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Street Children With Disabilities: Discrimination

two young boys running in muddy clothes, smiling at the camera.

Impacts Of Living with Disability As A Street Child

Ableism – discrimination against disability

The negative treatment of people living with disabilities is known as ableism (1). Sadly, this is experienced by almost all people living with disability at some point in their lives. People living in financial difficulty or poverty experience greater levels of disability-related stigma (2). The level of discrimination can also depend on an individual’s type of impairment (2). For example, children with intellectual disabilities often experience greater levels of exclusion than those with physical disability (2).

Amar, a 17-year old boy from Yemen was interviewed for a study on disability and poverty (3). He is deaf and uses sign language to communicate. He explained that he is made to feel uncomfortable when he uses sign language on the street (3). People often stare at him. This is not uncommon and sadly many other children with disability share his experience (4). It is also common for parents of children with disability to be made to feel like outsiders within their own communities (5). There is evidence that this also contributes to their rejection from jobs (5). This can have a further negative effect on a child’s health, with some feeling like they will only be further mistreated if they try to seek help from healthcare professionals (3).

Education as a street child with disability

The discrimination and judgement experienced by children often adds to the difficulties street children have with school (6). For example, according to Street Child, almost half of the children interviewed felt that discrimination was their main barrier to attending school (7). As children also experience discrimination due to disability, street children with disability can have a very difficult time trying to fit in. They can experience discrimination due to both factors, where already belonging to another disadvantaged group can make a child feel even more marginalised (8).

Tackling discrimination against street children and disability

The discrimination faced by street children urgently needs addressed, as negative attitudes prevent many from seeking help. This prevents many from receiving care when they need it (3).

Although it may be that attending specialised education for street children would result in less isolation, some projects such as ‘LEAP’ feel that it is important to include them in mainstream education. They also work to strengthen the systems which protect street and disabled children (9). This project is run by Chance for Childhood through partners in Western Kenya. They aim to improve education for street children and those living with disability (9).

In addition, organisations including Street Girls Aid are working to improve education, nutrition and the safety of street-connected children (10). In partnership with Chance for Childhood, this has helped many children like Ebo, a boy called from Accra who at 18 months old could no longer walk due to malnutrition. Through support by Street Girls Aid, Ebo and his mother were given the support they needed to improve Ebo’s health, and with time Ebo could not only walk again but he also joins in with singing and dancing with other children in his community (10). This is just one example of the good work improving the health of street children.

Impacts of disability on health, education and discrimination in street children

Overall, it is very likely that living with disability as a street child exacerbates the difficulties experienced by street children. They often suffer from poverty and poorer health, worse education and greater discrimination than non-disabled children and those not living on the street (11; 12; 13). However, organisations have together made some excellent steps towards better inclusion and protection of disabled street children. We hope to have highlighted their significance, while there are also many other interventions doing great work. Overall, the articles in this series aim to raise the awareness of the various disabilities and difficulties experienced by disabled street children. This group is often overlooked and therefore need our continued support (14). If interested in the other articles in this series, or indeed any of our other blog updates.

 


References

  1. Definition of ABLEISM [Internet]. Merriam-webster.com. 2021 [cited 24 August 2021]. Available from: https://www.merriam-webster.com/dictionary/ableism
  2. UK Department for International Development and other Government departments. Disability stigma in developing countries. K4D helpdesk service, Institute of Development Studies; 2018.
  3. Eid A, Ingstad B. Disability and Poverty: A Global Challenge. Bristol; 2011.
  4. Kuper H, Monteath-van Dok A, Wing K, Danquah L, Evans J, Zuurmond M et al. The Impact of Disability on the Lives of Children; Cross-Sectional Data Including 8,900 Children with Disabilities and 898,834 Children without Disabilities across 30 Countries. PLoS ONE [Internet]. 2014 [cited 24 August 2021];9(9):e107300. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159292/
  5. Rohwerder, B. (2018) Disability Stigma in Developing Countries. K4D Helpdesk Report. Brighton, UK: Institute of Development Studies.
  6. Weimert F. Discrimination is the biggest obstacle to education for children with disabilities — Street Child Switzerland [Internet]. Street Child Switzerland. 2018 [cited 5 May 2021]. Available from: https://www.street-child.ch/news/discrimination-education-children-with-disabilities
  7. Weimert F. Discrimination is the biggest obstacle to education for children with disabilities — Street Child Switzerland [Internet]. Street Child Switzerland. 2018 [cited 24 August 2021]. Available from: https://www.street-child.ch/news/discrimination-education-children-with-disabilities
  8. Children with disabilities [Internet]. Unicef.org. 2021 [cited 25 August 2021]. Available from: https://www.unicef.org/eca/children-disabilities
  9. LEAP from the Street – Learning, Educating And Protecting: Our new education project for street children in Kisumu, Kenya. | Chance for Childhood – Children’s charity [Internet]. Chance for Childhood. 2016 [cited 25 August 2021]. Available from: https://chanceforchildhood.org/latest-news/leap-street-learning-educating-protecting-new-education-project-street-children-kisumu-kenya/
  10. The streets are stealing children’s futures | Chance for Childhood – Children’s charity [Internet]. Chance for Childhood. [cited 25 August 2021]. Available from: https://chanceforchildhood.org/our-work/children-on-the-streets/
  11. Kuper H, Monteath-van Dok A, Wing K, Danquah L, Evans J, Zuurmond M et al. The Impact of Disability on the Lives of Children; Cross-Sectional Data Including 8,900 Children with Disabilities and 898,834 Children without Disabilities across 30 Countries. PLoS ONE [Internet]. 2014 [cited 24 August 2021];9(9):e107300. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159292/
  12. Clark J. Realising street children’s right to education | CSC [Internet]. Consortium for Street Children. 2019 [cited 25 August 2021]. Available from: https://www.streetchildren.org/news-and-updates/realising-street-childrens-right-to-education/#_edn1
  13. Weimert F. Discrimination is the biggest obstacle to education for children with disabilities — Street Child Switzerland [Internet]. Street Child Switzerland. 2018 [cited 5 May 2021]. Available from: https://www.street-child.ch/news/discrimination-education-children-with-disabilities
  14. Our work / Toybox [Internet]. Toybox.org.uk. [cited 26 August 2021]. Available from: https://toybox.org.uk/our-work

 

The Link Between Poverty and Disability in Street Children

Disabled girl with one leg using crutches to move around in the street, wearing a unicef backpack

Overview

As we briefly covered in disability in street children, disability is often connected to poverty (1). It is estimated that up to 30% of street children are living with disability (2). This makes disability very common among those living on the street. Many street children also experience severe poverty. Therefore, there is a strong link between poverty and disability in street children. This is a vicious cycle, with each factor exacerbating the effects of the other. Collectively, they have huge influence over the lives of street children (3).

Both poverty and disability are being continually studied by research bodies and charities. A better understanding of the causes of poverty and disability and the relationship between them can help put resources to better use. This understanding helps to improve policy making. Disability is a very serious issue in low and middle income countries. As such, reducing both rates of poverty and disability is part of the United Nations Sustainable Development Goals for 2030 (1). Part of this hopes to improve rates of disability among street children.

What is poverty?

There are many ways to define poverty. It is generally associated with factors such as socioeconomic status, income and location (1). However, the cut-off point for poverty is less clear when used in the context of street children. In which case, it is more effective to grade poverty in terms of a reduced access to healthcare and a shortage of basic resources (1). The little healthcare received by many street children increases their risk of disability (1).

Disability – a cause of poverty

Sadly, those living with disability are far more likely to also be living in poverty (1). There are various reasons for the poverty gap between disabled and non-disabled people. Some of this can be explained by the way society is currently structured. At present, the way in which we live is more focussed on what able-bodied people require (1). This makes it much harder to live life with disability. While making overall living more difficult, this also makes it harder for people living with disability to get jobs and to earn the money needed for food and living. This promotes exclusion and increases the risk of those living with disability ending up in poverty (4). Exclusion and discrimination make it more likely for a child living with disability to end up on the street (3).

In addition, children are also more likely to have to work on the street when a member of their family is living with disability (2). While this can be very dangerous, it is sometimes seen necessary for a family to survive. For example, in Ghana, many children work on the street to financially support a disabled family member (2).

Poverty – a cause of disability

Poor health

It is far more likely that a person will develop a physical impairment when living in poverty (1). This is most often due to poor health. Street children are much less likely to have access to essential resources, which has an impact on their health and wellbeing. Poor health is more likely when they do not have the resources to live healthy and free of disease.

Furthermore, it is also common for children with additional needs to require more resources. However, disabled children living in poverty often do not receive these. Without additional support, a disabled child is less able to carry out normal and essential tasks. This prevents them from living a healthy and more normal life (1).

Malnourishment

Inadequate healthcare, poor sanitation and malnutrition are experienced by many people in poverty, particularly street children (5). These factors often lead to severe disease and can result in permanent disability (4). For example, malnourishment can have a serious impact on a child’s health as it limits physical development (3). Poor nutrition during pregnancy can have detrimental effects on a developing baby and increases the risk of disease later in life (6).

Homelessness

Homelessness is another feature of poverty which can contribute to poor health and disability. Children living on the streets have limited contact with carers and family, where little support from care-providers can lead to poor mental and physical health. Therefore, children living or working on the street are commonly described as ‘children at risk’ (7). UNICEF also describes street children in a similar way by labelling them as ‘children in need of special protection’ (7). Since street children as a whole are particularly vulnerable, many children’s charities are working to better support and protect them.

