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The changing face of COVID-19: a live tracker of its impact on children

While children may not be the face of the coronavirus pandemic, they could be its biggest victims. We keep track of the latest evidence and research on the potential socio-economic impacts of the pandemic on children and their rights to survive, learn and be protected.

There is real and present danger that the 2020s will become a ‘lost decade’ with unprecedented reversals in development progress. And while children seem to be less susceptible to the direct consequences of the coronavirus (although emerging evidence suggests COVID-19 poses a health threat to them as well), they are becoming the biggest victims of its social and economic impacts.

In this live tracker we are summarising what we believe to be the pandemic’s most severe consequences on children living in low- and middle-income countries. We will regularly update this tracker whenever new evidence emerges.

Latest update from 4th November 2020, including evidence on child protection issues for children living in humanitarian contexts, new projections on extreme poverty and learning outcomes, as well as further country-specific evidence.

  

Child Poverty

The scale and depth of financial hardship among families threatens to roll back years of progress in reducing child poverty and to leave children deprived of essential services.

Child poverty is more than the lack of monetary means. To understand the full extent of child poverty as well as the impact of COVID-19 on it, we must look at children’s ability to access health, education, nutrition, water and sanitation and housing services. Using data from more than 70 countries, a new analysis jointly carried out by Save the Children and UNICEF has finds that around 47% of children were severely deprived of at least one of these critical needs before the coronavirus pandemic even hit.

We estimate that approximately 150 million additional children are living in multidimensional poverty due to the COVID-19 pandemic, a 15% increase that brings the total number up to 1.2 billion in low- and middle-income countries.

The economic fallout brought about by COVID-19 will likely reverse a positive, downwards trend and turn back the clock by decades, pushing children into poverty or increasing the depth for children already living in poverty – both if measured monetarily or multidimensionally. Based on economic projections by the World Bank and the IMF, our joint analysis with UNICEF estimates that, without urgent action to protect families, the number of children living in monetary poor households could soar between 90 to 117 million in 2020 (with poverty measured based on national poverty lines). For the first time, we are also able to look ahead to 2021, and while this comes with significant uncertainty, analysis suggests that the spike in poverty is unlikely to subside in 2021.

Across all age groups, the World Bank expects 88-115 million people being pushed back into extreme poverty (as measured by those living below $1.90 PPP per day) due to the pandemic this year, and up to 150 million by 2021.  A large share of the new extreme poor will be concentrated in countries that are already struggling with high poverty rates and numbers of poor, as projections suggest 8 out of every 10 new poor will be in middle-income countries. Before the pandemic, children made up more than half of the world’s extreme poor

Survive

Disruptions to essential health services and food supply due to the pandemic could lead to hundreds of thousands of additional child deaths and contribute to soaring levels of child malnutrition.

While children seem to make up less than 2% of diagnosed COVID-19 cases, we have reasons to be concerned by the secondary effects of the crisis on children: there is evidence for increasing child mortality either due to weakened or disrupted health services or due to reduced utilisations of routine services. Research by Johns Hopkins University covering 118 low- and middle-income countries and modelling for these effects estimates excess under-five mortality based on the severity and length of disruptions to essential health services. Depending on the scenario, under-five mortality could increase by between 10% and 45%, resulting in 250,000 to 1.2 million additional under-five deaths. 

More broadly, there are fears that the COVID-19 response will come at the expense of treating other diseases, especially in lower-income settings. For instance, UNAIDS estimates that in Sub-Saharan Africa alone a six-month disruption of antiretroviral therapy could lead to 500,000 additional AIDS-related deaths in 2020-21. Similarly, the WHO models that suspension in campaigns and loss of access to treatment for malaria could increase malaria deaths by 50% (with scenarios ranging from 7% to 99%), with children being disproportionally affected.

Children in emergency/conflict settings face a heightened risk of indirect health effects because they likely live in countries plagued by poor infrastructureweakened health systems ill-equipped to respond and eroded capacity for service provision, where distrust in institutions drives reluctance to follow public health directives and delivery of relief material by external actors might be impeded.

