Child-related Policies in the First Year of the COVID-19 Pandemic in 40 Countries

Child-related Policies in the First Year of the COVID-19 Pandemic in 40 Countries

AUTHOR(S)
Mary Daly; Sunwoo Ryu; Ertuğrul Polat

Published: 2023 Innocenti Working Papers
Child-related Policies in the First Year of the COVID-19 Pandemic in 40 Countries uses evidence to present a broad-ranging analysis of the child-related policies and activities undertaken by the 40 European Union (EU) and Organisation for Economic Co-operation and Development (OECD) countries. This working paper focuses on six policy fields: education, early childhood education and care (ECEC), parental leave, income support, food support and health-related provision. 

It concludes that:

Child and family policy was active during the COVID-19 pandemic

Developments tended to focus on protecting adults from risks rather than children.

Child-related measures took time to evolve and were, as a result, reactive in manner

There was a wide variety of measures adopted across countries.

This working paper was partially funded by the University of Oxford and UNICEF Innocenti – Global Office of Research and Foresight.
Evidence-based intervention design for behaviour change during a health emergency

Evidence-based intervention design for behaviour change during a health emergency

Published: 2023 Innocenti Research Report
As vaccine availability has increased in much of the world, challenges remain related to acceptance and uptake of COVID-19 vaccines, further compounded by global inequities in vaccine access and the emergence of new variants. As such, non-pharmaceutical interventions (NPIs) continue to be an important tool in slowing and preventing the spread of SARS-CoV-2. 
 
This series of rapid evidence assessments (REA), using the COM-B model as a theoretical framework, sought to understand the existing evidence about who delays or refuses COVID-19 vaccination and who does not adhere to NPI measures, why and in what contexts. The objective is to inform tailored policies and interventions that support vaccination acceptance and adoption of recommended NPI measures, drawing in the COM-B Behaviour Change Wheel. 

Demographics did not consistently predict non-adherence to protective behaviours during the COVID-19 pandemic. In terms of psychological capability, people with less COVID-19 knowledge are more likely to delay or refuse vaccination and not adhere to social distancing. In terms of social opportunities, people who perceive less social normative pressure to engage in protective behaviours are more likely to not adhere to social distancing and mask wearing recommendations. In terms of reflective motivations, people who perceive the protective behaviour to be less effective are more likely to delay or refuse vaccination and avoid mask wearing; people who perceive themselves to have less control over protective behaviours are less likely to adopt social distancing and mask wearing behaviours; and people who perceive themselves to be less susceptible to catching COVID-19 are more likely to avoid or refuse vaccination and to not adhere to mask wearing recommendations.
 
The series of REAs was used to develop an evidence-informed practical toolkit for policy makers and practitioners to inform decision making around future efforts to promote uptake and maintenance of some or all recommended NPIs to mitigate the spread of outbreaks of transmissible respiratory diseases, including potential new and emerging pandemic threats.   
Children and COVID-19 Research Library Quarterly Digest Issue 6

Children and COVID-19 Research Library Quarterly Digest Issue 6

Published: 2023 Innocenti Digest
This COVID-19 Digest explores this 'crisis of care'. It examines the evidence that has emerged in recent years on how COVID-19 has affected the care that women and children provide and receive. 12 studies, selected from the Innocenti's Children and COVID-19 Research Library, are highlighted to provide insights into several dimensions of the crisis that are highly relevant to children's well-being and that can provide lessons for responding to other types of crises that the world is facing or will face in the future. 
 
The pandemic, associated lockdowns, and other containment measures have had a disproportionate impact on the care and domestic work of women, particularly those who experience other intersecting inequalities, including race, class, gender identity, and location. This Digest examines the impact of the pandemic on gender imbalances in paid and unpaid work, focusing in particular on vulnerable and marginalized women and girls. Whether care and domestic work are unpaid in the home or paid, limited public or private investment in care services increases the cost of meeting families' care and domestic needs. These activities are overwhelmingly carried out by women and girls worldwide, affecting their educational and employment prospects and creating gender inequalities in leisure time. They are usually carried out without any monetary compensation or are paid at low rates. They are also likely to increase in the face of shocks and stresses such as those experienced by COVID-19.
What works to increase uptake of childhood immunization: a rapid evidence assessment of the impact of interventions targeting caregivers, healthcare workers and communities

What works to increase uptake of childhood immunization: a rapid evidence assessment of the impact of interventions targeting caregivers, healthcare workers and communities

AUTHOR(S)
Benjamin Hickler; John O'Rourke; Andrea Yearwood; Greg Sheaf; Sergiu Tomsa; Viviane Bianco; Mario Mosquera; Shivit Bakrania

Published: 2023 Innocenti Research Report
Vaccination is one of the most effective measures for preventing illness, disability and death among children. However, current vaccination coverage provides insufficient protection for all children, and deaths from vaccine-preventable diseases account for an estimated 21.7 per cent of deaths in children under 5 years old globally. 

This rapid evidence assessment (REA) looked at the global evidence regarding the  effectiveness of interventions to increase uptake of vaccination services. The findings have global relevance but were also used to make more specific recommendations to address challenges identified in consultations with UNICEF’s Europe and Central Asia Regional Office (ECARO). 
The Impact of Interventions Targeting Caregivers, Health Workers and the Community to Alter Vaccine Behaviours and Childhood Vaccination Uptake: A Rapid evidence assessment protocol

The Impact of Interventions Targeting Caregivers, Health Workers and the Community to Alter Vaccine Behaviours and Childhood Vaccination Uptake: A Rapid evidence assessment protocol

AUTHOR(S)
John O'Rourke; Andrea Yearwood; Greg Sheaf; Sergiu Tomsa; Viviane Bianco; Mario Mosquera; Shivit Bakrania; Benjamin Hickler

Published: 2022 Innocenti Working Papers

Vaccination is one of the most effective measures for preventing illness, disability and death. In Europe and Central Asia, routine immunization rates vary between countries and over time. Behavioural determinants of vaccine hesitancy in the region include diminished trust among caregivers and health professionals; knowledge and awareness of vaccination; perceptions of risk; and health professionals’ skills, knowledge and attitudes.

This rapid evidence assessment aims to summarize the impact of interventions targeting caregivers, healthcare workers and the community to improve intention and motivation to vaccinate and vaccination rates of children under 5 years old. The evidence will inform policy and programmatic recommendations.

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

AUTHOR(S)
Priscilla Idele; David Anthony; Lynne M Mofenson; Jennifer Requejo; Danzhen You; Chewe Luo; Stefan Peterson

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, 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 continue to hinder efforts to fully assess prevalence of infection and disease manifestations in children and adolescents and their role in transmission. Potential biologic differences in susceptibility to infection and transmissibility between children, adolescents and adults need to be assessed. Determination of mother-to-child SARS-CoV-2 transmission during pregnancy, the peripartum period, or through breastfeeding 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 and whether these predictors vary by geographic location and in settings where poor nutritional and health conditions and other vulnerabilities are more frequent. 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

AUTHOR(S)
Anna Gromada; Gwyther Rees; Yekaterina Chzhen

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

AUTHOR(S)
Priscilla Idele; David Anthony; Kaku Attah Damoah; Danzhen You

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

AUTHOR(S)
Richard de Groot; Sudhanshu Handa; Luigi Peter Ragno; Tayllor Spadafora

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

AUTHOR(S)
Frank J. Elgar; Candace Currie

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.

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