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Children and COVID-19 Research Library

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

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Children as an afterthought during COVID-19: defining a child-inclusive ethical framework for pandemic policymaking

AUTHOR(S)
Sydney Campbell; Franco A. Carnevale

Published: December 2022   Journal: BMC Medical Ethics
Following the SARS pandemic, jurisdictions around the world began developing ethical resource allocation frameworks for future pandemics—one such framework was developed by Thompson and colleagues. While this framework offers a solid backbone upon which decision-makers can rest assured that their work is driven by rigorous ethical processes and principles, it fails to take into account the nuanced experiences and interests of children and youth (i.e., young people) in a pandemic context. The current COVID-19 pandemic offers an opportunity to re-examine this framework from young people’s perspectives, informed by advances in childhood ethics and children’s rights. This paper revisits the Thompson et al. framework and propose adaptations to the ethical processes and values outlined therein. This work is informed by expertise in clinical ethics and literature related to impacts of COVID-19 and other pandemics on the health and well-being of children around the world, though with particular attention to Canada. During the processes of drafting this work, stakeholders were consulted—aligned with the approach used by Thompson and colleagues—to validate the interpretations provided. This study also proposes a new principle, namely practicability, to indicate the complex balance between what is possible and what is convenient that is required in ethically sound decisions in the context of services affecting young people. It outlines and discusses the strengths and limitations of our work and indicate next steps for scholars in the areas of childhood studies and child health.
Strategies to improve adolescent food security from the perspectives of policy advocates, parents, and adolescents

AUTHOR(S)
Kaitlyn Harper; Rebecca Skinner; Michelle Martinez-Baack (et al.)

Published: November 2022   Journal: Nutrients
This study explored strategies to improve adolescent food security using semi-structured in-depth interviews with 9 policy advocates, 12 parents and 15 adolescents aged between 17 and 20 years, living in households who were eligible for the Supplemental Nutrition Assistance Program in 2020. This study was part of a larger evaluation of adolescent food insecurity conducted in Baltimore, Maryland, USA during the COVID-19 pandemic. Three key strategies arose during analysis—improving federal nutrition assistance programs for households, federal nutrition assistance programs for individual adolescents, and leveraging school programs and resources. Respondents described concordant views regarding the role of the Supplemental Nutrition Assistance Program in supporting households but held discordant views about the role of other federal programs, such as the school nutrition programs and Pandemic Electronic Benefit Transfer program.
COVID-19‒related childhood BMI increases in China: a health surveillance‒based ambispective cohort analysis

AUTHOR(S)
Wenxin Ge; Jia Hu; Yue Xiao (et al.)

Published: May 2022

The COVID-19 pandemic‒related BMI gain and obesity prevalence changes in children have not been clearly elucidated, especially in China. This study aims to assess the impact of pandemic-related BMI and obesity prevalence change in Chinese children aged 8–12 years. On the basis of the Health Promotion Program for Children and Adolescents in Suzhou of China, a total of 72,175 children aged 8–12 years with complete data during 2017–2020 were included. Yearly BMI z-score changes and age- and sex-adjusted BMI changes before (2017–2019) and during (2019–2020) the pandemic were calculated. Multivariate mixed linear models were used to examine the possible difference in annual BMI change rate before and during the pandemic among subgroups.

Characteristics of pandemic work–life balance in Slovenian military families during the lockdown: who has paid the highest price?

AUTHOR(S)
Janja Vuga Beršnak; Živa Humer; Bojana Lobe (et al.)

Published: October 2021   Journal: Current Sociology
In April 2020, a survey was conducted among Slovenian military families, being one of the first surveys to be carried out in the country after the outbreak of the pandemic. The military was labeled a crucial institution in the efforts to combat the SARS-CoV-2 virus and was appointed to various activities, leading to a considerable increase in its workload. The burden of care and unpaid work at that time also intensified, becoming shifted onto the military family, particularly civilian female spouses. The survey’s purpose was to measure how military families evaluated their success in balancing between working from home, household work, childcare, and home schooling during the pandemic lockdown. The risk factors were observed on the micro (i.e., lack of extended family support, institutional childcare, and school lockdown) and macro (i.e., military support, national support measures) social levels. The analysis reveals that when it comes to military families the greatest price has been paid by female civilian spouses. The number of children and their age influence parents’ self-evaluation of their success with work–life balance. The results show that big families and families with primary school children have been struggling the most during the lockdown. Surprisingly, dual-serving families felt the most successful.
Patterns and predictors of adolescent life change during the COVID-19 pandemic: a person-centered approach

AUTHOR(S)
Jingyi Shen; Ruixi Sun; Jianjie Xu (et al.)