Isolation

Many people are also stigmatised when living in poverty and are seen as out-casts. This is disproportionately the case for street children. Therefore, street children living in poverty and with disability are often even more isolated.

Summary

There is a strong two-way relationship between poverty and disability. On the one hand, disability increases the risk of a person having to live in poverty. There are many reasons for this and it is often very complex. Children with disability often receive poorer education (10). This is often due to a lack of understanding and judgement from others, and impacts a child’s ability to find work later in life. Without work, poverty and a life on the street is far more likely for these children. Combined with the social exclusion experienced by many disabled children, it is clear that disability can contribute to poverty.

In addition, poverty also increases the risk of disability. Without sufficient money it can be very hard to access vital resources, such as healthcare and nutritional food. This negatively impacts a child’s physical health where disease, malnutrition and a lack of medicine can lead to the development of disability. Therefore, rates of disability are far higher amongst adults and children living in poverty (3).

Poverty and disability in street children

Overall, both poverty and disability are very common in street children (8). Living on the street and with disability has twice the negative impact on a child’s life. More help is urgently required to improve these children’s lives (9). Help us support vulnerable children.


References

  1. Palmer M. Disability and Poverty: A Conceptual Review. Journal of Disability Policy Studies [Internet]. 2011 [cited 13 June 2021];21(4):210-218. Available from: https://journals.sagepub.com/doi/abs/10.1177/1044207310389333
  2. Ingstad B, Eide A. Disability and Poverty: A Global Challenge. Chicago: Policy Press; 2011.
  3. Street Child. On International Day of Persons with Disabilities we Advocate for Inclusive Education — Street Child [Internet]. Street Child. 2019 [cited 13 June 2021]. Available from: https://www.street-child.co.uk/blog/2019/12/4/on-international-day-of-persons-with-disabilities-we-advocate-inclusive-education
  4. Mitra S, Posarac A, Vick B. Disability and Poverty in Developing Countries: A Multidimensional Study. World Development [Internet]. 2013 [cited 13 June 2021];41:1-18. Available from: https://www.sciencedirect.com/science/article/pii/S0305750X12001465
  5. Banks L, Kuper H, Polack S. Poverty and disability in low- and middle-income countries: A systematic review. PLOS ONE [Internet]. 2017 [cited 13 June 2021];12(12):e0189996. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0189996
  6. Roseboom T. Handbook of Famine, Starvation, and Nutrient Deprivation. The Netherlands: Amsterdam Public Health Research Institute; 2017.
  7. Panter‐brick C. Homelessness, poverty, and risks to health: beyond at risk categorizations of street children1. Children’s Geographies [Internet]. 2004 [cited 13 June 2021];2(1). Available from: https://www.tandfonline.com/doi/full/10.1080/1473328032000168787?casa_token=IrddfS6UXfoAAAAA%3AR_P9f01XM_z57spnmwwr9dOShWSZ33cpaFX98fy6UXBNkmOpVXvdkhqupQhPAM-m_PAhOhpH84VVlA
  8. Vameghi M, Sajjadi S, Rafiey H, Rashidian A. SYSTEMATIC REVIEW OF STUDIES ON STREET CHILDREN IN IRAN IN RECENT DECADE: POVERTY, A RISK FACTOR FOR BECOMING A STREET CHILD. Social Welfare [Internet]. 2010 [cited 13 June 2021];:337 To 378. Available from: https://www.sid.ir/en/journal/ViewPaper.aspx?ID=194296
  9. Mitra S, Posarac A, Vick B. Disability and Poverty in Developing Countries: A Multidimensional Study. World Development [Internet]. 2013 [cited 13 June 2021];41:1-18. Available from: https://www.sciencedirect.com/science/article/pii/S0305750X12001465
  10. Weimert F. Discrimination is the biggest obstacle to education for children with disabilities — Street Child Switzerland [Internet]. Street Child Switzerland. 2018 [cited 5 May 2021]. Available from: https://www.street-child.ch/news/discrimination-education-children-with-disabilities

Child Marriage

Female child poverty in India

Marriage is a formally recognised legal union between two people in a relationship. However, many girls around the world are subject to marriage against their will at a very young age. Child marriage occurs where at least one party to the marriage is under 18 years old. It is a type of forced marriage as one party does not freely consent to the marriage and may be coerced into marrying[1]. Child marriage is a practice which disproportionality affects girls more than boys with one in five girls being married before they reach the age of 18 compared to one in thirty boys[2]. It is often the result of gender inequality.

According to UNICEF, the number of child marriages has decreased globally from one in four girls marrying almost ten years ago to around one in five girls marrying today[3]. Nevertheless, the practice is still a global issue which is prevalent in many areas around the world. If it continues, by 2030, almost one billion girls will be subject to marriage at a young age[4].

In this article, we will firstly look at child marriage in the context of human rights and will consider where the practice remains predominate in the world. We will then explore the main drivers behind child marriage. Next, we will discuss the negative consequences of child marriage on girls today. Lastly, we will examine what may help to eradicate the practice globally.

Child marriage and human rights

Treaties and conventions

Child marriage is a practice which significantly violates a person’s human rights. The Universal Declaration of Human Rights, which paved the way for subsequent human rights treaties, was adopted in 1948 and states in Article 16 that ‘[m]arriage shall be entered into only with the free and full consent of the intending spouses.’ This was later reinforced in Article 1 of the Convention on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages which came into force in 1964.

In 1979 the Convention on the Elimination of All Forms of Discrimination against Women was adopted and according to Article 16, men and women have the same right to marriage. They also have ‘the same right freely to choose a spouse and to enter into marriage only with their free and full consent’. Article 16 goes on to state that ‘[t]he betrothal and the marriage of a child shall have no legal effect, and all necessary action, including legislation, shall be taken to specify a minimum age for marriage….’ Thus, it is clear that pressurising girls to marry against their will at a young age breaches the rights set out in these international treaties and conventions.

The United Nations Convention on the Rights of the Child

The United Nations Convention on the Rights of the Child, which is the main international treaty concerning children’s rights, does not specifically address child marriage. However, other rights contained within this Convention are linked to the practice. These include the right to freedom of expression (Article 13) and protection from violence and abuse (Article 19).

Resolutions and goals

Over a number of years, the United Nations has adopted many resolutions aimed at tackling the problem of child marriage. In 2013, the United Nations Human Rights Council adopted a resolution entitled ‘[s]trengthening efforts to prevent and eliminate child, early and forced marriage: challenges, achievements, best practices and implementation gaps’[5] and the United Nations Department of Economic and Social Affairs has set the goal of eliminating all ‘harmful practices, such as child, early and forced marriage and female genital mutilation’ as one its seventeen Sustainable Development Goals[6].

Where is the practice prevalent?

Despite being a human rights violation, the practice still takes place in no less than 117 countries around the world[7]. According to UNICEF, the highest rate of child marriage is in sub-Saharan Africa where 35% of girls are subject to marriage before the age of 18. South Asia follows this where 30% of girls are subject to marriage before the age of 18. Other countries where the practice remains prevalent include Latin America and Caribbean (24%); the Middle East and North Africa (17%) and Eastern Europe and Central Asia (12%)[8].

The reasons behind child marriage

Two girls in India subject to child marriage

Female child poverty

Poverty is one of the main causes of child marriage globally. Girls residing in poorer families are twice as likely to be subject to marriage before they reach the age of 18 than girls residing in better-off families[9]. Girls are often seen as placing an economic burden upon families and are regarded as expensive to educate, feed and clothe[10]. Therefore, families, and sometimes the girls themselves, regard marriage as a way of becoming financially secure and escaping poverty[11]. Due to the significant issue of gender inequality which is prevalent in many countries, girls often lack education and are dependent upon men economically. Accordingly, they may regard marriage as the only way to become financially better-off.

Dowries and ‘bride prices’

Additionally, often a girl’s family pay a dowry to the groom’s family. Normally, the younger the bride, the smaller the dowry. This is an incentive for families to subject their daughters to marriage at a young age[12]. Similarly, in situations where a groom’s family pays the bride’s family a ‘bride price’, families suffering from economic hardship may choose to marry their daughter at a young age in return for an economic profit[13]. Sadly, due to COVID-19, there has been many school closures and the pandemic has had a significant economic impact on many families and communities. Consequently, many more girls are at risk of the practice[14].

Social and cultural norms

The most significant driver of child marriage is poverty, however, the practice also occurs due to social and cultural rules. Child marriage is a ‘norm’ in many communities and if families do not coincide with the practice, their own communities may regard them as outsiders or exclude them[15]. Therefore, many parents marry their daughters young to gain social status. Furthermore, due to widespread patriarchal systems, women are often subservient to men. In certain countries, girls who have relationships outside marriage or fall pregnant before marriage bring disgrace and shame to their families. Therefore, parents may decide to marry their daughters at a young age to protect them and their family’s social position within communities[16].

Negative effects and consequences

Sick child in poverty

Social and mental health problems

The practice has many negative consequences on the lives of girls around the world socially, mentally and physically. Girls who marry at a young age no longer attend school and this therefore hinders their access to education[17]. Furthermore, the practice has a significant impact on the mental health of many girls. When girls marry at a young age, they have to move in with their husband’s family and the husband’s family home may be in a different town. Thus, girls may no longer be able to maintain social connections with people outside their new families. Additionally, due to the dowry paid, a girl’s husband may be older than her. Accordingly, she may not share the same interests as her husband. Once married, girls may also have children. Consequently, they lose their adolescence, freedom to play and make friends which can result in isolation and depression[18].

