The State of the World’s Children: For every child, vaccination
The COVID-19 pandemic interrupted childhood vaccination almost everywhere, especially due to intense demands on health systems, the diversion of immunization resources to COVID-19 vaccination, health worker shortages and stay-at-home measures.
Today’s report warns a total of 67 million children missed out on vaccinations between 2019 and 2021, with vaccination coverage levels decreasing in 112 countries.
Children born just before or during the pandemic are now moving past the age when they would normally be vaccinated, underscoring the need for urgent action to catch up on those who were missed and prevent deadly disease outbreaks.
In 2022, for example, the number of measles cases was more than double the total in the previous year. The number of children paralysed by polio was up 16 per cent year-on-year in 2022. When comparing the 2019 to 2021 period with the previous three-year period, there was an eight-fold increase in the number of children paralysed by polio, highlighting the need to ensure vaccination efforts are sustained.
The pandemic also exacerbated existing inequities. For far too many children, especially in the most marginalised communities, vaccination is still not available, accessible or affordable. Even before the pandemic, progress on vaccination had stalled for almost a decade as the world struggled to reach the most marginalised children.
Of the 67 million children who missed out on routine vaccination between 2019 and 2021, 48 million didn’t receive a single routine vaccine, also known as “zero-dose”. As of the end of 2021, India and Nigeria (both countries with very large birth cohorts) had the largest numbers of zero-dose children but increases in the numbers of zero-dose children were especially notable in Myanmar and the Philippines.
The children who are missing out live in the poorest, most remote and marginalised communities, at times impacted by conflict.
New data produced for the report by the International Center for Equity in Health found that in the poorest households, 1 in 5 children are zero-dose while in the wealthiest, it is just 1 in 20.
It found unvaccinated children often live in hard-to-reach communities such as rural areas or urban slums. They often have mothers who have not been able to go to school and who are given little say in family decisions.
These challenges are greatest in low- and middle-income countries, where about 1 in 10 children in urban areas are zero dose and 1 in 6 in rural areas.
To vaccinate every child, it is vital to strengthen primary health care and provide its mostly female front-line workers with the resources and support they need. The report finds women are at the front line of delivering vaccinations, but they face low pay, informal employment and threats to their security.
To address this child survival crisis, UNICEF is calling on governments to increase financing for immunization, to urgently implement and accelerate catch-up vaccination efforts to protect children and prevent disease outbreaks.
The report calls for governments to:
Urgently identify and reach all children, especially those who missed vaccinations during the COVID-19 pandemic. Strengthen demand for vaccines, including by building confidence. Prioritise funding to immunization services and primary health care. Build resilient health systems through investment in female health workers, innovation and local manufacturing.
“Immunizations have saved millions of lives and protected communities from deadly disease outbreaks in the past,” said Catherine Russell. “We know all too well that diseases do not respect borders. Routine immunizations and strong health systems help to prevent unnecessary deaths and suffering".
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Number of children without critical social protection increasing globally
by UNICEF, International Labour Organization
The number of children without access to social protection is increasing year-on-year, leaving them at risk of poverty, hunger and discrimination, according to a new report released by the International Labour Organization (ILO) and UNICEF today.
More than a billion reasons: The urgent need to build universal social protection for children warns that an additional 50 million children aged 0-15 missed out on a critical social protection provision – specifically, child benefits (paid in cash or tax credits) – between 2016 and 2020, driving up the total to 1.46 billion children under 15 globally.
According to the report, child and family benefit coverage rates fell or stagnated in every region in the world between 2016 and 2020, leaving no country on track to achieve the Sustainable Development Goal of achieving substantial social protection coverage by 2030. In Latin America and the Caribbean, for example, coverage fell significantly from approximately 51 per cent to 42 per cent.
In many other regions, coverage has stalled and remains low. In Central Asia and Southern Asia; Eastern Asia and South-eastern Asia; Sub-Saharan Africa; and Western Asia and Northern Africa coverage rates have been at around 21 per cent, 14 per cent, 11 per cent and 28 per cent respectively since 2016.
Failure to provide children with adequate social protection leaves them vulnerable to poverty, disease, missed education, and poor nutrition, and increases their risk of child marriage and child labour.
Globally, children are twice as likely as adults to live in extreme poverty – those struggling to survive on less than US$1.90 (PPP) a day – approximately 356 million children. A billion children also live in multidimensional poverty – meaning without access to education, health, housing, nutrition, sanitation, or water.
Children living in multidimensional poverty increased by 15 per cent during the COVID-19 pandemic, reversing previous progress in reducing child poverty and highlighting the urgent need for social protection.
“As families face increasing economic hardship, food insecurity, conflict, and climate-related disasters, universal child benefits can be a lifeline,” said Natalia Winder-Rossi, UNICEF Director of Social Policy and Social Protection.
“There is an urgent need to strengthen, expand and invest in child-friendly and shock-responsive social protection systems. This is essential to protect children from living in poverty and increase resilience particularly among the poorest households.”
“Strengthened efforts to ensure adequate investment in universal social protection for children, through universal child benefits to support families at all times, is the ethical and rational choice, and the one that paves the way to sustainable development and social justice,” said Shahra Razavi, Director of the Social Protection Department at the ILO.
Social protection is a universal human right and a precondition for a world free from poverty. It is also a vital foundation to help the world’s most vulnerable children fulfil their potential and increase their access to food, nutrition, education, and healthcare.
But worldwide, 1.77 billion children aged 0–18 lack access to a child or family cash benefit, a fundamental pillar of a social protection system. Children are twice as likely to live in extreme poverty as adults. 800 million children are currently subsisting below a poverty line of US$3.20 a day, and 1.3 billion children are living on less than US$5.50 a day.
The report emphasizes that all countries, irrespective of their level of development, have a choice: whether to pursue a “high-road” strategy of investment in reinforcing social protection systems, or a “low-road” strategy that misses out on necessary investments and will leave millions of children behind.
To reverse the negative trend, the ILO and UNICEF urge policymakers to take decisive steps to attain universal social protection for all children, including:
Investing in child benefits which offer a proven and cost-effective way to combat child poverty and ensure children thrive.
Providing a comprehensive range of child benefits through national social protection systems that also connect families to crucial health and social services, such as free or affordable high-quality childcare.
Building social protection systems that are rights-based, gender-responsive, inclusive, and shock responsive to address inequities and deliver better results for girls and women, migrant children, and children in child labour for example.
Securing sustainable financing for social protection systems by mobilizing domestic resources and increasing budget allocation for children.
Strengthening social protection for parents and caregivers by guaranteeing access to decent work and adequate benefits, including unemployment, sickness, maternity, disability, and pensions.
* The urgent need to build universal social protection for children; ILO–UNICEF joint report (136pp): http://uni.cf/41ReKpc
http://www.unicef.org/press-releases/number-children-without-critical-social-protection-increasing-globally http://www.unicef.org/documents/urgent-need-for-universal-social-protection http://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_869722/lang--en/index.htm http://news.un.org/en/story/2023/03/1134037
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