Published: September 2021   Journal: Current Psychology
The present study investigated patterns of adolescent life changes across multiple life domains and utilized a holistic-interactionistic perspective to examine their individual, familial, and societal correlates with a sample of 2544 Chinese parent-adolescent dyads. Adolescents were aged from 10 to 19 years old (50.16% girls). Latent profile analysis revealed five life change profiles, including three improved profiles at various degrees, one unchanged profile, and one worsened profile. The majority of adolescents had an improved or unchanged life. Multinomial logistic regression analyses found that most of the individual, familial, and societal factors predicted the group memberships. Notably, parent-adolescent conflict was a significant factor that predicted memberships of all patterns. These findings show the resilience of adolescents and indicate the need for policies and interventions that consider the holistic nature of adolescents’ person-context system, especially during a global crisis such as the COVID-19 pandemic.
COVID-19-associated school closures and related efforts to sustain education and subsidized meal programs, United States, February 18–June 30, 2020

AUTHOR(S)
Nicole Zviedrite; Jeffrey D. Hodis; Ferdous Jahan (et al.)

Published: September 2021   Journal: Plos One
Pre-emptive school closures are frontline community mitigation measures recommended by the US Centers for Disease Control and Prevention (CDC) for implementation during severe pandemics. This study describes the spatiotemporal patterns of publicly announced school closures implemented in response to the coronavirus disease 2019 (COVID-19) pandemic and assesses how public K-12 districts adjusted their methods of education delivery and provision of subsidized meals. During February 18–June 30, 2020, it used daily systematic media searches to identify publicly announced COVID-19–related school closures lasting ≥1 day in the United States (US).
Material hardship and child neglect risk amidst COVID-19 in grandparent-headed kinship families: the role of financial assistance

AUTHOR(S)
Yanfeng Xua; Merav Jedwab; Nelís Soto-Ramírez (et al.)

Published: September 2021   Journal: Child Abuse & Neglect

COVID-19 has exacerbated material hardship among grandparent-headed kinship families. Grandparent-headed kinship families receive financial assistance, which may mitigate material hardship and reduce child neglect risk. This study aims to examine (1) the association between material hardship and child neglect risk; and (2) whether financial assistance moderates this association in a sample of kinship grandparent-headed families during COVID-19. Cross-sectional survey data were collected from a convenience sample of grandparent-headed kinship families (not necessarily child welfare involved) (N = 362) in the United States via Qualtrics Panels online survey.

Promoting children's mental, emotional, and behavioral (MEB) health in all public systems, post-COVID-19

AUTHOR(S)
Kimberly Eaton Hoagwood; William Gardner; Kelly J. Kelleher

Published: April 2021   Journal: Administration and Policy in Mental Health and Mental Health Services Research
The COVID-19 pandemic exacerbates the mental, emotional, and behavioral (MEB) health problems of children and adolescents in the United States (U.S.). A collective and coordinated national economic and social reconstruction efort aimed at shoring up services to promote children’s MEB, like the Marshall Plan that helped rebuild Europe post-World War II, has been proposed to buttress against the expected retrenchment. The plan prioritizes children’s well-being as a social objective.
Effects of voluntary event cancellation and school closure as countermeasures against COVID-19 outbreak in Japan

AUTHOR(S)
Yoshiyuki Sugishita; Junko Kurita; Tamie Sugawara

Published: December 2020   Journal: Plos One
To control the COVID-19 outbreak in Japan, sports and entertainment events were canceled and schools were closed throughout Japan from February 26 through March 19. That policy has been designated as voluntary event cancellation and school closure (VECSC). This study assesses VECSC effectiveness based on predicted outcomes. A simple susceptible–infected–recovered model was applied to data of patients with symptoms in Japan during January 14 through March 26. The respective reproduction numbers for periods before VECSC (R0), during VECSC (Re), and after VECSC (Ra) were estimated.
Impacts of Pandemics and Epidemics on Child Protection: Lessons learned from a rapid review in the context of COVID-19

AUTHOR(S)
Shivit Bakrania; Cirenia Chávez; Alessandra Ipince; Matilde Rocca; Sandy Oliver; Claire Stansfield; Ramya Subrahmanian

 

This rapid review collates and synthesizes evidence on the child protection impacts of COVID-19 and previous pandemics, epidemics and infectious disease outbreaks. It provides lessons for global and national responses to COVID19 and recommendations for future research priorities.

The evidence on the impacts of pandemics and epidemics on child protection outcomes is limited and skewed towards studies on the effects of HIV/AIDS on stigma. There is also some evidence on the effects of Ebola on outcomes such as orphanhood, sexual violence and exploitation, and  school enrolment, attendance and dropout. The evidence on other pandemics or epidemics, including COVID-19, is extremely limited.