Physical health problems

Furthermore, girls face many physical health problems as a result of the practice. Many families believe that marrying their daughters at a young age protects them from sexually transmitted infections. However, this is not necessarily true. Research has shown that in Kenya, girls who are married are 50% more likely to have HIV than girls who are not married[19] and in Zambia, this is 59%[20]. Furthermore, girls who are subject to marriage at a young age are often not ready to have sexual intercourse or reproduce[21]. Statistics have shown that girls who are aged between 10 and 14 are five to seven times more likely to pass away during childbirth and girls aged between 15 and 19 are twice as likely to pass away during childbirth[22].

Additionally, young girls often face prolonged childbirth resulting in obstetric fistula.  Commentators have stated that girls who have suffered from obstetric fistula experience incontinence, shame and other health issues[23]. Alarmingly, between 50,000 and 100,000 women suffer from obstetric fistula every year and according to the World Health Organization, over 2 million girls in Asia and sub-Saharan Africa are living with this condition and it is not being treated[24].

What will eradicate the practice?

Increasing education

In order to tackle the problem of child marriage, there needs to be a focus on education. Girls subject to child marriage should develop knowledge about the consequences of marrying young. They also need to learn about the affect the practice may have on their futures. If there is legislation tackling the practice, girls need to know that this legislation exists. They should additionally become aware of who to get in touch with should they need help[25]. The parents of young girls also need to be educated about the risks of child marriage and should become aware of the fact that forcing their daughters to marry at a young age could be breaking the law. Furthermore, local community leaders need to be provided with education about the impact of child marriage. As role models, this could help to shift local community patterns and beliefs[26].

Working with local communities

Additionally, there needs to be more ground work within the local communities. Local governments need to enforce campaigns fighting against the practice. There also needs to be local media coverage and local NGOs must directly work with communities[27]. NGOs should also offer psychological assistance to victims[28]. It has been found that the programmes which are most successful at preventing child marriages are those which have given families financial incentives to keep girls at school, those which feed children during school (removing the burden of parents having to do this), and those which give employment opportunities to girls once they have finished school[29].

ActionAid, an international charity, has carried out significant work to end child marriage.Local ActionAid staff worked alongside a co-operative women’s group in India and ActionAid’s partner organisation called Swaraj to raise awareness about the impact of the practice, the importance of girls remaining in school, and girls’ rights to choose who and when they marry. In the community, young women used to marry at 15 or 16 years old. However, after raising awareness about the negative consequences of child marriage, the average age has increased. Now most women in the community do not marry until they are 22 years old[30].

Conclusion

Overall, it is clear that child marriage is still a widespread practice and it is a serious violation of a person’s human rights. Poverty primarily drives child marriage in many regions, however, it is also a deeply-rooted practice which occurs as a result of cultural and social norms. The practice negatively affects girls’ mental and physical health and wellbeing, their social life and their education. There needs to be more education along with cooperation with local governments, NGOs and the media to help raise awareness about the negative impact of child marriage on girls and eliminate the practice all together.

Footnotes

[1]United Nations Human Rights Office of the High Commissioner, ‘Child and forced marriage, including in humanitarian settings’ https://www.ohchr.org/EN/Issues/Women/WRGS/Pages/ChildMarriage.aspx> accessed 13 May 2021

[2]UNICEF, ‘115 million boys and men around the world married as children – UNICEF’, <https://www.unicef.org.uk/press-releases/115-million-boys-and-men-around-the-world-married-as-children-unicef/> accessed 21 May 2021

[3]UNICEF, ‘Child marriage’ <https://www.unicef.org/protection/child-marriage> accessed 13 May 2021

[4]Women Alliance, ‘Child marriage – a practice driven by poverty’ (December 2016) <https://www.womenalliance.org/child-marriage-a-practice-driven-by-poverty> accessed 13 May 2021

[5]United Nations Human Rights Council, ‘Resolution Adopted by the Human Rights Council, Strengthening Efforts to Prevent and Eliminate Child, Early and Forced Marriage: Challenges, Achievements, Best Practices and Implementation Gaps (A/HRC/RES/24/23)’ 2013

[6]Goal 5.3, Sustainable Development Knowledge Platform, ‘Sustainable Development Goals,’ Sustainable Development Knowledge Platform < https://sustainabledevelopment.un.org/?menu=1300> accessed 13 May 2021

[7]Women Alliance, ‘Child marriage – a practice driven by poverty’ (n 4)

[8]UNICEF, ‘Child marriage is a violation of human rights, but is all too common’ (April 2020) <https://data.unicef.org/topic/child-protection/child-marriage/> accessed 13 May 2021

[9]ICRW, ‘Child marriage and poverty’ <https://www.icrw.org/files/images/Child-Marriage-Fact-Sheet-Poverty.pdf> accessed 13 May 2021

[10]Nour, Nawal M. “Child marriage: a silent health and human rights issue.” Reviews in obstetrics & gynecology vol. 2,1 (2009): 51-6

[11]Girls Not Brides, ‘About child marriage’ <https://www.girlsnotbrides.org/about-child-marriage/why-child-marriage-happens/> accessed 13 May 2021

[12]United Nations Population Fund, ‘Child marriage – Frequently Asked Questions’ (January 2020) <https://www.unfpa.org/child-marriage-frequently-asked-questions> accessed 13 May 2021

[13]ibid

[14]United Nations Human Rights Office of the High Commissioner, ‘Child and forced marriage, including in humanitarian settings’ (n 1)

[15]Women Alliance, ‘Child marriage – a practice driven by poverty’ (n 4)

[16]Girls Not Brides, ‘About child marriage’ (n 11)

[17]Women Alliance, ‘Child marriage – a practice driven by poverty’ (n 4)

[18]Nour, Nawal M. “Child marriage: a silent health and human rights issue.” Reviews in obstetrics & gynecology vol. 2,1 (2009): 51-6

[19]ibid

[20]ibid

[21]Women Alliance, ‘Child marriage – a practice driven by poverty’ (n 4)

[22]Nour, Nawal M. “Child marriage: a silent health and human rights issue.” Reviews in obstetrics & gynecology vol. 2,1 (2009): 51-6

[23]Nyasha Chingono, My dreams were destroyed’: poverty costs child brides dear in Zimbabwe’ The Guardian (04 January 2019)

[24]World Health Organization, ‘Obstetric fistula’ (19 February 2018) <https://www.who.int/news-room/facts-in-pictures/detail/10-facts-on-obstetric-fistula> last accessed 21 May 2021

[25]Plan International, ‘Ending Child Marriage’ <https://plan-uk.org/about/our-work/child-marriage> accessed 24 May 2021

[26]ibid

[27]Women Alliance, ‘Child marriage – a practice driven by poverty’ (n 4)

[28]ibid

[29]Nour, Nawal M. “Child marriage: a silent health and human rights issue.” Reviews in obstetrics & gynecology vol. 2,1 (2009): 51-6

[30]ActionAid, ‘Child Marriage’ < https://www.actionaid.org.uk/our-work/womens-rights/child-marriage> last accessed 24 May 2021

The Sustainable Development Goals

This photo displays a group of children in Afghanistan waiting for a food distribution delivered by a charity as part of their effort to meet the Sustainable Development Goals

What are the Sustainable Development Goals?

In 2015, world leaders met to discuss an agenda for sustainable development. They came up with 17 Sustainable Development Goals (SDGs) to reach by 20301. These goals, that apply universally, are in place with the aim to end all forms of poverty, fight inequalities and tackle climate change, ensuring that no one is left behind.

The SDGs build on the success of the Millennium Development goals2, which range from halting the spread of aids to providing universal primary education. They were very successful and a great blueprint for the sustainable development goals. The consequent new goals call for action from all countries to promote prosperity while protecting the planet.

Sustainable Development goals are not legally binding; however, the United Nations expect government to create plans and take responsibility to work towards the SDGs within their own countries. Success of these goals relies on countries own sustainable development plans.

How do the Sustainable Development Goals relate to poverty and what is being done?

Goal One

The first two goals in the list relate directly to poverty. They are difficult goals to achieve, however, it is important to try anyway.

Firstly, sustainable development goal number one is to “End poverty in all its forms everywhere”. Poverty is measured as people living on less than $1.25 a day3. Within this goal there are 7 targets4. These include implementing social protection systems as well as equal rights to economic resources. In the United Kingdom, the government has been focusing on reducing homelessness. They are doing this by increasing the help available to those at risk of homelessness, promoting a fairer labour market; supporting those who are disadvantaged and improving Universal Credit.

Between 2010 and 2015, poverty had decreased globally from 15.7% to 10%. However, since then it has slowed dramatically. In 2019, it was at 8.2%5. Since then, poverty has increased due to the many implications of the pandemic. COVID-19 caused the first increase in global poverty in decades. In 2020 over 71 million people have been pushed into extreme poverty6. Natural disasters are also continuing to exacerbate poverty. Many people see their homes, or their livelihood destroyed, and the economic loss has been high.

Goal Two

The second sustainable development goal is to “End hunger and achieve food security and improved nutrition and promote sustainable agriculture.” across the world. In 2018, 26.4% of the population were affected by moderate or severe food insecurity7. In 2019, 144 million children under 5 were stunted (have been prevented from developing properly) and 47 million were affected by wasting (muscle and fat tissue ‘waste’ away)8. This again relates directly to poverty as it tends to be adults and children who cannot afford necessities who are suffering from hunger.

