Reference Crisis Country Key findings 
Centers for disease control and prevention 2008 - Impact of Seasonal Influenza-Related School Closures on Families[@38544] Influenza USA
  • 42.9% households had at least one child enrolled in meal program
  • School district B households (higher SES) were less likely to have children participating in meal programs than school district A households (lower SES) (p<0.05)
  • 10.0% of households with children in meal programs had difficulty replacing school-provided meals
Canadian Medical Association Journal 2020 - Addressing the indirect effects of COVID-19 on the health of children and young people[@38526] COVID-19 Nepal
  • Adverse childhood experiences (maltreatment, poverty, food insecurity) are associated with mental health problems, obesity, cardiovascular disease
  • Adverse experiences are more common for children experiencing mandated social isolation, particularly for vulnerable populations
  • Closures increase food insecurity in those dependent on school meals
  • Pandemic-related financial loss has reduced food security, access to markets, preventative nutrition deficiency programs, and decreased access for treatments for nutritional deficiencies
  • These factors may result in the increase of children suffering with acute malnutrition
  • 2,426 children and adolescents (6–17 yr.) in China showed a reduction of 7.3 hours per week in physical activity during isolation
  • 30 hr/week increase in screen time compared to pre-pandemic
  • Prolonged screen time causes feelings of sadness, irritability, concentration difficulties, resulting in mood disorder in adolescents
  • Physical distancing is challenging for those with additional needs
  • Increase in family violence is expected, likely to be associated with greater nonaccidental injury and mental trauma in children
Coalition to Support Grieving Students 2020 - Supporting grieving students during a pandemic[@38530] COVID-19 N/A
  • School supports are reduced due to school closures increasing social isolation felt by grieving children
End Violence Against Children 2020 - Leader’s Statement: Violence against Children; a Hidden Crisis of the COVID-19 Pandemic[@38560] COVID-19 N/A
  • Online communities important to children's learning/play
  • Increased cyberbullying, risky online behavior, exploitation
  • Lockdowns, school closures, loss of income, movement restrictions, overcrowding, and high levels of stress and anxiety increase the risk for maltreatment, gender-based violence, sexual exploitation
  • Refugees, migrants, those living without parental care, those with disabilities experience exacerbated risk for violence due to lack of access to supports such as teachers, friends, and social workers
Food and Agriculture Organization 2020 - The state of food security and nutrition in the world[@38547] COVID-19 Global
  • Food supply disruptions, loss of livelihoods, remittances as a result of COVID-19 create barriers for accessing nutritious foods
  • Difficulties for low SES families to maintain healthy diets
Humanitarian Country Team 2020 - Occupied Palestinian Territory COVID-19 Humanitarian Response Plan[@38549] COVID-19 Palestinian Territory
  • Food insecurity levels rise on the West Bank (herders/farmers/fishers are particularly vulnerable)
  • Increased levels of violence in children, greater risks of anxiety, trauma, psychological relapse
United Nations Office for the Coordination of Humanitarian Affairs and Food and Agriculture Organization 2020 - Flash Appeal; for Covid-19[@38555] COVID-19 N/A
  • 67,500 children will require treatment for malnutrition in the next 9 months in Mozambique
  • 3,000 children are being treated for SAM and 40,000 cases of pellagra since March 2019
  • Negative coping mechanisms due to financial struggles; increased child marriage, transactional sex, reduced opportunities for schooling
Onyango 2019[@38573] Ebola West Africa
  • 89% rape cases in Liberia were against children
  • Girls have increased responsibility in home, increasing opportunity for exploitation and sexual violence 
  • Girls became heads of households during the Ebola pandemic
  • Girls who lost parents to Ebola forced to engage in transactional sex to afford food/housing 
  • Children were afraid of rape shared these stories with each other 
  • Most girls believed teenage pregnancy was rising and 10% stated that girls were being forced into prostitution due to loss of family members 
  • Teenage pregnancy increased 65% from impacts of Ebola
Plan International 2015[@38524] Ebola  Liberia and Sierra Leone
  • Stigma faced by large number of children due to social isolation
  • Few children were completing studies during school closure
  • Data suggests girls are less likely to home study than boys 
  • Many parents are uneducated and cannot help children with schoolwork, children are too hungry to focus/busy working
  • Sports such as football, volleyball, kickball etc. could not be played and places of socialization were closed 
  • ∼ 70% of children in Sierra Leone and Liberia played at home
  • ~ 82 and ~ 85% in Sierra Leon and Liberia did not play in groups in groups, respectively.