The economic shock which families are facing, coupled with mitigation measures which risk disrupting food supply chains, pose a significant risk of food insecurity, with nefarious consequences for children. 

A recent analysis published by the Lancet estimates that COVID-19 will lead 6.7 million children under 5 to suffer from moderate to acute wasting in 2020 (a 14.3% increase), with 57% of cases in South Asia and 22% in Sub-Saharan Africa. Combined with an average of 25% reduction in coverage of nutrition and health services, this would lead to between 111,000 and 178,000 under-five deaths, more than half in Sub-Saharan Africa alone. This happens at a time when, at the height of the lockdown, school closures meant that 368.5 million children globally who rely on school meals might have lost access to a reliable source of food.

For all age groups, estimates vary. The Food and Agriculture Organization (FAO) estimates that the economic downturn following the pandemic might lead to an extra 14-80 million malnourished people. The World Food Programme (WFP) has issued a warning that unless swift action is taken the number of people suffering from acute food insecurity could double, jumping from 135 to 270 million. Oxfam warns that this might mean up to 12,000 people every day dying of starvation by the end of the year - more daily deaths than the coronavirus alone would cause.

Some regions will likely be more harshly hit than others. Sub-Saharan Africa is particularly affected, with 50% of the global food insecure population located on the continent even before the pandemic started. More than 50 million would suffer from hunger in West Africa alone, and the number of food insecure people could more than double in East Africa, jumping to 43 million.

As a direct consequence of COVID-19, immunisation campaigns have been suspended, despite research suggesting that the benefits of continuing immunisation are substantial, even when taking into account the risk of coronavirus infections, and that children who are losing out on life-saving vaccines might face negative long-term effects. According to the UN, at least 80 million children under 1 in almost 70 countries were likely affected in May; the Measles and Rubella Initiative predicts that 178 million people are at risk of missing measles shots in 2020; and World Vision expects reductions in DPT3 immunisation coverage of 30% in some of the poorest countries. The dire consequences of halted vaccinations campaigns are starting to emerge: 18 out of the 29 countries that have currently suspended measles campaigns because of the pandemic are reporting outbreaks; a mutated strain of poliovirus has been reported in more than 30 countries; and diphtheria and cholera are appearing in South Asia and Sub-Saharan Africa. 

Lockdown restrictions are restraining access to maternal health services, with devastating consequences for some mothers in labourJohns Hopkins estimates increases in maternal mortality ranging from 8% to 39% depending on the severity and duration of disruptions to routine health care. Measures contravening WHO recommendations are damaging maternal and child health alike; for instance, pregnant women have been denied beds in hospitals, and separation from a primary caregiver at birth increases a baby’s risk of death and contracting infections. The pandemic has also pushed a drop in the utilisation of maternal health services. 

More generally, an analysis of six of Save the Children’s health projects in five countries shows heavy essential service disruption across continents, with varying degrees of intensity by region and type of service. 

While mostly negative, COVID-19 and its economic consequences also have positive effects on a limited set of child health issues. For instance, a temporary drop in pollution is estimated to result in 6000 fewer cases of asthma in children in Europe and 4000 fewer under five deaths in China. Also, greater emphasis on hygiene measures and broader awareness might have contributed to lowering the incidence of infectious diseases and sexually transmitted infections.

The Center for Global Development has built an online and frequently updated inventory capturing many of the indirect health effects of COVID-19 due to disrupted and suspended health services across communicable and non-communicable diseases, immunisation, and child and maternal health.

In Burkina Faso, a survey finds that almost 1 in 10 (8.4%) respondents or their family members had to delay or skip healthcare visits due to the lockdown, while 1 in 4 respondents had to limit either the number or size of their meals in the past week - with poorer respondents more likely to report being affected by food security issues. Another survey by the World Bank finds that around 1 in 4 households were unable to access basic food at some point since the onset of the pandemic (March). When it comes to access to health services, one third of households in need of medicines were unable to access them, but the overwhelming majority (99%) of respondents seeking health treatment were able to receive it.

