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UNICEF Innocenti's complete catalogue of research and reports
Reimagining Migration Responses: Learning from children and young people who move in the Horn of Africa
SPOTLIGHT

Reimagining Migration Responses: Learning from children and young people who move in the Horn of Africa

The number of international migrants under 18 is rising, accelerated by complex and fast-evolving economic, demographic, security and environmental drivers. Based on interviews carried out with 1,290 migrant children and young people in Ethiopia, Somalia and Sudan, this report helps address the evidence gap on children and young people migrating in the Horn of Africa by providing a better understanding of their protective environments; their access to services and resources; and their perceptions of safety, well-being and trust in authorities and other providers. It concludes by offering policy and programme recommendations to rethink child protection approaches for migrants in the region.
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COVID-19: Missing More Than a Classroom. The impact of school closures on children’s nutrition
Blog Blog

COVID-19: Missing More Than a Classroom. The impact of school closures on children’s nutrition

In 2019, 135 million people in 55 countries were in food crises or worse, and 2 billion people did not have regular access to safe, nutritious and sufficient food. COVID-19 has exacerbated these hardships and may result in an additional 121 million people facing acute food insecurity by the end of 2020. Further, since the beginning of the pandemic, an estimated 1.6 billion learners in 199 countries worldwide were affected by school closures, with nearly 370 million children not receiving a school meal in 150 countries. The paper presents the evidence on the potential negative short-term and long-term effects of school meal scheme disruption during Covid-19 globally. It shows how vulnerable the children participating in these schemes are, how coping and mitigation measures are often only short-term solutions, and how prioritizing school re-opening is critical. For instance, it highlights how girls are at greater risk of not being in school or of being taken out of school early, which may lead to poor nutrition and health for themselves and their children. However, well-designed school feeding programmes have been shown to enable catch-up from early growth failure and other negative shocks. As such, once schools re-open, school meal schemes can help address the deprivation that children have experienced during the closures and provide an incentive for parents to send and keep their children, especially girls, in school.
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The Evolving Epidemiologic and Clinical Picture of SARS-CoV-2 and COVID-19 Disease in Children and Young People
The Evolving Epidemiologic and Clinical Picture of SARS-CoV-2 and COVID-19 Disease in Children and Young People
Published: 2020 Innocenti Working Papers
The initial impression that paediatric SARS-CoV-2 infection is uncommon and generally mild has been replaced by a more nuanced understanding of infectious manifestations in children and adolescents across low-, middle-, and high-income countries and by demographic structure, with recognition of a widening disease spectrum. Critical knowledge gaps, especially in low- and middle-income countries remain, that have significant public policy and programme implications. Insufficient data disaggregated by age, geography and race/ethnicity are hindering efforts to fully assess prevalence of infection and disease in children and adolescents and their role in transmission. Potential biologic differences in susceptibility to infection and between children and adults need to be assessed. Determination of mother-to-child SARS-CoV-2 transmission during pregnancy or peripartum requires appropriate samples obtained with proper timing, lacking in most studies. Finally, predictors of disease progression, morbidity and mortality in children need to be determined particularly as the pandemic moves to low- and middle-income countries, where poor nutritional and health conditions and other vulnerabilities are more frequent among children than in higher-income settings. Countries, UN agencies, public health communities, donors and academia need to coordinate the efforts and work collectively to close the data and knowledge gaps in all countries (high-, middle- and low-income) for better evidence to guide policy and programme decision-making for children and COVID-19 disease.
Cite this publication | No. of pages: 62 | Thematic area: Health
Worlds of Influence: Understanding What Shapes Child Well-being in Rich Countries
Worlds of Influence: Understanding What Shapes Child Well-being in Rich Countries
Published: 2020 Innocenti Report Card

A new look at children from the world’s richest countries offers a mixed picture of their health, skills and happiness. For far too many, issues such as poverty, exclusion and pollution threaten their mental well-being, physical health and opportunities to develop skills. Even countries with good social, economic and environmental conditions are a long way from meeting the targets set in the 2030 Agenda for Sustainable Development. Focused and accelerated action is needed if these goals are to be met.

The evidence from 41 Organisation for Economic Co-operation and Development (OECD) and European Union (EU) countries tells its own story: from children’s chances of survival, growth and protection, to whether they are learning and feel listened to, to whether their parents have the support and resources to give their children the best chance for a healthy, happy childhood. This report reveals children’s experiences against the backdrop of their country’s policies and social, educational, economic and environmental contexts.

