Profiles

This brief undertakes a regional analysis of the impact of the war in Ukraine – and subsequent economic downturn – on the situation of children in Eastern Europe and Central Asia. We specifically examine the impacts on child poverty, school years lost, and infant mortality. Based on a demographic snapshot of the region, our models predict that an additional 10 million people – including about 4 million children – will be pushed into poverty compared to pre-war predictions. About 4,500 more children will die before their first birthday, and 117,000 years of schooling will be lost. The brief concludes with implications for the work of UNICEF and government partners in addressing these poverty risks.

Integrated social protection programmes are increasingly being pursued as more effective and efficient ways to improve children’s health and nutrition outcomes.

Integrated social protection programmes are increasingly being pursued as more effective and efficient ways to improve children’s health and nutrition outcomes.

Since 2009, the Transfer Project has generated rigorous evidence on the impacts of cash transfers in sub-Saharan Africa (SSA) and has supported their expansion.1 The Transfer Project is a collaborative network comprising UNICEF (Innocenti, Regional and Country Offices), Food and Agriculture Organization of the United Nations (FAO), the University of North Carolina at Chapel Hill, national governments and researchers. It aims to “provide evidence on the effectiveness of cash transfer programmes, inform the development and design of cash transfer policy and programmes, and promote learning across SSA on the design and implementation of research and evaluations on cash transfers”. this brief summarizes the current evidence and lessons learned from the Transfer Project after more than a decade of research. It also introduces new frontiers of research.

The COVID-19 pandemic that swept over the world from early 2020 has triggered both health and economic shocks of unprecedented proportions in recent memory. Some estimates suggest that the consequences of these shocks will likely erase most of the progress made in global development over the past two decades. Many countries now risk falling further behind the attainment of national and international development goals, including the UN’s Sustainable Development Goals. Children are particularly vulnerable to the effects of these shocks due to their persistent higher levels of vulnerability, and the reality that school closures and other COVID-19 containment measures can be more damaging to children. This report examines the effect of previous economic crises on children’s well-being in UNICEF’s West and Central Africa Region (WCAR) and makes projections regarding the potential impacts of COVID-19-induced economic crises on priority indicators for the region.