Findings from a survey in Chad show that 1 in 4 (24%) households could not access needed medical treatments and 9 out of 10 (88%) were suffering from moderate or severe food insecurity. Rural households reportedly fared worse than urban ones in both dimensions (25 vs 20% for access to health services and 92 vs 75% for food insecurity).

A survey carried out in Colombia suggests that 43% of respondents had to delay or skip essential healthcare during the lockdown and that around half of them had to reduce the size (50%) or number (40%) of their meals at least once in the week preceding the survey. Despite a higher likelihood of receiving new government support over the month before the survey, households with schoolchildren reported being disproportionately affected by food security issues.

A survey conducted in Côte d'Ivoire finds that 14% of respondents skipped or delayed healthcare visits and 45% had to limit the number and/or size of their meals over the past week.

A survey in Ethiopia finds that most households in need of either medicines or medical attention were able to receive them (93 and 95% respectively). However, half of respondents (49%) experienced moderate or severe food insecurity, with rural and urban areas experiencing similar rates of deprivation.

According to a survey conducted in Ghana, 10% of respondents say someone in their household delayed or skipped needed healthcare visits since mid-March. Almost 1 in 2 respondents reported reducing meal size and/or number over the week previous to the survey, with families with age-school children being more likely to be unable to afford food due to income drops.

In Kenya, daily deliveries in a large regional hospital dropped by 33%. A survey by the World Bank finds that roughly 30% of respondents could not access needed medicines, while moderate or severe food insecurity affected adults and children in 45% and 30% of households respectively.

Findings from a survey Malawi show that the majority of respondents (79%) experience moderate or severe food insecurity, with urban households suffering disproportionately (82 vs 68%). When it comes to health services, around 15% of households in need of medical treatment and/or medicines could not access them. An earlier version of the survey found that households with school children were hard hit by school closures, with almost 1 in 2 respondents reporting children had to skip meals due to the suspension of school meals.

A survey conducted in Mali  finds that in July 3% of households reported going hungry due to lack of money or other means, while 40% were worried this might happen. 14% of respondents reported experiencing moderate to severe food insecurity over the past 30 days, more than 50% of which due specifically to COVID-19.

Results from a Mexico survey find that 1 in 3 people had to delay or skip essential health care and 20-25% had to limit the size and/or number of meals over the week prior.

Findings from a survey carried out in Mozambique between mid-July and mid-August show that 72% of families were food insecure, I.e. they were unable to buy their usual amount of food over the 7 days preceding the interview.

A study conducted in Nepal comparing key metrics before and during the lockdown finds that restrictive measures led to a 52.4% decrease in institutional childbirth, 50% increase in the stillbirth rate, and a 200% increase in neonatal mortality.

According to results from a survey in Nigeria, most households (91%) can access preventive care and most women (95%) within them can access ante- and post-natal care if needed. However, as of August 8 out of 10 respondents reported experiencing moderate to severe food insecurity. An earlier version of the same survey found that 1 in 5 households where children aged 0-5 either needed or were due for vaccination could not access child immunization services. It also showed that 69% of households who experienced shocks resorted to reducing food consumption as a coping mechanism. Another study conducted between April and May finds that state-level lockdown measures increase households' experience of food insecurity by 13 percentage points.

A survey from the Philippines finds that around 1 in 4 respondents had to reduce their meal size and/or number over the week preceding the survey. Poorer households report being disproportionately affected, while families with school-age children reported greater difficulties buying food because of income drops.

Evidence from a survey conducted in Rwanda finds that 13% of respondents delayed or skipped needed healthcare visits and more than 50% of households say they have had to reduce food consumption in the past week, with rural respondents reporting greater difficulties accessing food.

According to a survey conducted in Sierra Leone, 5% of respondents had to delay or skip necessary healthcare visits and more than 40%had to limit portion sizes at meal times or reduce the number of meals they eat.