Some of the 8 targets9 include addressing malnutrition in children, doubling agricultural productivity and incomes of small-scale food producers. They also include creating and implementing sustainable food production systems. In the United Kingdom, the government has created four general actions to achieve these goals10. For example, these includes a sustainable model of food production by working alongside the Food Standards Agency. Furthermore, promoting healthy lives and strengthening the Global Financing Facility. Recently, the pandemic has had implications on the progress of this goal. As well as this, conflict and climate shocks, many people have no access to food. Additionally, small-scale food producers are suffering. In developing regions, about 40-85% of all food producers have been compromised11.

The total number of people suffering from severe food insecurity has been on the rise since 2015. Due to the pandemic, around 370 million schoolchildren are missing the free school meals that they rely on12.

What is Poverty Child doing?

Our focus has always been on helping improve life for vulnerable children affected by urban poverty, delivering programmes aimed at getting poverty children to think differently about their life chances. However, we also recognise that the issue of poverty is complex and needs breaking down so that it can be more easily understood, which is why we also work on raising awareness of the wider issues here on our website.

To help the work that Poverty Child do, you can donate and/or volunteer. There are many ways to donate, including by recycling your unwanted items with us.

The 17 Sustainable Development Goals are:

  1. End poverty in all its forms everywhere.
  2. End hunger, achieve food security and improved nutrition and promote sustainable agriculture.
  3. Ensure healthy lives and promote wellbeing for all at all ages.
  4. Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.
  5. Achieve gender equality and empower all women and girls.
  6. Ensure availability and sustainable management of water and sanitation for all.
  7. Ensure access to affordable, reliable, sustainable, and modern energy for all.
  8. Promote sustained, inclusive, and sustainable economic growth, full and productive employment, and decent work for all.
  9. Build resilient infrastructure, promote inclusive and sustainable industrialisation and foster innovation.
  10. Reduce inequality within and among countries.
  11. Make cities and human settlements inclusive, safe, resilient, and sustainable.
  12. Ensure sustainable consumption and production patterns.
  13. Take urgent action to combat climate change and its impacts.
  14. Conserve and sustainably use the oceans, seas and marine resources for sustainable development.
  15. Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss.
  16. Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels.
  17. Strengthen the means of implementation and revitalize the global partnership for sustainable development.

Sustainable development goalsFootnotes:

  1. The Sustainable Development Goals (United Nations)
  2. The Millennium Development Goals (United Nations)
  3. Goal 1 (United Nations)
  4. Targets of Goal 1 (United Nations)
  5. Overview of Goal 1 (United Nations)
  6. Overview of Goal 1 (United Nations)
  7. Goal 2 (United Nations)
  8. Overview of Goal 2 (United Nations)
  9. Targets of Goal 2 (United Nations)
  10. United Kingdom Targets (Gov.co.uk)
  11. Overview of Goal 2 (United Nations)
  12. Progress of Goal 2 (United Nations)

Disability in Street Children: Causes and Impacts

Young boy in poverty in developing region.

Overview

A large number of children living with disabilities are living in developing regions (1). This is very important here at Poverty Child as many of these children are living on the street. This is a large public health concern, as disability in street children can greatly impact children’s physical and mental health.

Street children and poverty

Work at Poverty Child aims to improve the lives and outcomes of children living and working on the street. The term ‘Street Children’ is used to describe either children who live and work on the streets, or those who spend a a lot of time on the street but sleep away from public spaces (2).

Poverty is a main cause of children having to live on the street. Other causes include the death of family members, neglect or violence. Poverty is also a main cause of disability, where the cost of healthcare prevents many people from being able to access vital services (3). Disability can increase the probability of being in poverty, as it prevents many from being able to work. In addition, many children receive poorer education as a result of disability. To clarify, disability and poverty are closely linked, as both impact on the lives of street children. Disability in street children adds an additional hardship. For example, street children living with disabilities are more vulnerable to violence and typically have poorer health (2).

Furthermore, disabled street children are often ignored and they try to remain hidden as a result of the high levels of discrimination they experience (2). Work in Sierra Leone by Street Child has shown that discrimination is one of the biggest factors contributing to poor education for children living with disabilities (4).

In addition, the current Coronavirus pandemic has also had a large impact on street children living with disabilities (5). This has made it harder for them to access food or help. Currently, there is a need to remotely support children with disabilities due to Coronavirus.

Causes of disability in street children

There are a large number of factors which can cause disability in children (1). However, many of these have been tackled in higher income countries. Yet, many preventable diseases are continuing to cause disability in children of low-income settings (1). For example, disability may be caused by infectious diseases, infections by parasites and  diseases not directly spread from person to person (1). In addition, in poor regions and street children especially, factors such as malnutrition, maternal and perinatal disease and social unrest are also common causes (3).

Types of disability

A person with a disability has a long term physical, mental, intellectual or sensory impairment (6). Research from Street Child suggests that more street children have intellectual disabilities than physical ones. For example, this may include learning and social impairments. Subsequently, this can affect their education (7).

Figure describing both the social and medical models of disability. The diagram reads that the social model includes the impact of discrimination which can lead to poorer job prospects. In contrast, the medical model more closely describes the lack of physical ability and that the disability is the problem, not that of society.

The Medical and Social Models of Disability (6)

Models of disability

The social model of disability highlights the discrimination a person may face due to their disability (6). This stigma has existed for a long time, and remains an issue around the world. To add further, there is often a view that disability is the ‘fault’ of the person. Instead, society needs to be fully inclusive of people living with disability (8). In comparison, the medical model of disability more directly focuses on changes to the physical or mental abilities of a person (6).

Discrimination in disabled children

Children living with disability experience stigma and discrimination, on top of the difficulties caused by the disability itself (9). Discrimination is described by UNICEF as ‘any distinction, exclusion or restriction on the basis of disability’ (6). This causes many children to feel isolated and helpless (9).

Discrimination in education

Disability often prevents children from fully taking part in their community. As a result, this causes many to feel like outsiders within their own communities (8). For example, it is common for children with disabilities to be separated in classrooms. Some teachers will refuse to teach children with disabilities alongside other children (8). This continues to make those with disabilities believe there is something wrong with them. Furthermore, it also suggests to able-bodied children that the two groups need to be separated. This results in poorer education for disabled children. Many children begin to feel this stigma towards themselves, which results in them not wanting to seek help or access to health services. This further adds to the struggle of living with disability as a child. Furthermore, they have been left behind in the global attempt to improve education for street children as a whole (10).

Gender-based discrimination

Gender-based discrimination is also experienced by girls living with disabilities. Consequently, they overall receive less education and less career training than boys with disabilities and able-bodied girls of the same age (11). This exclusion is commonly as a result of them being invisible. Therefore, it is important that we work to include disabled girls within and out-with disabled communities (11).

Developments to disability in street children

Many organisations are working to improve the health and lives of children living in low income countries (1). In particular, programmes are working to improve the outcomes of disability in street children. For example, community-based programmes are being used to emphasise the importance of good health care for disabled children. The introduction of such programmes has helped improve childhood access to healthcare in Tanzania. This is a country currently struggling with high rates or childhood disability (1).

The United Nations Sustainable Development Goals for 2030 hope to make education more inclusive and more accessible to all children (10). However, there is a lack of research on the education of disabled children, particularly in those living on the streets (9). This is due to a lack of funding. As a result, this limits the improvements which can be made to the education of disabled street children. One way to solve this is through fundraising campaigns. These campaigns are increasing awareness and therefore support for projects. Subsequently, this increase in funding is helping to meet the needs of every child living with disability.

In addition, there is a mindset that we need to ‘fix’ children living with disabilities. This implies that something is wrong with them. Instead, it is better if we work to remove the stigma the children face. This would result in children being free to succeed no matter their impairment (8). For instance, UNICEF’s ‘Its about ability’ campaign is aimed at changing community perception of disability, which is helping to improve the acceptance and inclusion of disabled children (8).

Coronavirus

Sadly, the global pandemic had a negative impact on much of the progress being made. However, organisations such as Chance For Childhood have done great work to meet the needs of disabled street children through outreach teams during this difficult time. The result: much improved support of street children in Kenya and Ghana (5).

Overall, these programmes can collectively help us to improve disability in street children.