  • Children grieving were unhappy, lonely, heartbroken
  • Interviews suggested that the emotional well-being of children was challenged by disrupted friendships, bereavement, a loss of hope in education, loss of care and intimacy with parents
  • Food availability/increased prices were problematic
Save the children 2020 - Learning must go on: recommendations for keeping children safe and learning during and After the COVID-19 Crisis[@38545] COVID-19 N/A
  • Marginalized children may not have access to distanced education
  • Many low SES families rely on school-provided meals
  • Low SES families will reduce income further
  • Children who live in countries already in conflict situations face greater challenges
  • Girls more likely to drop out of school with school closures
  • Reduced access to schools for girls results in increased labour, forced marriage, early pregnancy, domestic/sexual violence 
  • Teenage pregnancy doubled to 14,000 during Ebola, girls were attacked/raped in quarantined home
  • Disruption of routines difficult for children with disabilities who require stability
  • Closures put children with disabilities at a greater risk of abuse 
The Alliance for Child Protection in Humanitarian Action 2020 - COVID-19: Protecting Children from Violence, Abuse, and Neglect in the Home[@38574] COVID-19 N/A
  • Quarantine instills fear/panic in children
  • Children are experiencing disrupted family connections, support and fear of the disease
  • Discrimination/stigma against children greater risk for psychosocial distress and violence
  • Increased risk of violence and exploitation can result in psychological distress, negative impact on development
The Government of Quebec 2020 - How children and teens experience bereavement[@38529] COVID-19 N/A
  • How children and adolescents react to loss of loved ones is dependent on their age, maturity, culture, relationship with the departed and support network
Thomas 2014[@38551] Ebola West Africa 
  • Food supply shortages mentioned (up to 40% of farmers in Sierra Leone abandoned farms) which may lead to malnutrition in children
Ukraine 2020 - Emergency Response Plan for the COVID-19 Pandemic[@38562] COVID-19 Ukraine
  • Those most vulnerable to food insecurity include farmers and owners of local food markets
  • Minorities face barriers to learning from home language instruction and lack of supports
  • Children with disabilities struggle more with home learning due to lack of access to equipment and services
UN 2020 - A joint Statement on nutrition in the context of the COVID-19 pandemic in Asia and the Pacific[@38550] COVID-19 Asia and the Pacific
  • Lost income increases food insecurity
  • School closures eliminate subsidized meals for low SES children
  • Quarantine has increased the trend of non-diversified diets, increased consumption of processed foods, decreased consumption of nutritious foods (whole fresh fruits and vegetables) 
  • Food systems and supply chains are being disrupted by lockdowns and restrictions 
  • Infants, young children, pregnant women, breastfeeding mothers face risks to nutritional status
  • School closures prevent children from accessing crucial school health and nutrition services, including nutritious school meals
UN 2020 - COVID-19 Nepal preparedness and response plan[@38553] COVID-19 N/A
  • Education of children has been disrupted, threatening continuity of education for children and the community 
UNDP 2014 - Assessing the socio-economic impacts of Ebola Virus Disease in Guinea, Liberia and Sierra Leone[@38572] Ebola Guinea, Liberia and Sierra Leone
  • Reduction in employment, increased poverty and decreased food security
UNICEF 2020 - UNICEF Response to the COVID-19 Pandemic: Background Paper for the Executive Board[@38548] COVID-19 N/A
  • Strain on mental health of children and caregivers increased pressures and risk of violence against children, child marriage 
  • Child protection is at risk due to lack of social services and family separation (child protection decreases by 25%)
  • Children with disabilities have an increased risk of violence, sexual abuse and exploitation
  • There is a marked increases in child poverty: 106 million children living in poor households by end of 2020
  • Pandemic-related nutritional issues include:
    • Disruptions to food supply chains and local food markets
    • Increasing poverty reduces access to nutritious foods
    • Reduced access to essential nutrition services, including school meals (369 million children use) and services to prevent/treat stunting, wasting and micronutrient deficiencies
UNICEF 2020 - All means all: equity and inclusion in COVID-19 EIE response[@38559] COVID-19 N/A
  • Vulnerable children may struggle in continuing education online:
    • Confinement may have psychosocial impacts
  • Increased safety risks for vulnerable (e.g. child abuse in the home)
  • Neglect in children with disabilities 
  • Greater isolation for girls and increased care for ill relatives and siblings
UNICEF 2020 - Children’s Rights and Digital Business During COVID-19 and Beyond[@38522] COVID-19 N/A
  • Issues that may arise with increase in online access for children: 
    • Access and equity  
    • Rights for technology and content in education
    • Safety of children online
    • Fighting the spread of misinformation
    • Data protection and privacy for children
    • Surveillance and Infection Control
    • Digital marketing and responsible commercial practices