In South Africa lockdown measures have reduced deaths from non-natural causes such as road accidents and homicides, where road injuries are the second biggest cause of death for children age 5 to 14. Results from a survey show that hunger was a problem both before and after the government put in place top-up grants: in April almost 1 in 2 households ran out of food, while in May-June 15% of respondents reported a child had gone hungry in their household in the past seven days, more than half of which for more than 2 days. Additionally, during lockdown around 1 in 4 respondents (23%) could not access medication, condoms or contraception in the past four weeks, with the share climbing to 39% among respondents with a chronic health condition. When it comes to maternal health, 1 in 10 (11%) new or prospective mothers in need of ART reported running out of it, while 1 in 6 reported at least a 2-month gap in care.

In Syria, food prices suffered a +200% increase in under a year, adding a hunger crisis on top of a humanitarian one.

Findings from a survey in Uganda show that over the 30 days preceding the interview more than 4 in 10 respondents suffered moderate or severe food insecurity, with the poorest 40% being disproportionately affected by the latter. Additionally, 19% and 33% of respondents in need of medical treatment and medicines respectively could not access them. Rural households in need of medicines had a harder time accessing them than their urban counterparts (36% vs 26%) and the same applies to medical treatment (21% vs 15%).

Results from a survey in Zambia find that around 1 in 10 respondents delayed or skipped needed healthcare visits since the onset of the lockdown, and around 40% had to limit portion sizes at meal times or reduce the number of meals at least once in the past week. 

Learn

The pandemic is going to exacerbate the global learning crisis many low- and middle-income countries were already facing before and pose a real risk that some children will drop out indefinitely.

Remote learning will likely deepen education inequalities and learning gaps because of the digital divide and different loss of learning by socio-economic group. Worldwide, 50% of the students out of the classroom do not have access to a computer, and 40% lack internet access at home; with those figures as high as 90% and 82% in Sub-Saharan Africa, respectively. Household wealth is the biggest determinant of internet access, with the overwhelming majority of students living in the poorest households being excluded from accessing online services and therefore many remote learning opportunities. The divide extends beyond internet access: UNICEF research finds that in 40 of the 88 countries for which data is available, urban households are more than twice as lively to own a TV than rural households. Connectivity is an issue not only for households, but for schools too: in low-income countries, only 20% of schools are connected.

Finally, online education might disadvantage girls and children with disabilities. Globally, 25% fewer women have access to the internet than men, and in Sub-Saharan Africa women are 50% less likely to use the internet than men. Furthermore, evidence suggests children with disabilities are least likely to benefit from remote learning

Prolonged school closures could worsen learning outcomes in the long-term and widening existing inequalities, with an increasing number of children falling below minimum proficiency standards. Summer loss literature could give an indication in terms of potential effects and equity impacts: when schools are closed during the summer breaks, learning for children from more disadvantaged socio-economic backgrounds flattens, while children from privileged socio-economic backgrounds continue to gain new skills. In short, more privileged children continue to learn at home, while more disadvantaged children fall further behind as schools are closed. 

Cross-country inequalities will broaden, too: evidence by UNICEF, UNESCO, and the World Bank finds that low- and lower-middle-income countries have already lost nearly four months of schooling since the onset of the pandemic compared to an average of six weeks among high-income countries, and have also been more likely not to reopen schools and miss reopening dates. Additionally, while low- and middle-income countries were more likely to enact remedial programmes than high-incomes ones (1 in 2 vs 1 in 3), they were also more likely (20-30%) not to take any measures to improve connectivity for pupils than richer countries (4%).

Estimates by Save the Children suggest that an additional 90-117 million children living in poverty could lead to between 7.0 and 9.7 million more children dropping out of school. The World Bank estimates that the pandemic will result in 7 million dropouts in primary and secondary school, decrease individual LAYS (Learning-Adjusted Years of Schooling) by 0.3-0.9 down to 7-7.6, and cost $10 trillion in future earnings if schools are shut down for 5 months. UNDP predicts that even in a conservative scenario, the effective out-of-school rate for primary education in 2020 will spike to 20%, with the highest setback suffered by the lowest human development countries. 