 


References

  1. Cameron D, Nixon S, Parnes P, Pidsadny M. Children with disabilities in low-income countries. Paediatrics & Child Health [Internet]. 2005 [cited 25 April 2021];10(5):269-272. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722543/
  2. org. The Facts about Street Children | Consortium for Street Children [Internet]. Consortium for Street Children. 2019 [cited 5 May 2021]. Available from: https://www.streetchildren.org/about-street-children/
  3. Simkiss D, Blackburn C, Mukoro F, Read J, Spencer N. Childhood disability and socio-economic circumstances in low and middle income countries: systematic review. BMC Pediatrics [Internet]. 2011 [cited 25 April 2021];11(1). Available from: https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-11-119
  4. Weimert F. Discrimination is the biggest obstacle to education for children with disabilities — Street Child Switzerland [Internet]. Street Child Switzerland. 2018 [cited 5 May 2021]. Available from: https://www.street-child.ch/news/discrimination-education-children-with-disabilities
  5. Chance For Childhood. How we’re supporting vulnerable children during Coronavirus | Chance for Childhood – Children’s charity [Internet]. Chance for Childhood. 2020 [cited 5 May 2021]. Available from: https://chanceforchildhood.org/latest-news/how-were-supporting-vulnerable-children-during-coronavirus/
  6. Desk Review for Developing Measures on Discriminatory Attitudes and Social Norms towards Children with Disabilities in Europe and Central Asia region [Internet]. Dornsfife: UNICEF; 2018. Available from: https://www.unicef.org/eca/media/13391/file
  7. Kamara J. A Study on the Barriers to Education for Children with Disabilities in Sierra Leone [Internet]. Chicago: Street Child; 2018. Available from: https://static1.squarespace.com/static/5620ddc4e4b04789570e5fca/t/5b570243aa4a997ca1cf356b/1532428909558/A%2BStudy%2Bon%2Bthe%2B%2BBarriers%2Bto%2BEducation%2Bfor%2BChildren%2Bwith%2BDisabilities%2Bin%2BSierra%2BLeone%2B.pdf
  8. Children with disabilities [Internet]. Unicef.org. 2021 [cited 25 April 2021]. Available from: https://www.unicef.org/eca/children-disabilities
  9. Maulik P, Darmstadt G. Childhood Disability in Low- and Middle-Income Countries: Overview of Screening, Prevention, Services, Legislation, and Epidemiology. PEDIATRICS [Internet]. 2007 [cited 25 April 2021];120(Supplement):S1-S55. Available from: https://pediatrics.aappublications.org/content/pediatrics/120/Supplement_1/S1.full.pdf
  10. The World Bank. Education: Children with disabilities are being left behind, says World Bank/GPE report [Internet]. 2017. Available from: https://www.worldbank.org/en/news/press-release/2017/12/01/children-with-disabilities-are-being-left-behind
  11. The State of the World’s Children 2013 [Internet]. Unicef.org. 2013 [cited 25 April 2021]. Available from: https://www.unicef.org/reports/state-worlds-children-2013

 

What is Poverty?

Indian child in poverty looking through barbed wire

Poverty is a global issue that affects many people. Across the world there is thought to be 734 million people who live on less that $1.90 a day1 (according to studies in 2015).

Poverty is the state of not having enough material possessions or income for a person’s basic needs such as food, clothing and shelter. Its manifestations include hunger and malnutrition, limited access to education and other basic services, social discrimination and exclusion, as well as the lack of participation in decision making. Pre-pandemic, around 10% of the world population were living in extreme poverty and struggling to fulfil basic needs2, such as health, education and access to water and sanitation. It is a complex issue that may include social, economic, political and geographical elements. There is no single best measure of poverty, it does not mean the same thing for everyone.

In 2015, the United Nations Member States all agreed upon 17 Sustainable Development Goals to protect the planet and improve the lives and prospects of everyone, everywhere.

As part of the 15-year plan, the first goal is to end poverty3. The Sustainable Development Goals main reference to ending poverty is in target 1.A: “Ensure significant mobilisation of resources from a variety of sources, including through enhanced development cooperation, in order to provide adequate and predictable means for developing countries, in particular least developed countries, to implement programmes and policies to end poverty in all its dimensions.” Many charities, including Poverty Child, are working on this common goal. However, this is a large task and figures show that currently, we will not reach that target. The aftermath of the pandemic threatens to push a further 70 million people into extreme poverty4.

How do you measure poverty?

There is not one distinguished measure of poverty, it is a complex issue that has many dependents. Poverty can mean something different to a lot of people. The UK measures poverty in different ways, two commonly used measures5 are:

  • People in relative low income (living in households with income below 60% of the median that year).
  • People in absolute low income (living in households with income below 60% of (inflation-adjusted) median income in the same base year – usually 2010/11).

Absolute low income looks at whether living standards at the bottom of the distribution are improving over time. Income can be measured before or after housing costs are deducted (BHC or AHC). Poverty levels tend to be higher after housing costs as poorer households tend to spend a higher proportion of their income on housing.

According to a House of Commons Library report, 11 million people were living in relative low income BHC (UK) in 2018/19. This was 17% of the population. Of that, 2.8 million children were living in poverty6. Another measurement is destitution, this is where someone is not able to afford basics such as shelter, heating and clothing and is the lowest level of poverty.

What causes poverty?

There are many causes of poverty, these can vary across the world. Some of the major causes in the UK include:

  • Low pay.
    72% of children living in poverty have at least one parent in work7. However, the long-term effects of being in the lowest paid 20% of the UK labour market has been a major cause of enduring poverty in the UK. Often in the case of low paid jobs, there are not opportunities for promotion and the hours are unpredictable.
  • Worklessness.
    Since 2006, there has been a 60% rise in the number of people moving repeatedly between work and unemployment8.
    68% of children in families with no working adults are in poverty9. Often people want to work but they are not able to due to different barriers to work. This is heightened during the pandemic when many businesses are having to close and subsequently workers are being let go.
  • Inadequate benefits.
    Currently, in-work benefits are not sufficient to overcome labour market challenges and keep people out of poverty. Not only that but housing and childcare costs are constantly increasing, this increases families risks of poverty. The social security system should provide a safety net to prevent people falling into poverty – this is not the case for most.

There are many other causes for poverty, such as discrimination, abuse and trauma, and weak relationships. These causes could be a consequence of a random life event or moment, that then catches people in a trap and keeps them in a cycle that they cannot escape. This could simply be getting sick and not being able to work for a while.

The effects of poverty can be severe. They can lead to homelessness, health issues, family issues, drug or alcohol abuse and lower educational achievement, to name a few. It has a huge impact on the community and those surrounding it. Poverty affects more than one in four children in the UK today. Children who grow up in poverty miss out on what many of us take for granted, clothing, three meals a day, even a school trip. It is often found that students who are in poverty are less likely to be successful at school and then earn less as adults. This cycle is vicious but not inevitable. If we work together, it will be possible to have a stronger economy and a fairer society that will help everyone.

What does Poverty Child do?

Poverty Child is part of that movement to help the children who are living in poverty10. We are a charity that is dedicated to improving the life for street and slum connected children. Our mission is to empower them to achieve their true potential. Anyone could fall on hard times and find it difficult to make ends meet. It is important to be there to help everyone when they do.

Some of the work that we offer includes:

  • Mobile clinics.
    These provide basic healthcare to children in poorer areas.
  • Street schools
    A cordoned street that becomes a classroom for learning basic literacy and numeracy.
  • Day Centres
    A safe place for children to get a meal, wash, counselling and basic schooling.
  • Night Centres
    A safe place for a child to sleep at night.

This work is currently focused abroad.

Please look through our blog to see more information on ways you can help our charity. This can include donating directly or volunteering. It is also possible to recycle coins and currency, mobile phones, cameras and other gadgets, old jewellery, stamps and ink cartridges. Please visit our homepage for more information.

 

Bibliography

1,2,4

Nations, U., 2021. Ending Poverty | United Nations. [online] United Nations. Available at: <https://www.un.org/en/global-issues/ending-poverty> [Accessed 3 April 2021].

3

Nations, U., 2021. Goal 1: End poverty in all its forms everywhere. [online] United Nations Sustainable Development. Available at: <https://www.un.org/sustainabledevelopment/poverty/> [Accessed 3 April 2021].

5, 6

Francis-Devine, B., 2021. Poverty in the UK: Statistics. [online] Commons Library. Available at: <https://commonslibrary.parliament.uk/research-briefings/sn07096/> [Accessed 3 April 2021].

7,8,9

CPAG. 2021. Child Poverty. [online] Available at: <https://cpag.org.uk/child-poverty> [Accessed 3 April 2021].

10

Poverty Child. 2021. Poverty Child – empowering street and slum connected children. [online] Available at: <https://povertychild.org> [Accessed 3 April 2021].

Additional Resources:

JRF. 2021. What is poverty?. [online] Available at: <https://www.jrf.org.uk/our-work/what-is-poverty> [Accessed 3 April 2021].

United Nations Sustainable Development. 2021. Take Action for the Sustainable Development Goals. [online] Available at: <https://www.un.org/sustainabledevelopment/sustainable-development-goals/> [Accessed 3 April 2021].

 

 

Helping 100 Children At-Risk in Payatas, The Philippines – Final Update

Children at Fairplay Sports Centre in Payatas

We wrote previously about a project we’re co-funding with our partner Fairplay For All Foundation that launched in February 2018. The project set out to help 100 children living in poverty and at-risk in the Payatas slum area, The Philippines. Over the course of the project, the physical growth and mental status of these children has been looked at periodically, using five key performance indicators (KPIs): Body Mass Index (BMI), Learned Optimism (LO), Growth Mindset, Risk of Depression and Adverse Childhood Experiences (ACEs).

Now, a little more than a year from when the project launched, we can present the third and final wave of results. The KPI scores measured in this study not only indicate the impact of the Fairplay’s current activities in Payatas, but also give crucial suggestions for the organisation’s future work.

If you would like to find a summary of the first and second wave of results and also read more about how the KPIs are measured, you can check out our previous articles on this project.

As for the final update of the KPIs…

The third wave of measurements were taken in March 2019, with 72 out of the original 100 players available to participate.

Body Mass Index (BMI)

The final scores for BMI are some of the most positive among the various KPIs measured. While the average BMI has stayed relatively steady over the course of the project (still being in the underweight category), there was been a 23 percent increase in the number of children reporting a ‘normal’ BMI. This is due to several previously underweight and overweight children finding a better BMI – a combination of improved nutrition and exercise.