Does COVID-19 Affect the Health of Children and Young People More Than We Thought? The case for disaggregated data to inform action
Does COVID-19 Affect the Health of Children and Young People More Than We Thought? The case for disaggregated data to inform action
Published: 2020 Innocenti Research Briefs

Contrary to the current narrative, the risks of COVID-19 disease in children and young people depend largely on where individuals live and how vulnerable they are to disease and ill health.

It is commonly accepted, at least for now, that children and young people under 20 years of age have largely been spared the direct epidemiological effects on their own health and survival of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for COVID-19 disease. This narrative is based predominantly on early data from the countries first affected by the virus, notably China (Wuhan province) and Italy in early 2020, and also from other high-income countries (HICs) including the United States and some European nations. This narrative has conditioned the subsequent screening and testing for SARS-CoV-2 virus in children and young people under 20, which have been notably lower than for other age cohorts in many, but not all, countries. But demographic profiles differ widely between countries, and assumptions and narratives based on evidence taken from ageing societies, typical of HICs, may not hold for more youthful and growing populations, as illustrated by the contrast between the age-cohort profiles of COVID-19 cases for Italy and Kenya. For this reason, and given that the vast majority of the world’s children and young people live in low- and middle-income countries (LMICs) and territories, we began to investigate the burden of COVID-19 cases among children and young people under 20 globally.

Cite this publication | Thematic area: Health
Adolescents’ Mental Health: Out of the shadows. Evidence on psychological well-being of 11-15-year-olds from 31 industrialized countries
Adolescents’ Mental Health: Out of the shadows. Evidence on psychological well-being of 11-15-year-olds from 31 industrialized countries

AUTHOR(S)
Zlata Bruckauf

Published: 2017 Innocenti Research Briefs

Mental health is increasingly gaining the spotlight in the media and public discourse of industrialized countries. The problem is not new, but thanks to more open discussions and fading stigma, it is emerging as one of the most critical concerns of public health today. Psychological problems among children and adolescents can be wide-ranging and may include attention deficit hyperactivity disorder (ADHD), disruptive conduct, anxiety, eating and mood disorders and other mental illnesses. Consistent evidence shows the links between adolescents’ mental health and the experience of bullying. Collecting internationally comparable data to measure mental health problems among children and adolescents will provide important evidence and stimulate governments to improve psychological support and services to vulnerable children.

Child Malnutrition, Consumption Growth, Maternal Care and Price Shocks: New Evidence from Northern Ghana
Child Malnutrition, Consumption Growth, Maternal Care and Price Shocks: New Evidence from Northern Ghana
Published: 2017 Innocenti Working Papers

Childhood malnutrition remains a significant global health concern. In order to implement effective policies to address the issue, it is crucial to first understand the mechanisms underlying malnutrition. This paper uses a unique dataset from Northern Ghana to explain the underlying causes of childhood malnutrition. It adopts an empirical framework to model inputs in the production of health and nutrition, as a function of child, household and community characteristics. The findings suggest that child characteristics are important in explaining inputs and nutritional outcomes, and that maternal agency and health contribute to improved health status. Household resources in the form of consumption are positively associated with food intake and nutritional outcomes. Simulations show that income growth, improving maternal care and avoiding sudden price shocks have a positive but rather limited effect on the reduction of malnutrition. Effects are greater in children under two. Hence, policies that address underlying determinants simultaneously, and target the youngest population of children, could have the largest effect on reducing malnutrition in this population.

The Impact of Cash Transfers on Food Security
The Impact of Cash Transfers on Food Security

AUTHOR(S)
Lisa Hjelm

Published: 2016 Innocenti Research Briefs

Vulnerable populations in sub-Saharan African countries often face high levels of food insecurity which disproportionately affect households living in poverty and children are particularly at risk. This review of eight social cash transfer programme evaluations has shown that cash transfers have an impact on several different dimensions of food security. However, few evaluations include child-specific questions and to make stronger links between food security and nutrition status individual-level indicators are needed. Despite limitations, there is good evidence that cash transfers have a large impact on food security.

Early-life Exposure to Income Inequality and Adolescent Health and Well-being: Evidence from the Health Behaviour in School-aged Children Study
Early-life Exposure to Income Inequality and Adolescent Health and Well-being: Evidence from the Health Behaviour in School-aged Children Study
Published: 2016 Innocenti Working Papers

Children and adolescents living in relative poverty – regardless of overall material conditions – tend to experience more interpersonal violence, family turmoil, and environmental hazards that increase risk of injury, engage in more health compromising behaviours (e.g., physical inactivity, poor nutrition, smoking), report lower subjective well-being, and exhibit more social skills deficits and emotional and behavioural problems.