I recently had the privilege of visiting Northern Ghana to participate in the implementation of a study to assess the long-term impacts of the LEAP 1000 programme. LEAP 1000 is a cash plus intervention which provides cash and health insurance coverage for pregnant or lactating women with children up to 15 months. The study implementation involved training and data collection from beneficiary and non-beneficiary households, seven years after the commencement of the LEAP 1000 pilot intervention. The pilot programme, which was evaluated by the Transfer Project between 2015 and 2017, reported modest impacts on key household and child level indicators including food consumption, food security, economic productivity, and children’s material wellbeing. There were no impacts on child nutrition outcomes, adding to the growing body evidence on the limitations of cash transfer as a silver bullet to address children malnutrition challenges. The primary focus of the current study is to assess the longer-term impact of the LEAP 1000 on child labour and examine the educational and health trajectories of children that were engaged in child labour in the period between 2015 and 2017. The study will also look at other outcomes including asset accumulation, human capital accumulation, housing conditions, productive activities, and resilience to shocks. The study is funded by the United States Department of Labor (USDoL), led by the UNICEF Innocenti – Global Office of Research and Foresight, and implemented with researchers from ISSER.Being my first field visit anywhere in 3 years, I was excited to go back to localities that I had been to many times before. The mission was overall successful, and after observing a number of interview sessions, I returned from the mission with four reflections: Interviews and surveys place a large burden on respondents and researchers need to do everything to minimize this burden as much as possible. A paper on Monitoring and reducing respondent burden of statistical surveys outlines the four factors that constitute perceived respondent burden, including: frequency of contact, length of contact, required respondent effort, and stress of disturbing questions. It also proposes some of the innovative approaches to try and reduce respondent burden by combining surveys within and among agencies, building frameworks for improved data sharing, sample overlap controls, and improved use of modelling and estimation techniques. High respondent burden is not only bad for the respondents, but it also has huge implications for data quality through recall bias, social desirability bias and outright misrepresentation to avoid further questions.Without a deep understanding of context, policies and programmes that may have worked elsewhere will be ineffective or inefficient at best, or summarily fail. Visiting the communities and people we seek to impact with our research, policy, or programmes is a must for any persons involved with development. Otherwise, there is bound to be a huge disconnect between theories and realities with non-trivial consequences on effectiveness and efficiency. Putting faces to some of the abstract indicators and interacting with local actors doing their level best against several constraints, was re-energizing. Seeing the physical context where the elegant theoretical and conceptual frameworks of development are expected to be operationalized is always enlightening. The visit was also another reminder of the daunting task the global community faces in the effort to sustainably lift millions of people out of poverty in all its forms.Doing more for those most left behind is not only morally imperative, but economically justifiable. From playing cards to making articulated trucks from discarded metal cans, and talking about social issues, I was impressed by the talent and creativity of the children I interacted with in these communities. They demonstrated high levels of intellectual ability that I believe can be competitive anywhere in the world if they have comparable opportunities and exposure to develop the talents. Having grown up in a somewhat similar environment, I can easily point to several incredible talents that were never fully developed primarily due  to household financial constraints. The public returns to many low-cost interventions in education and health can be huge, as this blog highlights in the case of Burundi. Leaving no one behind requires equity-informed public policies to ensure a level playing field for every child, regardless of the disadvantages imposed by the conditions at birth.A fragmented space of diverse development actors creates duplication and redundancy, and promotes competition in areas where cooperation would lead to better outcomes. Transformative changes are more likely to be achieved with transformative policies and programmes underpinned by strong and sustainable systems. Looking at the current state of people’s welfare and reflecting on the numerous governmental and non-governmental development interventions and investments made in Northern Ghana in the past three decades, it was hard to imagine not having any of these interventions over the years. How much ‘good’ has been achieved with all the interventions, and could the same resources be used in a different way to achieve greater ‘good’? There are obviously no easy answers to these questions, and ‘good’ will be interpreted differently by different people. Nonetheless, there is undoubtedly more to gain when policies and programmes are more integrated rather than the contemporary fragmented and less coordinated interventions from diverse development players. I have personally been involved in the impact evaluations of at least five development interventions in Northern Ghana, and I can see how these interventions could benefit from synergies and ultimately be more impactful than the sum of impacts (if any) achieved by each programme separately. As the global economy faces severe uncertainties, and as most governments in the developing world continue to grapple with a looming debt crisis, finding more efficient and effective ways to development is critical. More multi-donor trust funds and partnerships will be valuable in this regard.Millions of people around the world continue to live in poverty through no fault of their own, and the global development architecture will not be able to achieve the objectives of the SDGs unless there is renewed effort to achieve more coherence and integration in development policy and practice, a better understanding of local contexts, and a focus on equity to ensure that no one is left behind. ##### Acknowledgment and DisclaimerFunding for the study, including the mission is provided by the United States Department of Labor under cooperative agreement number IL‐2669414-75-K-36. One hundred percentage of the total costs of the project or program is financed with USG federal funds, for a total of US$1,730,500 dollars. This material does not necessarily reflect the views or policies of the United States Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the United States Government.