Overall, these results are trending in the right direction and suggest that the sport and meal programs are having a positive impact on the children in Payatas.

Learned Optimism (LO)

As with BMI, the average scores for LO have stayed mostly similar over the period, at around level 5 for self-esteem (moderately low) and level 0 for optimism (very pessimistic).

There were, however, some bigger changes within some of the specific categories. The proportion of children described as ‘very pessimistic’ has fallen from 70 to 58 percent, reflecting a positive change at the bottom end of the scale and thus for those deemed most ‘at-risk’. On the other hand, self-esteem scores have dropped markedly, as those with ‘moderately high’ self-esteem fell from 23 to 4 percent and those in the ‘moderately low’ category increased from 33 to 58 percent.

Growth Mindset

Again, like BMI and Learned Optimism, the results of the mindset test have stayed relatively stable in the time frame, with the average score staying the same at 36 and the majority of players (60 percent) still having either a strong growth mindset or a growth mindset with some fixed ideas.

Upon reflection, Fairplay has admitted that this test does not seem to translate too well in the context of the children in Payatas. The measuring tool appears to be too Westernised and relies on self-reporting to a large degree with the ‘right’ answer being relatively easy to spot. As such, a more appropriate tool to measure the children’s resilience will be considered in the future.

Risk of Depression

The average score for Risk of Depression has remained at the ‘severely depressed’ level. The biggest change is that a high proportion of children with a ‘moderate’ risk of depression (Wave 1: 41%; Wave 3: 19%) have been tipped into the ‘severely depressed’ category (Wave 1: 45%; Wave 2: 65%). Essentially, this means that the children are at greater risk of depression now than they were a year ago.

The obvious culprit for this is the infamous War on Drugs in the area which has led to several of the players’ parents to be killed or imprisoned and also resulted in the children themselves being increasingly harassed or threatened by the police. Economic inflation has meant that many of the children face rising financial pressures at home too.

Adverse Childhood Experiences (ACEs)

The ACE measurements differ from the other KPIs used in this study in that they cannot go down – once a child has experienced a certain type of childhood trauma it is added to their score accumulatively, up until they reach the age of 18.

As expected, the average ACE score for the children in Payatas has increased and is now at 4 out of 10, compared to 3 out of 10 last February.  This represents a ‘moderate’ level of childhood trauma, which is worrying given the young age of the children involved. If this trend continues, it is likely that many will reach the critical level of childhood trauma (level 6) before they are 18 years old.

These results make Fairplay’s work in Payatas ever more important and suggest a growing need for projects that help relieve trauma and stress experienced by the children and target those who are hit the hardest.

Final conclusions

Overall, it is fair to say that the children taking part in this study have made only slight progress over the course of the project, with some positive changes in the KPIs and some more negative.

Unfortunately, these children have faced increasing external challenges during the time period, notably the impact of the War on Drugs and economic inflation, which has affected not just them as individuals but also the Payatas community as a whole. It may be the case that, in the context of these rising pressures, the programs offered by Fairplay have actually acted as a buffer, helping the children better deal with the challenges they face. Without the use of a control group, however, it is impossible see how their results compare to other children in the area who haven’t had access to the programs.

Nevertheless, this project has played an extremely helpful role in recognising the challenges faced by the children in Payatas and given Fairplay a good indication as to how they can streamline their programs to better benefit the children in the future.

Next steps

The Youth Center: The Youth Center is one of the biggest developments in Fairplay’s work in Payatas so far. The centre will open Tuesday to Saturday and act as a social support system for children in the community. There will be a range of facilities offered at the centre, many of which build upon the activities currently being provided. These include economic opportunities, counselling sessions, academic tutoring, free healthy meals and a mother’s club. In this way, Fairplay aims to offer a more holistic approach in relieving the pressures felt by the children in the area and getting the wider community involved in achieving success.

Changes to the research process: Fairplay hopes that their research concerning children’s physical and mental wellbeing can continue to inform their work in Payatas. Ongoing research should offer a long-term perspective on the challenges faced by the children in the community and evolve each year as more appropriate tools are found. Some suggestions have already been mentioned in this post:

  1. If funding is available, a control group – a group of children of a similar age and situation who do not have access to the project – should also be tested. The control group results can be compared to those of the children at the centre to see if these children experience any ‘buffer’ effects due to being part of the programs.
  2. The ‘growth mindset’ test should be replaced with another measure of childhood resilience, resulting in a more appropriate and child-friendly way of exploring this factor.

Here at Poverty Child we are optimistic that the change in operations at Fairplay’s centre will lead to positive changes in Payatas and that the research collected over the course of the project will be used to better reflect the needs of the children in the community. We are excited to see that the donations raised by our fundraisers and kind sponsors are being used positively and are working towards helping vulnerable and at-risk children.

Street Children: Everything About This Global Humanitarian Crisis

Street Children in Cambodia

Across the world there are millions of children who face the reality of spending their everyday life living or working on the streets. The quality of life of these children is poor, as they are exposed violence, deprived living conditions and a lack of access to basic necessities, healthcare and education. The numbers of street children around the world are also likely to be rising, especially in developing countries where rapid urbanisation has led to the creation of urban slums in which children often experience extreme poverty.

A global crisis is rapidly unfolding and yet the international community continues to largely ignore children connected to the street. As a result, the need to alleviate the problems causing children to become involved with the street as well as support and protect those already living in these conditions is ever more vital.

Here we introduce the crisis, with four main sections:

  1. Who are street children?
  2. What causes children live and work on the street?
  3. Life on the street
  4. How do street children process into adulthood and what are the long-term effects of street involvement?

Who are street children?

Who does the term ‘street children’ refer to?

Street children are a group of children with diverse characteristics and have very complex lives. Because of this, definitions of the term ‘street child’ are often disputed and vary significantly between policy makers, researchers, NGOs and other social actors.  Earlier work on street children tended to focus on just those living (sleeping) and/or working on the streets (1). More recently the term has also come to include those who spend a significant amount of time on the streets (2), whether that be hanging out with friends, accompanying their parents working on the street or for any other reason.

Generally speaking we can say that street children are children who, for whatever reason, depend on the streets for their survival. The street is a central reference point for them, plays a significant role in their everyday life and forms a vital part of their identity (3).

How many street children are there and where do they live?

Latest figures on the number of street children living globally emerged more than a decade ago, published by the international children’s charity, Unicef. In 2005, the organisation predicted that there are more than 100 million street children around the world (2). This is just an estimate, however, and many other agencies working with street children have doubted the accuracy of the claim (1).

Finding a more accurate and up-to-date figure for the number of street children globally is difficult due to the challenges which come along with counting these children: street children tend to move around a lot, they may also not want to be found or are scared and mistrustful of authorities (2). Since definitions of the term ‘street child’ and methods used for counting vary significantly between organisations, it can also prove unreliable to compare and compile data collected in different cities or regions (3)(4)(5).

While the true number of street children living globally is disputed, many researchers and NGOs agree that their numbers are rising. This is occurring alongside the world’s growing population and due to certain global trends, such as rapid urbanisation, increasing inequalities and migration (3). Although it is often thought that street children only live in the poorer nations of Asia, Africa and South America, they are found all over the world, including in richer countries and regions (2).

Street children have diverse characteristics and experiences 

As mentioned above, street children are not a clearly defined, consistent group (5). Their characteristics are diverse, coming from a range of different backgrounds, ethnicity and ages (3).

Stereotypically street children are often thought of as boys and it is true that studies in many locations have counted more boys on the street than girls (2)(5). This is likely due to the more traditional gender roles at play in many cultures, which encourage boys to be independent, work and socialise outside of the home, while girls stay indoors (5). Girls are also often less visible on the street, keeping out of sight to protect themselves from the dangers of street living or being more likely to work as domestic servants or involved in commercial sex (5)(6).

As a result of their varying identities and locations in which they live, street children will have different experiences, needs and struggles and will use the street in diverse ways (5)(7).

What causes children to live or work on the street?

Push and pull factors

Broadly speaking we can put the presence of children living, working or spending large amounts of time on the street down to a range of so called ‘push’ and ‘pull’ factors. Push factors are aspects which force children on to the street (3). These could be reasons such as family collapse, death, economic difficulties, domestic violence, abuse or neglect (8)(10). Pull factors, meanwhile, are circumstances which make the street attractive to a child, for example friendships or the sense of independence, freedom and adventure (3)(2).

In many cases, the process of a child becoming involved in the street is not the result of a single one of these factors, but rather a combination of reasons which have left them in an extremely vulnerable position and meant that the street has become their best or only option for survival (2)(5).

The society in which a child lives also has a huge influence on their likelihood of taking to the streets. In many countries there are wider societal problems at play which make life challenging for children and intensify the conditions which make street involvement more likely.

Broader societal problems

Poverty and income inequality: In societies where income inequality is high, children from the poorest families can be forced onto the street as a means of economic survival for themselves or their families (4)(10). Once there, they are likely to take part in income-generating activities, such as begging, street trading, collecting raw materials, or more dangerous practices, such as stealing or commercial sex work (6)(9)(10).

Financial instability not only puts a strain on families economically, but also emotionally (10). Research has found that stress associated with economic hardship can cause a weakening of relationships between family members (10)(4). This can lead to more conflicts within the family and increased incidences of domestic violence, abuse and neglect, all of which can contribute to a child leaving home (4).