Why Income Inequalities Matter for Young People’s Health: A look at the evidence
Why Income Inequalities Matter for Young People’s Health: A look at the evidence
Published: 2016 Innocenti Working Papers

Although child and adolescent inequalities are still less understood than those of adults, we have made progress in understanding the pathways that lead to negative outcomes and the limitations of some ‘adult-specific’ indicators as proxies of young people’s health and well-being. Nonetheless, the academic literature has been able to establish a clear negative relationship between a person’s material circumstances and their health outcomes and behaviours such as being overweight, lack of physical activity, higher levels of smoking and mental health problems, all of which persist throughout a person’s life. The personal and societal toll of these effects is clear, yet policies are still lagging behind, tackling proximal causes rather than ‘the causes of the causes’ of these health inequalities. This paper aims to summarise relevant knowledge on the socio-economic causes of health inequalities in children. It will not only provide a foundation to the Innocenti Report Card 13 in terms of outlining our knowledge regarding the drivers of health inequality but it will also help us shed light on its consequences.

Cite this publication | No. of pages: 24 | Thematic area: Adolescents, Health | Tags: adolescent health, income, inequality
Inequalities in Adolescent Health and Life Satisfaction: Evidence from the Health Behaviour in School-aged Children study
Inequalities in Adolescent Health and Life Satisfaction: Evidence from the Health Behaviour in School-aged Children study
Published: 2016 Innocenti Working Papers

International studies of inequalities in adolescent health tend to focus on the socio-economic gradient in average outcomes rather than their dispersion within countries. Although understanding the extent to which differences in health are related to socio-economic disadvantage is important, focusing exclusively on socio-economic status risks neglecting differences in the distribution of health outcomes within and between countries. To fill this research gap, this study analyses variation in the extent of inequality in the lower half of the distribution in five indicators of adolescent health and well-being – health symptoms, physical activity, healthy eating, unhealthy eating, and life satisfaction – across EU and/or OECD countries that took part in the latest cycle of the Health Behaviour in School-aged Children study.

Family Affluence and Inequality in Adolescent Health and Life Satisfaction: Evidence from the HBSC study 2002-2014
Family Affluence and Inequality in Adolescent Health and Life Satisfaction: Evidence from the HBSC study 2002-2014
Published: 2016 Innocenti Working Papers

A large body of literature has established socio-economic gradients in adolescent health, but few studies have investigated the extent to which these gradients are associated with very poor health outcomes. The current analysis examined the extent to which the socio-economic background of adolescents relates to very poor self-reported health and well-being (the so-called ’bottom end’). We examined the following as indicators of adolescent health: psychosomatic health complaints; physical activity; healthy eating; unhealthy eating; and life satisfaction. Adolescents who scored below the mean of the lower half of the distribution of a given indicator fall in the “bottom group” on this indicator. The largest, most persistent and widespread socio-economic gradients are in life satisfaction, physical activity and healthy eating, while the findings are mixed for unhealthy eating and psychosomatic health. Socio-economic inequalities were largely stable, but in a sizeable minority of the countries, socio-economic inequalities in physical activity and healthy eating have widened between 2001/02 and 2013/14, while inequalities in unhealthy eating and life satisfaction have narrowed in several countries.

Poverty and Children’s Cognitive Trajectories: Evidence from the United Kingdom Millennium Cohort Study
Poverty and Children’s Cognitive Trajectories: Evidence from the United Kingdom Millennium Cohort Study
Published: 2016 Innocenti Working Papers

Existing evidence is inconclusive on whether a socio-economic gradient in children’s cognitive ability widens, narrows or remains stable over time and there is little research on the extent of ‘cognitive mobility’ of children who had a poor start in life compared to their peers. Using data from five sweeps of the United Kingdom (UK) Millennium Cohort Study (MCS) at the ages of 9 months, 3 years, 5 years, 7 years and 11 years, this paper explores the cognitive ability trajectory of children in the bottom decile of the distribution at a given age, and the factors that drive or hinder their progress relative to their peers. The paper analyses children’s risks of moving in and out of the bottom decile of the cognitive ability distribution. The findings indicate a relatively high level of cognitive mobility between ages 3 and 11, especially in the pre-school period (between ages 3 and 5), with children from income-poor households more likely to get ‘trapped’ in the bottom of the age-specific cognitive ability distribution.

