To understand the cascading effects of Covid-19 on the lives of children belonging to the most marginalized section, Save the Children-Bal Raksha Bharat did a Rapid Need Assessment focused on key areas like health and nutrition, poverty and inclusion, education, and child protection. The survey stated that isolation from the peer group has had a major impact on the mental well-being of the children with increased cases of child labour and substance abuse among children as they struggle to cope with a lack of coping mechanisms to express their feelings and thoughts. This situation was further aggravated with, as perceived by parents, children being out of school and lacking learning opportunities at home (61%).
In the backdrop by Covid-19, Save the Children India (SC-India) had done two rounds of rapid need assessments (RNA-1, and RNA 2) to understand cascading effects of pandemic. Post devastating second COVID wave, SC-India decided to do a third round of rapid assessment (RNA-3).
The assessment focused on capturing the voices of the most marginalized people in the society including women and children with special attention given to adolescent participation through innovative yet thoughtful tools to make sure that the affected children and youth are heard. For the study, 4,052 respondents (2743 adults and 1309 adolescents) spread across 24 districts across six states namely, Madhya Pradesh, Jharkhand, Delhi, Karnataka, Maharashtra and Assam were interviewed. The findings of this assessment will be used to inform organizational response strategy across themes for medium- and long-term interventions and influence government and other stakeholder’s policy and programme interventions to effectively address issues related to children’s rights.
Effect of COVID on children’s mental health:
Findings related to the mental health of children in the last 18 months (June 2020 to December 2021) reveal that most of the children (39%) were worried about death, illness, separation of a loved one, or fear of disease. Feelings of loneliness (27%) and disturbed sleep (26%) due to worries were also reported. Being in a physical fight during the past 18 months was also reported by one-fifth of children (20%). State wise, feelings of loneliness (59%) and being worried about death, illness, separation, or disease (83%) was maximum in Karnataka whereas being disturbed sleep patterns was majorly reported in Delhi (51%) while physical fighting was maximum in Jharkhand (42%).
44% of children reported that they could not share their sorrow/anger/stress-related feelings with anyone and 3 out of 4 children could not share serious concerns like domestic/spousal violence with anyone.
In an indirect inquiry on child abuse, parents observed changes in their children’s behavior in terms of ‘abnormal interest about sex or genitals’ (12%), ‘Fear of being left alone with a given person (27%), ‘Sudden emotional or behavioral change’ (27%), ‘Abandonment of previous play habits’ (29%), ‘Genital/anal injuries’ (15%) and ‘Interest in age-inappropriate content online’ (25%).
One-fourth of parents (24%) feel that there is an increase in either scolding or punishment of their children post COVID (Post March 2020). This is reportedly the maximum in Delhi (46%). Parents’ perceptions on probable risks to children during COVID indicate (Since March 2020) that ‘Parent’s absence from home during COVID/lockdown due to any reason to be most risky (77%) and ‘Girl child taking-up more household chores during COVID/lockdown’ to be least risky (56%). The most sensitized proportion of caregivers belonged to Maharashtra and least from Assam.
Anindit Roy Chowdhury, Chief Programme Officer, Save the Children said, “Lockdown owning to COVID 19 not only led to reduced socializing amongst people but also increased the intensity of different emotions that parents and children feel. This brought a complex array of challenges that had mental health repercussions for children and adolescents. Our assessment has shown an increase in feelings of loneliness, anxiety, anger, grief and substance abuse among children. To ensure that the well-being of the most vulnerable families and their children are not compromised, we have come up with a set of recommendations as part of this assessment. We hope this serves as valuable evidence to influence and support effective measures taken by Government of India.”
Effect of COVID on Health & Hygiene Services:
A little less than one-third (29%) adolescent girls could not access any kind of adolescent, reproductive and sexual health (ARSH) related information during COVID-19 with Karnataka (92%) being most impacted and Jharkhand (1%) along with Delhi (1%) being least impacted. 5% of adolescent girls and females could not access sanitary napkins in times of need (June 2020 to December 2021) by any means with highest being 15% in Madhya Pradesh. Overall, around 88% households (highest in Madhya Pradesh-100% and least in Delhi-69%) faced one or other kind of problem(s) to get sanitary napkins. Of those who faced problems, the top three challenges were inability to visit the shop (33%), non-availability of the product in the shop (32%) and lack of enough money to buy (30%).
The Government IEC initiatives on importance of handwashing as a preventive measure to curtail COVID spread however, had a very positive impact on hand washing behavior of general public. More than four-fifth of the respondents (81%) specified ‘increased frequency of washing hands’ as a change in hand washing behavior post March 2020 (maximum being 93% each in Maharashtra and Karnataka and minimum of 60% in Delhi).
With the aim of making effective and wide changes, the following are the cross-cutting recommendations from the report:
• Strengthen child protection mechanisms through an increase on allocations of resources to adapt and strengthen Childline in the context of any emergency. Increase awareness and ensure Childline toll-free number 1098 is accessible for children/parents in distress. Strengthen dissemination of information on Gender Based Violence (GBV) response services (such as helpline numbers), through digital, tele-calling, audio-visual, mass media (radio / cable TV), and traditional paper-based media. Keeping in mind the emotional. Intellectual and mental well-being of the children, government should formulate a policy for Child and Adolescent Mental Health (CAMH) which can be used to create an enabling environment enforcing positive mental health. Along with this there should be provision of mental health and psychosocial support to combat the impact of COVID-19 for children, parents, caregivers, educational personnel and their communities.
• Improve continuation and access to essential health care services. The supply of sanitary products can be improved by supporting local small business and microenterprises to meet demand and reduce the reliance on global supply chains. Ensuring that ARSH related Information package is part of every government’s emergency health response in any kind of pandemic is crucial. Primary health care needs to be upscaled, both in terms of quantity and quality through increase the availability of financial resources for health care. Improved coverage and quality of essential Maternal & Child health care services like ANC, Immunization, PNC and childhood illnesses, especially among the most marginalized and vulnerable populations.