Inadequate social protection for vulnerable children: Many children experiencing hardships and violations of their basic rights at home are reliant on government social services or support from NGOs to provide them with care and protection. In situations where these provisions are unavailable, not accessible or inadequate to meet their needs, children are left vulnerable and exposed to many forms of abuse (3)(11). These children may take to the streets as a means of protecting themselves from the dangers they face at home, after being left with no feasible alternative (1).

Wars, conflicts, epidemics and disasters: Numbers of street children often increase during times of crisis, such as wars, health epidemics, natural disasters, famine and economic recessions. While the consequences of such events are varied, they typically result in death, displacement and disruption of the normal running of services. All of these factors lead to a deepening of poverty and can leave children without care and protection stopping them from becoming involved in the street (5). Recent examples of crises that have had a damaging impact on children include:

  • The 2014 Ebola crisis in Sierra Leone to which over 12,000 children lost their primary care giver (12).
  • The war and refugee crisis in Iraq which forced more than 12.3 million children from their homes (13).
  • The HIV/AIDS pandemic which has left an estimated 16.6 million children as orphans, 90% of whom live in Sub-Saharan Africa (5).

Patterns of urbanisation: Over the last fifty years, movement from rural to urban areas has increased significantly. Currently the highest levels of rural to urban migration are taking place in Asia and Africa, where rapid urbanisation has led to the creation of large unplanned, informal settlements and urban slums (5). Physical conditions in these areas are poor and the settlements are often characterised by poverty, limited resources, little access to social provisions and large family populations per household (3)(5). Children living in these slums are at risk of being forced onto the streets to earn a living or survive, given their poor economic background, little education and limited means for securing their basic needs (11).

Discrimination against certain groups: Studies in many locations have found higher percentages of children from ethnic minorities on the streets than those from native backgrounds. This is the case in South Eastern Europe where children from Roma backgrounds represent a large proportion of children on the street, as high as 89 percent in Serbia and 67 percent in Bosnia and Herzegovina. In these countries, Roma families face many challenges in their everyday lives, including extreme poverty, unemployment, little access to services, as well as prejudice, discrimination and intolerance, which are likely to be the reasons behind this trend (10).

Discrimination not only affects ethnic minorities but also other marginalised groups. In the Democratic Republic of Congo, the HIV pandemic has led to an extreme form of discrimination targeted at AIDS orphans. These children are frequently accused of witchcraft, shunned by their extended families and left with no option but to struggle on the streets to survive (5).

Life on the street

Challenges faced by street children

For the many children who have moved onto the street to live or work, life is extremely challenging. On the streets they are subjected to poor physical conditions and have little access to basic necessities, such as food, clothing and shelter (10). They are also likely to find it difficult to access relevant social services, such as healthcare, either because they do not have the documents required for using such services, lack information or are discriminated against by service providers (3).

Low school attendance is common among children in street situations too. Many street children struggle to stay in standard education because of the attendance requirements, routine and discipline of school, especially when having to juggle work on the street alongside. In addition, street children often experience discrimination from other pupils and teachers, have little family support to help them with schoolwork and find the topics taught irrelevant to their everyday lives, meaning that they do not enjoy school (2)(10)(11).

Violence becomes a part of everyday life

Another major difficulty of life on the street is the constant threat of violence. While the street can be a place for friendships, violence between street children is also common. A study looking at children living alone on the streets in Kenya and Tanzania found that incidences of violence took place as a result of stealing, conflicts over owing money and securing places to stay. A lot of this behaviour was directed at younger children, who not only experienced physical abuse, but also sexual abuse at the hands of older street youths. Many of these older children had been raped themselves when they were younger and used sexual abuse as a means of expressing power and anger over their younger peers (4).

In addition to violence from other street inhabitants, street children are vulnerable to experiencing abuse from the police, local business owners and other members of the public (3)(5). Police brutality against street children has been witnessed in many locations worldwide. In Kenya, for example, there has been extensive reporting of the maltreatment of street youths by the country’s authorities which has sometimes led to bodily harm and even death (14).

Forced sex-selling and begging is also common on the streets, leaving children at risk of abuse and exploitation from the adult organisers of this work. Sex work is particularly prevalent among girls: a study in Tanzania found that 79 percent of girls counted on the street at night were involved in commercial sex work, rising to 86 percent of the 15 to 18 year old girls counted (9).

Crime as a means of survival and coping mechanism

Street children are often viewed negatively by officials and others in the community. They are seen as a problem and associated with crimes, such as stealing, loitering, sleeping in prohibited places, selling goods illegally, as well as using drugs and alcohol (2).

Stereotypes of street children as ‘criminals’ and ‘delinquents’ fail to understand the complex lives that these children lead (1)(3). In many incidences, street children only resort to illegal work practices or crimes like stealing after being left with no other alternative to earn a living or for survival (2)(4). They can also be forced into it by adults and other children who are exploiting them. Drugs and alcohol, on the other hand, are often used as a coping mechanism by street children, thought to offer a relief from the harsh realities of their everyday lives (1)(4).

How do street children process into adulthood and what are the long-term effects of street involvement?

Pathways in adulthood

Research has shown that children’s lives can develop in numerous directions once being involved with the street (4). Some of these pathways are more negative, as former street children are more likely to take part in organised crime and end up in the penal system. In Brazil it is thought that over a third of street children have been placed inside young offender institutions (13).

Some of the pathways which street children take into adulthood are more positive. They can find routes into housing, off-street work or education (1). In many cases, children require interventions from the government, NGOs or other support networks to help with the transition into off-street life and overcome barriers, such as costs, lack of documentation, fear and discrimination (1)(4)(5). With this support not available for every child, it is the case that many children remain street dwellers into late adulthood (1).

Worryingly, several studies have also indicated that there is a high mortality rate among street children. Incidences of death among street youth can be linked to a number of factors, including their exposure to violence, high rates of substance use, mental health problems and susceptibility to illness and diseases like HIV, combined with their lower uptake of health care (1)(14). The nature of street work is often dangerous, meaning that street children are also prone to accidents, such as when begging close to traffic in busy cities (10).

Long-term effects of street involvement

The experiences which street children face in the early stages of lives can have a range of impacts on their physical, mental and emotional wellbeing. All of these factors have consequences on a child’s long-term health and personal development through adolescence and into adulthood.

Mental and emotional impacts: Violence is one of the biggest dangers of street life, affecting children not just physically, but also mentally and emotionally. Research suggests that incidences of abuse can severely affect children’s ability to trust and form attachments and, thereby, make it difficult to form appropriate and meaningful relationships in the future (3)(4). The violence experienced by street children can also result in trauma and emotional distress, which if not addressed can cause psychological damage and mental health problems, such depression, post-traumatic stress and anxiety (4).

High levels of substance use, which is common among street children, has also been proven to have a negative effect on mental health (1)(3)(4).

Physical impacts: The physical conditions which street children are subjected to are poor. They often work and sleep in areas which are dirty, polluted and exposed to harsh weather. These environments pose a major risk to children’s health, as chest problems are likely and infectious diseases like malaria and cholera spread easily. Since many street children lack food or have a poor diet, it is also common for them to experience shunted growth and appear physically much younger than their actual age (4). Being deprived of nutrition negatively affects a child’s activity and motivation levels too, which are important for their cognitive development (10).  

Given the lack of medical care accessible to children on the street, those suffering from health problems or injuries from accidents and assaults frequently do not get the treatment they need (4)(10). This can increase the severity of the issue in the long term and even have fatal consequences.

To conclude…

With millions of children living and working on the streets around the world and evidence to suggest these numbers are rising, it is clear that the global humanitarian crisis of street children needs to be tackled. Before coming to the streets, these children have already lived in deprived conditions, often experiencing extreme poverty, family collapse, death, abuse or neglect at home, meaning that the street has become their best or only option for survival. On the streets they face more dangers, including high rates of violence, poor physical conditions and a lack of access to healthcare, education and basic necessities, like food, clothing and shelter.

Without proper support street children may struggle to adapt to life off the street and pursue negative pathways into adulthood, such as becoming involved in organised crime and ending up in the penal system. If their issues are not addressed, they are also likely to experience long-term impacts on their mental and physical health, and even face higher risks of death. As this is the case, the support from charities and NGOs is vital in helping alleviate the problems of street children and providing them with the care and protection they need.

Sources used in this article:

  1. Benitez S (2011) State of the World’s Street Children: Research. Consortium for Street Children.
  2. Consortium for Street Children (2015) Street-Connected Children Myth Busters: Challenge Your Perceptions.
  3. OHCHR, United Nations Children’s Fund, Consortium for Street Children and Aviva (2013) Protection and promotion of the rights of children working and/or living on the street.
  4. Smeaton, E (2012) Struggling to Survive: Children Living Alone on the Streets in Tanzania and Kenya. Railway Children.
  5. Ray P, Davey C and Nolan P (2011) Still on The Streets – Still Short of Rights: Analysis of policy and programmes related to street involved children. Plan and Consortium for Street Children
  6. Railway Children (2016) Children on the streets of Kitale: Headcount findings 2015.
  7. Consortium for Street Children (2015) Advocacy and Action Guide: Making rights a reality for street-connected children.
  8. Comic Relief (2009-12) Street and Working Children & Young People’s Programme (SWC&YP) Strategy 2009-12.
  9. Government of the United Republic of Tanzania and USAID Kizazi Kipya Project (2018) Street-Connected Children in Tanzania: Headcount Findings 2017.
  10. Duci V and Tahsini I (2016) Regional research on prevalence of street children phenomenon in Albania, Bosnia and Herzegovina, Montenegro and Serbia. Save The Children.
  11. Guga E S (2010) Final Evaluation of Building the Capacity of Local CBOs and Government Agencies to Improve the Lives of Migrant Children Project. FTF/ICT/ CSC, Dar es Salaam.
  12. Street Child (2015) The Street Child Ebola Orphan Report.
  13. Consortium for Street Children (2016) Street Children: A Global Picture (Infographic/Map).
  14. Embleton L, Ayuku D, Makori D, Kamanda A and Braitstein P (2018) Causes of death among street-connected children and youth in Eldoret, Kenya. BMC International Health and Human Rights, 18 (19).