Does Market Access Mitigate the Impact of Seasonality on Child Growth? Panel data evidence from northern Ethiopia
Does Market Access Mitigate the Impact of Seasonality on Child Growth? Panel data evidence from northern Ethiopia
Published: 2016 Innocenti Working Papers

Seasonality in agricultural production continues to shape intra-annual food availability and prices in low-income countries. Using high-frequency panel data from northern Ethiopia, this study attempts to quantify seasonal fluctuations in children's weights. In line with earlier studies, we document considerable seasonality in children’s age and height adjusted weights. While children located closer to local food markets are better nourished compared to their counterparts residing in more remote areas, their weights are also subject to considerable seasonality. Further analysis provides evidence that children located closer to food markets consume more diverse diets than those located farther away. This leads us to conclude that households located near these food markets are not able to insulate their children from seasonal weight fluctuations.

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Learning at a Distance: Children’s remote learning experiences in Italy during the COVID-19 pandemic
Publication Publication

Learning at a Distance: Children’s remote learning experiences in Italy during the COVID-19 pandemic

Italy was the first country in Europe to implement a nationwide lockdown. Children and their families lived in nearly complete isolation for almost two months. Students missed 65 days of school compared to an average of 27 missed days among high-income countries worldwide. This prolonged break is of concern, as even short breaks in schooling can cause significant loss of learning for children and lead to educational inequalities over time. At least 3 million Italian students may not have been reached by remote learning due to a lack of internet connectivity or devices at home. This report explores children’s and parents’ experiences of remote learning during the lockdown in Italy, drawing on data collected from 11 European countries (and coordinated by the European Commission’s Joint Research Center). It explores how children's access and use of digital technologies changed during the pandemic; highlights how existing inequalities might undermine remote learning opportunities, even among those with internet access; and provides insights on how to support children’s remote learning in the future. *** L'Italia e’ stata il primo paese in Europa ad aver applicato la misura del lockdown su tutto il territorio. I bambini e le loro famiglie hanno vissuto in quasi completo isolamento per circa due mesi. Gli studenti hanno perduto 65 giorni di scuola rispetto ad una media di 27 negli altri paesi ad alto reddito del mondo. Questa interruzione prolungata rappresenta motivo di preoccupazione, in quanto persino interruzioni piu’ brevi nella didattica possono causare significative perdite nel livello di istruzione dei ragazzi e portare col tempo a diseguaglianze educative. Almeno 3 milioni di studenti in Italia non sono stati coinvolti nella didattica a distanza a causa d una mancanza di connessione ad internet o di dispositivi adeguati a casa. Questo rapporto analizza l’esperienza della didattica a distanza di ragazzi e genitori in Italia durante il lockdown, sulla base dei dati raccolti in 11 paesi europei (e coordinati dal Centro comune di ricerca della Commissione Europea). Studia il cambiamento nell’accesso e nell’uso delle tecnologie digitali dei bambini e ragazzi durante la pandemia; mette in evidenza come le diseguaglianze esistenti possano diminuire le opportunità offerte dalla didattica a distanza, anche tra coloro che hanno accesso ad internet; e fornisce approfondimenti su come sostenere la didattica a distanza di bambini e ragazzi in futuro.
Time to Teach: Teacher attendance and time on task in Eastern and Southern Africa
Publication Publication

Time to Teach: Teacher attendance and time on task in Eastern and Southern Africa

There is a learning crisis. Fifty-three per cent of children in low- and middle-income countries are in ‘learning poverty’, i.e. they cannot read and understand a simple text by the end of primary school age. In sub- Saharan Africa, the learning poverty rate is 87 per cent overall, and ranges from 40 per cent to as high as 99 per cent in the 21 countries with available data. Teachers attending lessons and spending quality time on task is a critical prerequisite to learning. However, in sub-Saharan Africa, teacher absenteeism ranges from 15 to 45 per cent. Teacher absenteeism and reduced time on task wastes valuable financial resources, short-changes students and is one of the most cumbersome obstacles on the path toward the education Sustainable Development Goal and to the related vision of the new UNICEF education strategy: Every Child Learns. Whilst the stark numbers are available to study, and despite teacher absenteeism being a foremost challenge for education systems in Africa, the evidence base on how policies and practices can influence teacher attendance remains scant. Time to Teach (TTT) is a research initiative that looks at primary school teacher attendance in eight countries and territories in the Eastern and Southern Africa (ESA) region: the Comoros; Kenya; Rwanda, Puntland, State of Somalia; South Sudan; the United Republic of Tanzania, mainland; the United Republic of Tanzania, Zanzibar; and Uganda. Its primary objective is to identify factors affecting the various forms of teacher attendance, which include being at school, being punctual, being in the classroom, and teaching when in the classroom, and use this evidence to inform the design and implementation of teacher policies.

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