    • Cybersecurity for children 
    • Supporting play and participation
    • Innovating to support children’s rights 
UNICEF 2020 - The Socio-economic Impact of COVID-19 on Children and Young People in the Eastern Caribbean Area[@38556] COVID-19 Eastern Caribbean Area
  • Education affected by prolonged interruption of courses and exams
  • Half have no internet and 40% relied on access outside the home
  • Reductions in future academic performance and increased dropout rates
  • Quarantine increases stress resulting in violence and neglect for children (exacerbated by unemployment and poverty)
  • Pronounced reductions in wages or earnings
UNICEF 2020 - COVID-19 and its implications for protecting children online[@38568] COVID-19 N/A
  • ↑ Internet use ↑ risk of sexual exploitation due to greater online contacts
  • Quarantine means that families are in closer contact, increasing child abuse online and offline
  • Extended unstructured time online=increased cyberbullying
  • Covid-19 introduced the use of instant messaging, online gaming and chat services to children with less online experience, who are also less resilient to harmful behavior
The alliance for child protection in humanitarian action - COVID-19 protecting children from violence, abuse and neglect in home[@38574] COVID-19 N/A
  • Common risk factors for violence, abuse and neglect:
    • Increased poverty and food insecurity due to job loss
    • Reduced access to education in person or online
    • An increase in children's digital activity and a decrease in caregiver monitoring, which exposes them to greater digital risks
    • ↑ children’s digital activity ↓ in monitoring=greater digital risks
    • Absence of school provided meals
    • Disruption of peer/social support networks for children/caregivers
    • Disruption of community/social support services
    • Children/caregivers routines are broken down
    • Increased alcohol and/or substance use by adolescents/caregivers 
    • Additional childcare arrangements
UNICEF 2020 - Framework for reopening schools 2020[@38563] COVID-19 N/A
  • Interruption of education has long-term impacts (e.g. ↓ social cohesion, ↑ inequality, and poor health outcomes)
  • School closures impact's child ability to learn 
  • Children less likely to return to school when out for a prolonged time
  • Being out of school ↑ risk of threats such as teenage pregnancy, sexual exploitation, child marriage, and violence
  • School closures interrupts services (e.g. immunization, feeding, mental health)
  • School closures cause stress/anxiety due to ↓ interaction and disrupted routines
  • Increased negative impacts for marginalized children
UNICEF 2020 - Gender-responsive social protection during COVID-19: Technical note[@38575] COVID-19 N/A
  • Economic shock will impact low income families the most
  • Long-term effects expected to ↑ homicides and violent assault
  • Longer-term and gendered impacts for children
  • Child marriage for girls increases disproportionately during times of crisis
UNICEF 2020 - Humanitarian Action for Children: Coronavirus (COVID-19) Global Response[@38543] COVID-19 N/A
  • Vulnerable children are in danger of dropping out of school because of significant inequities in accessing remote learning, widening the education gap
  • Negative developmental impacts on children due to ↓ access to play, care etc.
  • Quarantine is isolating women and children in homes that are not safe
  • 106 million additional children will be in poor households by end of 2020
  • School closures negatively impact learning, health, nutrition, protection and well-being
  • School interruptions create a risk of permanent dropout, especially for girls, children from poor households and children with disabilities
  • Internet access ranged from 1-86% depending on the region with most <50%
  • Poorer households in low-middle income countries have poorer access to technologies (e.g. TV, radio, and power supply)
  • 369 million have missed school meals which are relied upon by many
  • 265 million estimated to face starvation by end of the year
  • Estimates say children < 5 years with wasting disease could increase by 15 per cent over the first year of the pandemic (higher increases expected in Africa)
UNICEF 2020 - Migrant and Displaced Children in the Age of COVID-19: How the Pandemic Is Impacting Them and What Can We Do to Help[@38534] COVID-19 N/A
  • Misinformation ↑ discrimination and xenophobia towards migrant children
  • Border restriction reduces relief needed by marginalized children
  • 80% of children in Yemen are malnourished and rely on humanitarian aid 
  • Migrant/displaced children experience ↑ effect of limited access to education due to language barriers for refugees and enrolment issues
  • Online learning results in unequal access due to poor electricity in remote locations and refugee camps
  • Economic downturns ↑ child married or sexual exploitation, domestic violence, social exclusion, and separation from caregivers
  • Migrant/displaced children unaccompanied due to disruptions in protection services, resulting in increased living on streets and greater risk for harms
UNICEF 2020 Reaching out to Partners in the Time of COVID-19: Key results for Children Nutrition[@38546] COVID-19 West Central Africa region (WCA)
  • 80% increase in food insecurity expected for people in the WCA region
  • Increased food insecurity and COVID-19 effects are expected to ↑ level of SAM by 20%