Adolescence (10-19 years) is a make or break period when individuals begin to consolidate their physical, cognitive, emotional and socio-economic foundations that will shape their lives. Adolescence is a critical period as many individuals never fully recover from any developmental shortcomings they experience. Yet in today’s world, many adolescents lack access to critical services in health, education, psycho-social support, parental guidance and an enabling environment that would adequately prepare them for a safe transition to adulthood.Adolescence is a critical period as many individuals never fully recover from any developmental shortcomings they experience.The World Bank Human Capital Project and the African Union roadmap on taking full advantage of the demographic dividend recognize the importance of investing in young people as a necessary condition for the realization of several national goals and the SDGs. Nonetheless, a yawning gap exists between this understanding and the reality in several countries. Expenditure on social services are widely perceived as costs with no tangible public returns, at least in the short run. As a result, there is usually a tendency to underinvest in building human capital in favor of items such as roads or bridges for which benefits are more tangible and immediate, and which also tend to be politically more expedient.In an effort to draw attention to this investment gap and the practical implications of the lack of investment, the UNICEF Country Office in Burundi, working in coordination with government ministries (under the leadership of the Ministry of Youth, Posts and Information Technology) and other development partners (UNFPA, UN Women and UNDP) have recently undertaken an investment case for adolescents in the country.Burundi currently faces many challenging socio-economic conditions as it recovers from a period of social and political instability. GDP per capita was estimated at about $262 in 2019, down from $305 in 2015 (WB, 2020). Burundi is ranked 185 out of 189 countries on the UNDP Human Development Index of 2019; and ranked 138 out of 157 on World Bank Human Capital Index of 2018. Adolescents make up about 25 per cent of the population, of which about 30 per cent are already out of school. Only 10 per cent of the relevant age cohort complete secondary education, and there are many issues relating to the quality of education. Adolescent mortality rate is 277 per 100,000, ranking 172 out of 183 countries by WHO in 2017. Malaria and tuberculosis account for 27 per cent and 25 per cent respectively of these deaths. Among males, the death rate due to road accident is 24 per 100,000. About 9 per cent of girls 15-19 are mothers with an unmet need for family planning at 55 per cent and maternal conditions account for 21 deaths per 100,000 girls of ages 15-19.Children play a game at a recreational space in Rumonge Province, Burundi, opened in January 2019. Members of the community have assumed responsibility for its management and funding.Burundi’s investment case focuses on interventions aimed at improving the health and education/skills acquisition of adolescent girls and boys. The health interventions include preventive and curative strategies relating to reproductive health, maternal and child health, malaria, mental health, HIV/AIDS, tuberculosis, human papillomavirus (HPV), and road accidents. The education interventions include those targeted at formal education:  teaching and learning, school infrastructure and cash for the poorest students; and those targeted at non-formal education: social innovation and entrepreneurship, trade certificates and professional training.Direct benefits of the health interventions are estimated using the OneHealth Tool  which takes into account current prevalence of each condition and the morbidity and mortality that can be averted by adopting various tested interventions[i]. All together, the health interventions are expected to lead to:a reduction in the adolescent fertility rate by 23.7 per cent resulting in 25,817 fewer (usually unplanned) births;1,361 stillbirths and 1,580 newborn deaths to adolescent mothers averted;75 maternal deaths of adolescents averted;15,157 fewer children of adolescents stunted;6,300 adolescents lives saved from tuberculosis;1,500 adolescent lives saved from road traffic injuries;5,798 adolescents saved from serious disability from road traffic crashes; and16,842 lives saved form cervical cancer over the lifetime of the targeted cohort.The education interventions, compared to following the status-quo, are projected to achieve:Increase in school enrolment of adolescents (15-19) from a current level of 55 per cent to 71 per cent by 2030;Reduction from 30 per cent to 11 per cent of students leaving school with only primary education;350,000 additional beneficiaries acquire a trade certificate;40,000 adolescents acquire vocational training; andproductivity of males aged 20-24 in 2050 increased by 85.9 per cent while that of females aged 20-24 in the same year is increased by 102.2 per cent.Put together, the health and education interventions would inevitably result in a healthier and more productive labour force that can transform the economic fortunes of the country in the coming decades. The total (cumulative) cost for financing all the proposed interventions up to 2030 is about USD 1.2 billion (approximately $124 million per annum), which is modest compared to all the immediate benefits enumerated above. What is even more reassuring is the fact that the estimated economic value and social benefits from these investments are more than tenfold the cost.The results of the modeling framework show that, an annual investment of $8.8 million in the health interventions over the period 2019 – 2030 would accrue social and economic benefits of magnitude that translate to a benefit-to-cost (BCR) ratio of 16.4. Similarly, investments of $115.2 million per annum in the education interventions over the period 2019 – 2030 is expected to provide a BCR of 9.7. The full report is available here.[ii] The economic benefits are realized from the output of people who would otherwise be dead or severely disabled, and from the increased productivity from a more skilled and healthier workforce.Analysis of recent budgets of the Burundi government shows an already high commitment to education and health (about 30 per cent in 2018/2019 budget) leaving limited fiscal space for these additional expenses to be borne by the Government. There may be some room for increasing tax revenues and increasing the efficiency of public spending, but the key to bridging the financing gap lies in increased overseas development assistance and innovative financing schemes such as the Global Financing Facility, the Global Fund to fight HIV/AIDS, Malaria and TB, and GAVI.The fallout of the COVID pandemic will likely put more adolescents at risk of missing out on key development milestones and government budgets will likely become overstretched as the effects of the global economic slowdown continue to bite. As noted by the Executive Director of UNICEF at the launch of the Generation Unlimited initiative in 2018:The change in demographics the world is experiencing, coupled with fast-moving technological advances, presents a critical moment in history. If we act wisely and urgently, we can create a skilled cohort of young people better prepared to create sustainable economies, and peaceful and prosperous societies. Young people may represent 25 per cent of the global population, but they account for 100 per cent of the future. We cannot afford to fail them.[i] Models take account of the effectiveness of interventions and potential uptake where necessary[ii] Future costs and benefits are discounted as appropriate. Frank Otchere is social policy specialist with the UNICEF Office of Research - Innocenti in Florence, Italy.

