Drawing by Anastasia, 7, from a village in east Ukraine bombed by the Russians.

“Children’s exposure to adverse experiences is much higher than we had once thought, with a global systematic review finding that a billion children a year are victims of violence. The past two years have tipped the balance of these scales against all children. Emergencies increase family violence and mental health distress. More than seven million children have lost a parent or main care giver to covid-19, and the global pandemic has exacerbated pre-existing inequalities and risks for childhood adversity. Parenting in war is violently undermined: in chaos and emergency, families face extreme, unanticipated challenges. We also know that adverse experiences are often unwittingly transmitted across generations.

On the positive side, we now have convincing evidence of how to increase protective factors for children. Parenting programmes have been found to be effective at supporting parents to be the good care givers that they overwhelmingly want to be. They prevent and disrupt the intergenerational transmission of violence and trauma and improve mental health for parents and children. When combined with economic assistance (“‘cash plus care”) they are even more effective. The research is now so strong—with 77 systematic reviews and more than 100 randomised trials in lower resource countries—that the World Health Organisation (WHO) is developing guidelines for parenting programmes. In doing so, parenting programmes parallel other public health interventions for children that are backed up by robust evidence, such as polio vaccines and antenatal care. In emergencies, families need evidence based support that is accessible, relevant, and simple.”

More on Ukraine’s children: use evidence to support child protection in emergencies via BMJ.

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