COVID-19 is having a devastating impact on early education, too: research by UNICEF estimates that at least 40 million children have missed out on early education in their pre-school year because of COVID-19. 

A survey in Burkina Faso finds that only in 50% of households do all children devote time to remote learning during school closures, and almost 4 in 10 respondents cannot say with certainty that children in the family will go back to school. Richer households are more likely to report that all of their primary-school-aged children are devoting time to home learning, and are also more likely to have a member of the household doing home-schooling. Another survey by the World Bank finds that 9 in 10 students stayed “intellectually active” during COVID-19, despite only 1 in 5 being in touch with their teachers.

According to findings from a survey in Chad, only 15% of respondents reported that children in their household are engaged in remote learning and only 5% are in touch with teachers. Urban pupils fare better than their rural peers (28 vs 10% and 9 vs 4% respectively), and so do richer students compared to poorer ones (18 vs 11% and 7 vs 3%).

A survey carried out in Colombia suggests that the overwhelming majority (96%) of primary- and secondary-age schoolchildren are spending time learning from home while schools are closed.

A survey conducted in Côte d'Ivoire finds that 79% and 84% of primary- and secondary-school children spent time on education while schools were closed, but 20% of respondents did not expect schoolchildren in their households to go back to school once schools reopened.

Evidence from Ecuador shows that children with less access to remote learning are more than twice as likely not to do any schoolwork.

A survey carried out in Ethiopia finds that, in households with children who had been in school before the onset of the pandemic, only 24% of primary school and 32% of secondary school children are engaging in remote learning activities during school closures, with urban children being engaged in remote learning twice as much than their rural peers.

A survey conducted in Ghana finds that 36% and 43% of primary and secondary school pupils respectively are not spending any time on education at home, and those who do spend less time than they did in school. Additionally, only one third of households reported receiving communication from their child’s school.

A nationally representative survey carried out in Kenya finds that over 80% of respondents are very worried that the pandemic will have long-term effects on their children’s education. A survey by the World Bank finds that in around 1 in 4 households, children have not spent any time on education or learning activities over the 7 days preceding the interview.

Findings from a survey in Malawi show that only 24% of households report having children between 6 and 18 engaged in educational activities, with urban children being twice as likely to be doing so than their rural peers (38 vs 20%), and only 5% had contact with teachers.

A survey conducted in Mali finds that in July 62% of households reported that none of their children had returned to school after resumption of classes. Only in 3.3% of households had all children returned to school (NB: Not all classes where resumed, but only certain levels, which partially accounts for the low numbers).

Results from a survey in Mexico find that over 90% of respondents report that all primary and secondary school children in their household are spending time on education while at home, and close to 9 in 10 (87%) say children in the families will most likely or definitely go back to school once these reopen.

According to findings from a survey Nigeria, 28% of households with children report that children are attending school despite widespread school closures nationally. As of August, the overwhelming majority (95%) of respondents in households with children planned to send back children in the household to school in September. However, only around 1 in 2 (56%) households with children reported that children in the household were engaging in remote learning activities.

In a survey from the Philippines only 60% of respondents indicate that children in their household have already enrolled in school and 20% report they will not enrol children if schools reopened in August.

Evidence from a survey conducted in Rwanda finds that 80% of primary- and secondary-school age children are devoting time to remote learning during school closures.

Results from a phone survey in Senegal suggest that the likelihood of a child’s engagement in learning activities during lockdown is negatively correlated with wealth and level of education of the respondent.

According to a survey conducted in Sierra Leone, most respondents report all children in primary (78%) and secondary (76%) school in their household are spending time on education at home, but only 55-60% are spending an average of more than two hours per day on education.