UNICEF 2020 - Safe to Learn during COVID-19[@38558] COVID-19 N/A
  • School closure results in ↓ social interactions crucial in developing social-emotional skills, normal development, and building coping skills
  • School closures will especially affect disabled, indigenous, refugee children, those in remote or rural areas, in countries with ongoing crisis, and those with limited access to family support networks or online education
  • Girls and children with disabilities are at a greater risk for violence
  • ↑ Gender inequalities, ↑ risk for child marriage and teenage pregnancies
  • Confinement and economic pressures in historic pandemics ↑stress ∴ increasing family conflict, violence against children and exploitation
UNICEF 2020 - Scope of Food crisis as COVID-19 poses new risks to Nutritional needs of Children Malawi[@38554] COVID-19 Malawi
  • ↑ Food insecurity results in undernutrition and poor feeding practices
  • Small farm holders are particularly at risk for food insecurity 
  • Vitamin A access expected to ↓ due to reduced access to health care facilities
  • School closure, market disruptions, suspension of nutrition programs, and poverty is expected to↑nutrition deficiencies, obesity, and undernutrition ↓ quality, quantity, frequency and diversity of diet
  • Adolescent girls at risk for not having psychosocial support and ↑ GBV
UNICEF 2020 - Yemen Five Years on Report[@38583] COVID-19 Yemen
  • School closures, lockdowns, curfews, and the worsened economic conditions↑ risk for violence, forced marriage, sexual exploitation, and reduced access to child protection
UNICEF 2020 COVID-19 response: considerations for children and adults with disabilities[@38561] COVID-19 N/A
  • Children with disabilities are at risk for exclusion from education if remote learning is not accessible or they do not have assistive devices
Save The Children 2020 - Keeping Children Safe Online During the COVID-19 Pandemic[@38567] COVID-19 N/A
  • Survey in Thailand showed youth spend a lot of time playing online games, watching movies, using Facebook or suffering the internet 
  • Youth have ↑ exposure to harmful content such as violence, self-harm, inappropriate advertising to children, and misinformation about COVID 19
  • Online communities allow play, and continued education but ↑online exposure ↑ risk of cyberbullying, sexual exploitation and risky behaviour 
  • Children may talk more to strangers due to increased time online, and worry about what is happening in the world around them
  • Online platforms raise privacy concerns surrounding visible home environments and links can be misused for stealing information 
UNICEF 2020- Technical Note: On COVID-19 and Harmful Practices[@38577] COVID-19 N/A
  • School closure → learning loss and drop out to care for sick and work
  • Quarantine reduces safe spaces resulting in ↑ tensions, violence in homes
  • Quarantines ↑ GBV, sexual exploitation, forced early marriage, teenage pregnancy, separation from friends and caregivers, and ↓ protection 
  • Adolescent girls are more affected by pandemics due to ↑ loss of education, loss of reproductive health services, and social networks
  • Fear of infection, violence and mistreatment by health workers prevents adolescent girls from seeking health services 
  • Loss of family can ↑ risk of abuse of children, especially in adolescent girls  
  • Discrimination of those suspected to be infected →violence against children
  • Marginalized adolescents (e.g. disability) are vulnerable to stigma and abuse
  • Young children are more affected by loss of livelihood, poverty, unemployment, disruption in skill building activity, loss of aspirations and empowerment
United Nations Human Rights oPT 2020 - The rights of children amid COVID-19[@38517] COVID-19 Palestine Territory
  • ↑ Depression, anxiety, isolation, uncertainty, worry, boredom, and rejection Low income has made access to quality food for children a challenge
  • Long periods from school ↓ chances marginalized children will return
  • Confinement ↑ risk for child abuse and being forced into crowded conditions
  • Children with reduced freedoms (e.g. detained) ↑ risk for violence, abuse, GBV
  • Vulnerable to abuse include children in poverty, with a disability, living on the streets, with underlying conditions, and with refugee status
WHO 2001 - A human rights approach to tuberculosis[@38552] Tuberculosis N/A
  • Households may lose income or acquire debt due to TB
  • When child caregiver is occupied with caring for a relative with TB, the child may be neglected; become malnourished, or lose education
WHO 2014 - Psychological First Aid during Ebola virus disease outbreaks[@38532] Ebola N/A
  • Child pre-existing mental/physical disabilities ↑ risk for discrimination
  • Young girls at ↑ risk for violence due to self-protection challenges
  • Orphaned children experienced stigma and rejection from the community
  • Stigma/discrimination → isolation of children putting them at ↑ risk for harm
WHO 2020 - Global status report on preventing violence against children[@38576] COVID-19 N/A
  • Physical distancing has ↑ risk of intra-family violence and online abuse 
  • Child abuse and witnessing of violence between parents/caregivers increased
  • Spikes in calls to helplines about child abuse and intimate partner violence
  • Declines in # of child abuse cases referred to child protection services
  • ↑ in online harms, including sexual exploitation and cyber-bullying due to ↑ internet use by children