There are various pathways through which infectious disease outbreaks can exacerbate vulnerabilities, generate new risks and result in negative outcomes for children. Outcomes are typically multi-layered, with immediate outcomes for children, families and communities - such as being orphaned, stigmatization and discrimination and reductions in household income - leading to further negative risks and outcomes for children in the intermediate term. These risks include child labour and domestic work, harmful practices (including early marriage), and early and adolescent pregnancy.

Lessons from previous pandemics and epidemics suggest that the following could mitigate the child protection risks:

  • Responding to children in vulnerable circumstances, including orphans (e.g. throughpsychosocial interventions focused on improving mental health and community-based interventions that provide families with resources and access to services)
  • Responding to stigmatization and discrimination (e.g. throughinformation and communication campaigns and support from public health systems, communities and schools)
  • Investing in social protectionenable livelihoods during outbreaks and to counteract shocks
  • Promoting access to health, protective and justice services, which may be restricted or suspending during infectious disease outbreaks
  • Ensuring continued access to education, particularly for girls, who may be adversely affected

There is a high burden of proof for data collection during the current COVID-19 outbreak than there would be in normal circumstances. Evidence generation strategies during and after the COVID-19 crisis should consider rigorous retrospective reviews and building upon monitoring, evidence and learning functions of pre-existing programmes – particularly where there is ongoing longitudinal data collection. There should also be efforts to synthesize evidence from existing research on the effectiveness of interventions that respond to the key risk pathways identified in this review.

 

 

 

Research Brief: Impacts of Pandemics and Epidemics on Child Protection: Lessons learned from a rapid review in the context of COVID-19

 

This research brief summarizes the findings of a rapid review that collates and synthesizes evidence on the child protection impacts of COVID-19 and previous pandemics, epidemics and infectious disease outbreaks. It provides lessons for global and national responses to COVID19 and recommendations for future research priorities.

The evidence on the impacts of pandemics and epidemics on child protection outcomes is limited and skewed towards studies on the effects of HIV/AIDS on stigma. There is also some evidence on the effects of Ebola on outcomes such as orphanhood, sexual violence and exploitation, and  school enrolment, attendance and dropout. The evidence on other pandemics or epidemics, including COVID-19. is extremely limited.

There are various pathways through which infectious disease outbreaks can exacerbate vulnerabilities, generate new risks and result in negative outcomes for children. Outcomes are typically multi-layered, with immediate outcomes for children, families and communities - such as being orphaned, stigmatization and discrimination and reductions in household income - leading to further negative risks and outcomes for children in the intermediate term. These risks include child labour and domestic work, harmful practices (including early marriage), and early and adolescent pregnancy.

Lessons from previous pandemics and epidemics suggest that the following could mitigate the child protection risks:

  • Responding to children in vulnerable circumstances, including orphans (e.g. throughpsychosocial interventions focused on improving mental health and community-based interventions that provide families with resources and access to services)
  • Responding to stigmatization and discrimination (e.g. throughinformation and communication campaigns and support from public health systems, communities and schools)
  • Investing in social protectionenable livelihoods during outbreaks and to counteract shocks
  • Promoting access to health, protective and justice services, which may be restricted or suspending during infectious disease outbreaks
  • Ensuring continued access to education, particularly for girls, who may be adversely affected

There is a high burden of proof for data collection during the current COVID-19 outbreak than there would be in normal circumstances. Evidence generation strategies during and after the COVID-19 crisis should consider rigorous retrospective reviews and building upon monitoring, evidence and learning functions of pre-existing programmes – particularly where there is ongoing longitudinal data collection. There should also be efforts to synthesize evidence from existing research on the effectiveness of interventions that respond to the key risk pathways identified in this review.

 

 

 

A Rapid Review of Economic Policy and Social Protection Responses to Health and Economic Crises and Their Effects on Children: Lessons for the COVID-19 pandemic response

This rapid review seeks to inform the initial and long-term public policy responses to the COVID-19 pandemic, by assessing evidence on past economic policy and social protection responses to health and economic crises and their effects on children and families. The review focuses on virus outbreaks/emergencies, economic crises and natural disasters, which, like the COVID-19 pandemic, were 'rapid' in onset, had wide-ranging geographical reach, and resulted in disruption of social services and economic sectors, without affecting governance systems. Evidence is also drawn from the HIV/AIDS pandemic, due to its impacts on adult mortality rates and surviving children.

The available evidence on the effects of economic policy and social protection responses is uneven across outcomes, regions, and type of policy response as a large body of literature focused on social assistance programmes. Future research on the COVID-19 pandemic can prioritize the voices of children and the marginalized, assess the effects of expansionary and austerity measures,  examine the role of design and implementation, social care services, pre-existing macro-level health, demographic and health conditions and the diverse regional health and economic impacts of the pandemic. The paper also provides key lessons for public policy responses to the COVID-19 pandemic.

 

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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.