Findings from a survey in Uganda show that only 59% of households have any child attending any remote learning activity, a drop from pre-COVID level and with significant gaps between rural and urban areas and richest and poorest households.

A study in Venezuela finds 1.7 million students from primary to university education abandoned their studies between 2019 and 2020. 

Results from a survey in Zambia find that only around 60% of respondents report that primary- and secondary-age schoolchildren in their households are spending time learning from home during school closures; however, the overwhelming majority (96%) say their children will most likely or definitely return to school after the lockdown. 

Be Protected

The mitigation policies for, and economic repercussions of, COVID-19 are likely to have devastating effects for many children’s rights, with girls and young women being particularly at risk.

Save the Children’s own estimates predict that the economic fallout of COVID-19 will put up to half a million more girls at risk of child marriage in 2020 and up to 2.5 million more by 2025. The pandemic could cause 13 million additional child marriages by 2030 due to a combination of prevention programmes being paused and potential effects of increasing poverty on the prevalence of early marriage. 

Save the Children projections expect that the increased poverty caused by the pandemic will cause up to 1 million additional teenage pregnancies in 2020. Disruptions to health services and supply chains could lead to loss of access to contraception for 47 million women (of all age groups), which may result in 7 million unintended pregnancies. Most likely, the pandemic is undercutting access to contraceptives and SRHS around the world. 

UNFPA and partners project 2 million additional cases of female genital mutilation (FGM) and 200 million cases of gender-based violence as the consequence of the pandemic. While coherent data is still lacking, many countries do experience stark increases in the reports of domestic violence. Basing on reported increases in domestic violence and given the strong co-occurrence between child abuse and domestic violence, World Vision estimates that over the next three months COVID-19 will drive violence against children (physical, sexual, and emotional) up by 20-32%. 

There are concerns, as families experience economic hardships, parental deaths and school closures, COVID-19 will increase the prevalence of child labour, reversing a 20-year downwards trend. Basing on evidence from South AfricaVietnamEcuador and other countries, the ILO finds that a 1 percentage point rise in poverty leads to at least a 0.7 percentage point increase in child labour, with dramatic consequences considering the major recession the pandemic has caused. Additionally, children face increased risk of physical violence as unemployment of parents is increasing in countries across the world and violence prevention and response services are disrupted. A survey by UNICEF warns that while 104 out of 136 responding countries have suffered disruption in this area (and around two thirds of affected countries reported at least one service suffered heavy disruption), only 70% reported mitigating measures to be in place to tackle the gap.

Children with disabilities – up to 10% of all children – are disproportional at risk of violence and are particular vulnerable due to their dependence from care givers and face-to-face-services

Unprecedented, unstructured, and sometimes unsupervised screen time during lockdown puts children at greater risk of harm, including cyberbullying, online sexual exploitation and abuse, and sextortion. 

Evidence suggests that the pandemic and lockdown measures also jeopardise children’s mental health. Surveys conducted by Save the Children, the World Bank, and UNICEF in several countries consistently find that the pandemic and its consequences cause abnormal levels of distress in children. Additionally, there are fears that quarantined children “might be more susceptible to mental health problems because of their higher risk of infection, and the grief and fear caused by parental loss or separation;” similarly, previous research on the effect of health-related disasters on children’s psychological wellbeing finds that 30% of isolated or quarantined children met criteria for PTSD, a percentage four times higher than in non-quarantined peers. When it comes to teenagers, evidence suggests that social deprivation deriving from implementation of lockdown measures can be harmful at a time when social stimuli are key to adolescents’ development. 

A decline in facilities-based deliveries could cause birth registrations to plummet

Young women and girls are likely to suffer disproportionately from the crisis. First, they experience structural vulnerabilities, such as weaker safety nets to protect them from economic shocks. For instance, women and girls make up 60% of the world’s hungry, making them particularly vulnerable in emergencies. Second, the crisis might exacerbate existing inequalities, jeopardising or reversing hard-won gains towards gender equality. On a final sombre note, women and girls face specific challenges – such as gender-based violence (GBV), child marriage, and teenage pregnancy. As we laid out above, all of these are proven to rise during and in the aftermath of pandemics, with devastating effects for women and especially for adolescent girls.

