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Combating COVID-19’s effect on children

| October 30, 2020 | 0 Comments

BY GABRIELA RAMOS AND STEFANO SCARPETTA

On average across the Organisation for Economic Co-operation and Development (OECD) countries,1 one in seven children grow up in poverty.

Poverty and income inequality influence significantly the extent to which children are exposed to COVID-19 risks. Poorer families are less financially resilient and are more exposed to job and earnings losses, while their children are likely to be disproportionally disadvantaged by school closures. Growing up in poorer neighbourhoods increases the risk of catching the virus and being a carrier and experiencing underlying health issues and reduced prevalence of vaccination among children;2 it also affects access to a range of necessities such as good nutrition, quality housing, sanitation issues, space to play or study, and opportunities to engage in online schooling.

Universal health coverage has become a policy priority in many developing countries, but achieving this objective is particularly challenging, as in many low- and middle-income countries, healthcare systems are underdeveloped and public revenues to finance expansion are limited.3 The current crisis will aggravate health concerns beyond COVID-19 for many children, as measles immunisation campaigns have been delayed in 24 countries and will be cancelled in 13 others, putting more than 117 million children at risk of missing out on measles vaccines.4

COVID-19 and the associated policy responses have already led to a huge downturn in overall economic activity and employment, and are likely to increase global poverty.

Researchers Summer, Hoy and Ortiz-Juarez5 estimate that as many as half a billion people, or 7% of the world’s population, could fall into poverty, and in some regions, the negative effects could lead to poverty levels equivalent to those recorded 30 years ago. Analysts Vos, Martin and Laborde6 suggest that the increase in absolute poverty will be greatest in south-Saharan Africa, where 40–50% of the global poverty increase would be concentrated.

The future not great for girls

Girls in developing countries face risks of early marriage and teenage pregnancies. Every year, 12 million girls are married before their 18th birthday, and about 7.3 million births per year are due to teenage pregnancies. In the aftermath of the Ebola epidemic in Sierra Leone, the increase in teenage pregnancies was most pronounced in vulnerable communities.7 Adolescent pregnancy rates increased drastically as a result of school closures, and the loss of parents or primary adult carers left children without resources, often homeless, and forced them to resort to new ways to find food, including exchanging sexual favours for girls; the loss of access to contraceptive items because of the disruption of supply chains and reduced access to health centres, and the higher exposure of adolescent girls to gender-based violence.8 COVID-19 will also defer public efforts to combat early marriage and female genital mutilation, while increasing poverty is anticipated to increase rates of child marriage and teenage pregnancies in vulnerable communities. The total effect of the COVID-19 pandemic is projected to result in 13 million additional child marriages.9

Economic downturns have a large effect on child poverty risks. For example, almost 40% of American adults would not, at this time, be able to cover a US$400 emergency with cash.10 Such families would be unlikely to deal with an income loss associated with COVID-19, and their limited access to healthcare increases the risk of contracting – and subsequently spreading – the virus.

Poor-quality housing, poor nutrition and maltreatment exacerbated by COVID-19

Poor housing quality affects children’s ability to flourish. On average, more than one in five children between 0–17 years old live in an overcrowded household in European OECD countries. In all countries for which data are available, the risk of overcrowding is twice as high for children in low-income households compared to those in high-income households. But even children who do not live in income-poor households can face housing-related deprivation such as noise or crime, due to the quality of the dwelling or the neighbourhood. Attempts to contain and mitigate the COVID-19 crisis through lockdowns may also be particularly challenging in developing countries where the vast majority of poor households face deplorable housing conditions, and live in overcrowded spaces, making social distancing and proper self-isolation nearly unmanageable.

COVID-19-related closures of early childhood education and care (ECEC) facilities, schools and after-school clubs have exposed many children in low-income families to food insecurity and poor nutrition. When schools are closed, beneficiary children eat less and also consume less nutritious food. During COVID-19, poor nutrition is paired with home confinement and lower levels of physical activity.

The COVID-19 outbreak acts as a catalyst for a considerable rise in child maltreatment11 by exacerbating some of the known contributing factors, such as household poverty, overcrowded housing, social isolation, intimate partner violence (IPV) and parental substance abuse.12 In some families, COVID-19 creates a ‘pressure cooker’ situation, in which family stress may reach toxic levels. Research underlines the harm excessive or prolonged activation of stress responses has on children’s health and development, particularly on young children.13

In addition, the COVID-19 outbreak severely compromises the effectiveness of child protection systems to help children experiencing maltreatment. Reductions of face-to-face contact make it hard for child protection workers to work with vulnerable children and families and properly assess risks. Less frequent contact means less monitoring of children’s well-being and reporting of concerns.