It is a known fact that in nearly every country, children are more likely to live in (monetary) poverty than adults (19% versus 9% respectively in 2018). This has immediate effects on the well-being of children, their development prospects and consequently their adult life. Cash transfer programs targeted at the poorest households have become one of the key policy tools for ameliorating the situation with a proven track record of success.However, contemporary approaches to targeting are notoriously error-prone. Deserving groups may be excluded, some miss out due to fluid transitions in-and-out of poverty. Cash transfers are operationally costly, and sometimes give rise to intra-community tensions. Some cash transfer programmes impose conditions that diminish dignity, re-enforce gender stereotypes that exacerbate women’s time poverty, or promote political patronage.Universal child grants are monthly cash transfers that are provided to the caregiver of every single child that lives in a defined jurisdiction – perhaps only subject to legal status requirements. Universal child grants are proposed as a possible solution to fix these challenges associated with the targeted cash transfer schemes. They can essentially reduce child poverty to the bare minimum or eradicate it altogether. Two obvious objections are the fiscal implications of full coverage and the potential unintended negative consequences (such as increasing fertility or reduced labor supply).Universal child grants are monthly cash transfers to the caregiver of every single child that lives in a defined jurisdiction.Click image to access the report.Recently UNICEF, ILO and the Overseas Development Institute convened an international conference to explore arguments and evidence from implementation of alternative cash transfer schemes and their implications for universal child grants. (Find all key conference background documents – agenda, session recordings, participant list, concept note here) I had the pleasure of attending and presenting at this conference and am eager to share key takeaways and reflections.First, it would be better to use the word ‘benefits’ in place of ‘grants.’ While this may sound like mere semantics, the word ‘benefits’ frames the proposition as a need to fulfill an entitlement: a positive right, not the idea of a favour, which the word ‘grants’ is more associated with. If there are no costs associated with changing the framing, I would think ‘universal child benefit’ would be more appealing term, but I will stick to ‘universal child grant’ for the rest of the this post.The next three takeaways are communicated in three numbers: 35, 8 and 1.5.35% of children/households receive child/family cash benefits globally. Differences exist across countries and regions with 88% coverage in Europe and Central Asia, 28% in Asia and the Pacific and 16% in Africa. Given the large shares of children in Africa and Asia, these figures imply that almost two thirds of children (1.3 billion) are not covered by any form of social protection. Some 23 countries already have non-contributory universal child grants while an additional 40 countries have non-contributory means-tested schemes, and there are a lot of lessons learnt from these schemes to inform other countries in design and implementation. (Click on the report cover image to download the full ILO-UNICEF report)8 policy options have been proposed for creating fiscal space in national budgets to fund universal child grants outlined in this paper:Re-allocating of public expenditures;Increasing tax revenues;Expanding social security coverage and contributory systems;Lobbying for aid and transfers;Eliminating illicit financial flows;Using fiscal and foreign exchange reserves;Managing debt; andAdopting a more accommodative macroeconomic framework.The paper illustrates how Governments can apply them based on their unique circumstances. The authors contend that “fiscal space for social protection and the SDGs exists even in the poorest countries.”  Mario Györishowed how reallocating the funding for a current food and energy subsidy could create fiscal room to fund a universal child allowance, with greater impact on poverty.1.5% of GDP, on average, is required to fund universal child grants in various countries. An important contribution frm one session at the conference was that funding for universal child grants should be indexed as a share of government expenditure and not GDP, and I fully agree with this position. Linking funding to government expenditure would directly put the question of prioritization (not trade-offs) in focus.The World Bank and the IMF representatives in the final plenary agreed, in principle, to the idea of universal social protection for children (at least for those aged 0-2 years).  Michal Rutkowski, Senior Director for Social Protection and Jobs at the World Bank described the idea of supporting children (especially the vulnerable) and investing in their future as marriage made in heaven: good social contract and good economics.Author's presentation at the International Conference on Universal Child Grants, Geneva. Click image to access slides.Listening to presentations from different countries, it was clear that governments around the world recognize the need to progressively move towards universal child grants in some shape or form. There were discussions about administration and implementing challenges, and the question of the covering the last mile (reaching the hardest to reach). The question of benefit level and provision for the caregiver (or rest of the household) are also open questions for which there was not much time to cover.To achieve SDG goal 1.3 to implement nationally appropriate social protection systems for all children, the best route would be through universal child grants. They should be prioritized in government allocations as an important first step towards social protection for all. A global universal child grant fund – like the Global Fund for HIV, Tuberculosis and Malaria should be created to accumulate enough reserve to finance grants starting with the poorest countries, and where political conditions are least favourable. These are often the very countries where child poverty rates are highest and where the investments would yield the highest returns. Operational headwinds may abound but that should not be enough justification for delaying action. I look forward to the final publications from the conference and the next steps in the space. Frank Otchere  Social Policy Specialist at UNICEF Innocenti, is a Statistician and Demographer by training, and has worked on several Transfer Project impact evaluations, including Ghana, Malawi and Zimbabwe.