Evidence from South and Southeast Asia finds that the pandemic is affecting women’s mental health more often than men’s, women are less likely to be covered by health insurance, and women’s unpaid domestic/care work has increased more often than for men. A rapid needs assessment conducted by UN Women in mid-April in 49 countries across 5 regions finds that 80% of the countries which provided data registered an increased in calls to helplines (by up to 400%). What is more, 70% of the countries reported a spike in cases reported by health centers – at a time when availability and access to services has plunged.

The Center for Global Development provides a useful overview of new studies researching the impact of the pandemic on violence against women and children (VAW/C). Findings suggest that effects are mixed depending by country, study, and type of violence; however, an apparent drop in VAW/C may well be due to a plunge in service availability and likelihood of reporting during lockdown. 

Children in emergency/conflict settings face a heightened risk of indirect effects because they likely live in countries plagued by poor infrastructureweakened health systems ill-equipped to respond and eroded capacity for service provision, where distrust in institutions drives reluctance to follow public health directives and delivery of relief material by external actors might be impeded. Additionally, children in humanitarian settings face a disproportionate risk of harm when it comes to child protection, with emerging evidence pointing to an increase in child marriages, sexual abuse and exploitation, child labour, and child recruitment into armed forces.

Preliminary evidence by UNFPA points to an increase in domestic violence in Syria, with a small-n interview by Women Now reporting that COVID-19 is contributing to the spike. The Global Protection Cluster warns that in North-West Syria, 80% of communities report spikes in child marriage and child labour as coping strategies for loss of income. Additionally, humanitarians on the ground report that lack of safety nets are forcing people with disabilities to “search for food in rubbish containers or look through landfills for sellable and reusable material.” The same source reports that a similar situation is unfolding in the DRC, where children’s risk of forced labour and commercial sexual exploitation is being exacerbated by a loss of parental livelihoods. Anecdotal evidence gathered by World Vision paints a similarly worrying picture, with reports of children being left to provide for themselves and left vulnerable to abuse due to the complex interplay between conflict, poverty, and public health emergency.

A national impact and needs assessment conducted in Bangladesh in April finds that beatings by parents/guardians were up by 42% and calls to the child helpline had increased by 40%.

A survey conducted in Burkina Faso finds that access to contraception has gotten more difficult since the pandemic started for 25% of respondents.

Nigeria and Kenya registered a 30-50% increase in cases of sexual- and gender-based violence (SGBV) since the lockdown started.

A nationally representative survey carried out in August in Kenya finds that almost 7 in 10 (69%) respondents report experiencing more conflicts with family members over the past two months, 62% of which involved physical violence

In the Philippines, the government reported that cases of online child sexual abuse between March and May 2020 tripled compared to the same timeframe in 2019.

In Tanzania the Legal and Human Rights Center has reported an increase in femicides.

Survey results from South Africa find that during lockdown around 1 in 4 respondents (23%) could not access medication, condoms or contraception in the four weeks preceding the interview.

A survey conducted by the Joining Forces Coalition in May in Uganda finds that 56% of respondents observed child labour had increased since lockdown due to COVID-19 economics.

A rapid needs assessment conducted by Save the Children in Venezuela in June finds that 1 in 3 surveyed households report that aggression and hostility against children at home has increased due to isolation measures.

Cross-country evidence shows that during the lockdown children have been involved in economic activities to varying degrees, sometimes to the detriment of time spent on education (4% in Colombia, 5% in Rwanda, 10% in Zambia and Ghana, 11% in Sierra Leone, 47% in the Philippines). Beyond countries, the rate varies basing on age, too: involvement in economic activities amount to 65-70% for primary school children in Burkina Faso, Côte d'Ivoire, and Mexico, and to around 70-80% for secondary school children in these countries.

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