence from previous pandemics and epidemics, and anecdotal and emerging evidence from the ongoing COVID-19 crisis. Multifactorial impacts fall into five key domains: direct health; health and nutrition systems; economic protection; social and child protection; and child development and early learning. The review proposes program and policy strategies to guide the reorientation of nurturing care, prevent the detrimental effects associated with deteriorating nurturing care environments, and support the optimal development of the youngest and most vulnerable children. These include the provision of cash transfers and essential supplies for vulnerable households and strengthening of community-based platforms for nurturing care.

Brighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and families. Due to COVID-19-related school closures, states were under “shelter in place” orders, and Brighter Bites administered a rapid assessment survey to identify social needs among their families. The purpose of this study is to demonstrate the methodology used to identify those with greatest social needs during this time (“high risk”), and to describe the response of Brighter Bites to these “high risk” families.

Little is known about the social needs of low-income households with children during the coronavirus-2019 (COVID-19) pandemic. This rapid-response survey examines social needs, COVID-19–related concerns, and diet-related behaviors during the shelter-in-place phase of the US pandemic among low-income households with children enrolled in a nutrition program. Results show higher levels of financial instability; concerns about unemployment, food insecurity, and COVID-19; and reduced frequency of eating out and grocery shopping.

This briefing has three specific aims: 1) to assess the latest developments in government expenditure and revenue trends in low and lower-middle income countries, to understand how the protracted crisis is impacting; 2) to review latest available information about government budgetary allocations to education, health and social protection; 3) to provide recommendations for governments, international agencies and the private sector.