 

Improving The Fairplay Sports Centre In Payatas

A safe space to play

Children must be able to play. This allows them to relax, get exercise, create social support networks and life skills. Payatas, a slum area in The Philippines, is far from a united community. With limited space and resources, conflict between differing groups often arises. Children can get caught up in this. Our partner, Fairplay For All Foundation, provides a space for every child. It doesn’t matter which part of the community they come from. They come to play sports at the centre in an environment of cooperation and teamwork. This environment is crucial as it helps them develop confidence and social skills.

Problems with the sports centre

Fairplay approached us in 2016 about the issues they had with their space and equipment. Children played barefoot during training sessions and competitions. Every day Fairplay carried water in so that players could drink and wash after football. Many groups had to share one pitch, which was of poor quality and flooded in the rainy season. There was no electricity to light the pitch. Plus, it had no protection from fly-tippers and trespassers.

Improving security at the sports centre

At first, we committed to building a second pitch. We wanted to help expand their facility so that more children could play sports. This proved too far a goal for us though, as we failed to raise enough funds to meet the costs of doing so. Fairplay faced a dilemma. Where were the funds going to come from to expand? A question too often asked by NGOs. An answer soon presented itself leading to them securing funds from another partner.

Upon reevaluation of our budget, we decided to contribute towards security instead. We paid for a perimeter wall around the pitch. Once completed, the wall immediately improved the centre both in appearance and security. Trespassers were no longer able to get in where before they caused much nuisance. Some would use the pitch as an open toilet. Others would use it to burn copper wires that they’d scavenged. The copper extracted from the burnt cabling fetches up to £1.50 per kilo.

We’re super proud of the impact of our contribution. Thanks to our supporters, Payatas’s children can continue their development through football unimpeded.

Further improvements to the sports centre

Fairplay have by no means sat on their laurels since then. The’ve continued to find new funding partners to make the space much better. Their efforts are bearing fruit. A new second court has doubled the number of coaching sessions and games played. Improved drainage now prevents pitch flooding; meaning usage even in the rainy season! A new water filter means players have clean drinking water and can shower before they go home. Pitches, toilets, showers and offices are now used in the dark thanks to a new electricity feed. Opening up new opportunities for the community to enjoy the centre. A new shoe bank provides children with second-hand but good quality trainers. This not only reduces the risk of injury but makes all the difference to how children enjoy football.

These improvements to the sports centre may seem basic, but they are essential. The changes Fairplay has implemented means more of the community can benefit. More children can play, they can play for longer and they better enjoy taking part. The impact is huge.

What’s next?

There is still more work needed to complete all the desired improvements at the centre. The challenge is setting the right priorities in line with available resources. Fairplay want to build a roof over one of the courts. This would make the pitch usable in heavy rain, and protect it from the elements prolonging its life.

We want to continue to play a role in improving the sports centre with Fairplay. The benefits to the children and community are immediate and tangible. Stay tuned for updates. Read more about our work in Payatas with Fairplay.

Some images of the sports centre

Helping 100 Children At-Risk in Payatas, The Philippines – Mid-Term Update

Street Child with Football

We wrote previously about a project we started with our partner, Fairplay Foundation for All, which set out to help 100 children living in poverty and at-risk in the Payatas slum area, the Philippines. Thanks to kind sponsors and the hard work of our fundraisers, we’ve funded the nutrition aspect of this project: the initiative to provide free healthy and nutritious meals to children after the twice-weekly football sessions.

In our last article we talked about how Fairplay had measured the children against five key performance indicators (KPIs) to use as a baseline to understand how they are suffering and what could be done about it. Six months on, all of these KPIs, aside from the Adverse Childhood Experiences (ACEs), have been measured again. We’ll give an outline of how these results compare below, as well as some details about what will happen next in the project.

Be sure to check out our previous blog post to see an outline of the project and the baseline results in more detail.

Update on the KPIs

During this second wave of measurements, only 93 out of the 100 children who originally took part in the project were available. This means that the sample size is slightly smaller.

Body Mass Index (BMI)

The mid-term results show that there has been a slight improvement in the physical growth of the children in Payatas. While the average BMI is still classified in the underweight category, it has increased slightly from 18.4 to 18.6. The majority of the children are still also underweight, but this proportion dropped by 7 percentage points, from 68 to 61 percent. Meanwhile, the number of children at a ‘normal’ weight increased from 26 to 29 percent.

This is particularly pleasant news to us here at Poverty Child, as it means that our funding towards providing nutritional assistance to the children has had some effects and has led to improvements in their physical health.

Learned Optimism (LO)

On average, the reported level of optimism and self-esteem amongst the children has remained relatively steady. The average score for self-esteem has stayed at level 5, described as ‘moderately low self-esteem’, while average level of optimism has increased just slightly from -1 to 0, both of which are in the ‘very pessimistic’ category.

There has, however, been positive changes within some of the specific categories. The number of children reporting ‘moderately high self-esteem’ has grown from 23 to 35 percent. At the same, the proportion of those described as ‘very pessimistic’ has fallen from 70 to 54 percent. These results have been offset by changes in other categories, which is why the average scores have stayed very similar. Nevertheless, if the trend continues, it does suggest significant improvements for the most at-risk groups.

Growth Mindset

The mid-term results suggest that the overall mindset of the children has stayed largely stable. The average score in the last round of testing was 36, characterised as a ‘growth mindset with some fixed ideas’, and this has remained the same in the tests this time around. While some of the children have shifted between categories, others have improved only slightly and within their steady category, which is why the overall percentages have remained very similar.

Although there has been no strong improvement in the mindset of the children, we did mention in our last article that baseline results of this test were unusually positive compared to the other KPIs. In addition, the Emotional Quotient (EQ) club which is targeted at promoting social and emotional development was delayed in starting and is due to begin in September. It is understandable, therefore, that the project has seen no specific changes in the children’s mindset so far.

Risk of Depression

The results of the depression test mid-way through the project are alarming. Since the baseline test, the average score among the children has increased from 24, classified as ‘moderately depressed’, to 26, categorised as ‘several depressed’. The proportion of children in the ‘severely depressed’ category has increased too: in the second round of testing, 67 percent of children were categorised as ‘severely depressed’ compared to 45 percent in the first round.

Fairplay has sought to identify reasons why these scores may have increased so much over the last few months and have highlighted the recent political and economic struggles in the Payatas community. The drug war in the Philippines has now become infamous internationally, with recurring incidences of police brutality being reported in Payatas.  Several children taking part in the project have had one or both parents arrested, while others have had family members killed. This has not only had an emotional impact on those affected directly, but also created anxiety and fear in the community as a whole. On top on this, the worsening economy, with high inflation, has created additional financial stresses on already vulnerable families.

It is likely that these deeper issues have threatened the mental well-being of residents in Payatas, as well as the outcomes of the project so far. They suggest the need for extra social and emotional support for the families in the long-term.

What happens next?

The results of the tests mid-way through the project have given a good indication as to how the project is going so far and what can be improved upon in the next six months and beyond. Here are some of the next steps the project will take:

  1. Starting the weekly EQ club in September: Due to difficulties in finding the right person for the role, the Emotional Quotient (EQ) club that was intended to begin in February has been postponed and is now scheduled to start in September. Currently in Payatas, there is a large social divide within the community, where residents who live on different streets and areas have negative views and stereotypes of one another. The EQ club intends to work on this problem by helping the children grow more self-awareness and empathy, before mixing youth from opposite groups together. This is with the aim of reconciling their perceived differences and potentially breaking the social divide in Payatas.
  2. Sport sessions for mothers: Another new initiative is to organise social sport for mothers of attending children, including volleyball sessions, Zumba classes, and similar activities, so that they are able to participate in exercise together. Hopefully, this will build relationships in the community and help gain the trust of parents who sometimes have reservations about sending their children to the centre.
  3. Expand topics covered at the Youth Group sessions: Taking into account the results of the mid-term tests, the Youth Group will seek to include more sessions on topics such as promoting optimism and seeing stress as a challenge rather than a threat. This is with the hope of sustaining improvements in growth mindset, optimism, and lessening the risk of depression.
  4. Further recommendations to come at the end of the project: It is difficult to know how the situation in the community will develop and unfold in the next six months and beyond this. Currently, the economic and political pressures in Payatas are the biggest challenges faced by the project, and the community development team is still learning how to overcome these. The final tests done at the end of the project will indicate the overall effect of the interventions and these outcomes can be used to develop strategies to support the children most at-risk.

To see a final update on these KPIs and how the children are doing at the end of this project, be sure to keep up-to-date with our work.