Children in out-of-home care and homeless family children at high risk

The restrictions introduced due to COVID-19 pose particular difficulties for children in out-of-home care (such as foster care). Children in out-of-home care generally have additional care needs, often due to difficult family circumstances and accumulated disadvantage prior to their entry into care.14

While measures such as home confinement and school closures can increase the level of pressure and anxiety felt by children in general, some effects may be stronger in children in out-of-home care. Potential difficulties include increased risks of absconding from care placements and heightened outbursts of challenging behaviours. In the context of COVID-19, however, these behaviours occur when access to therapeutic and social work services is disrupted. For carers of children with high needs, school is a regular source of respite that is now no longer available. COVID-19 will also intensify difficulties for children who are unhappy in current placements.

COVID-19 adds to the challenges already experienced by children in homeless families. These include higher likelihood of lower well-being, poor physical and mental health, and poorer educational outcomes.15 Children in homeless families face greater risk of complications from COVID-19 due to poorer baseline health. Compared to the general child population, they experience higher rates of asthma, respiratory illness and infectious disease. Poor nutrition and obesity are more common.16

Parents of children in homeless families will experience particular challenges in keeping children safe. First, parents face greater challenges in reducing children’s risk of contracting the virus. For example, parents will experience intense pressure, if living in emergency shelters and hotel rooms, to contain children day after day in small spaces and to safely use shared kitchen and bathroom facilities. In the case of one family member falling ill, self-isolation will not be possible.

Children with disabilities

The COVID-19 outbreak challenges the well-being of children with disabilities, across education, health, and social and family life dimensions. It has introduced significant stress and disruption to the lives of children who, under normal circumstances, thrive on structure and routine.

In general, learning loss during school breaks can be higher for children with disabilities.17 For children with higher needs, disruption to schooling and respite care placements have the potential to push some families into crisis. Moreover, the presence of a sibling with a disability in the home will compromise parents’ abilities to meet the new demands of home schooling for other children and to manage family stress.

COVID-19 is disrupting access to therapeutic supports at a time when children with disabilities and their families are adjusting to big changes to day-to-day life. Many children with disabilities receive therapeutic support to develop communication and social-emotional skills and help them cope better at school and at home. These children would now need further help to build and maintain new routines and calming and coping skills. But many families lack guidance and information about available services and the types of assistance they are eligible for,18 which is particularly problematic in a period of widespread confinement.19

Child labour and migrant children hard-hit by COVID-19

Children in impoverished communities are unlikely to participate in digitally supported home learning during school closures and they are at risk of dropping out of school altogether, since their parents may not be able to afford school fees when schools reopen. COVID-19 will lead to an increase in extreme poverty, which without solid social safety nets is a key driver of child labour.20 The efforts many countries have made to combat child and forced labour over the past decade risk being brought to an abrupt halt.

About one in five children in OECD countries are either foreign-born or have at least one foreign-born parent. These children are particularly vulnerable in the COVID-19 crisis. First, across the OECD, almost half of all children in immigrant households live below the relative poverty line – twice that level of children in native households.

Children of immigrants are also much more likely to live in poor housing conditions: overcrowding is, at 17% OECD-wide, more than twice as high in immigrant households as in nativeborn households (8%).

Immigrant parents tend to have less stable jobs, making them particularly vulnerable in the current economic context, with potential negative repercussions on their children’s wellbeing. What is more, some immigrant groups – notably the undocumented – may not have access to healthcare.

However, a number of countries have provided special
waivers for basic and emergency healthcare services.

In European OECD countries, about a third of all immigrants have only little or no mastery of the hostcountry language. This not only hampers access to relevant information, but also makes it a lot more difficult for them to support their children in home schooling. Parental support in schooling is also rendered more difficult due to the low education levels of some migrant parents, especially in the EU, where 11% of immigrant adults have, at most, primary education – compared with 5% of native-born.

The children of the world need help

Child refugees, including unaccompanied minors, represent around 13 million children worldwide, the vast majority in developing countries. Those who reside in camps or crowded settlements in such countries are in particularly vulnerable situations since they have little or no formal education, are excluded from social protection and because movement restrictions may keep them from obtaining a more secure status.21 Moreover, the COVID-19 crisis increases the risk that refugee children in such situations will be separated from their families if one parent becomes infected and isolated, in which case a significant number of children will be pushed into a very vulnerable situation.

Gabriela Ramos and Stefano Scarpetta are researchers working with the OECD. They have given their kind permission for us to feature an extract from the policy brief entitled ‘Combatting COVID-19’s effect on children’, which can be read in full, with references, at: http://www.oecd.org/coronavirus/policyresponses/combatting-covid-19-s-effect-on-children2e1f3b2f/#endnotea0z2

Category: Spring 2020

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