Peer-reviewed article
Assessing the prevalence of young children living in households prepared for COVID-19 in 56 low- and middle-income countries
Chunling Lu, Yiqun Luan, Sara Naomi Naicker, S. V. Subramanian, Jere Richard Behrman et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how many young children under five in 56 low- and middle-income countries live in households prepared to prevent COVID-19 and other communicable diseases. Preparedness was measured by whether households had space for quarantine, adequate toilets and hand hygiene facilities, regular media access, and phone ownership. Only 19.4% of young children on average lived in prepared households, with large disparities between wealthy and poor families and between urban and rural areas. The findings show most young children in these countries lack the basic household infrastructure needed to protect them during pandemics.
Key points
- Only 19.4% of young children under five across 56 LMICs lived in households meeting all COVID-19 preparedness criteria
- Preparedness ranged from 0.6% in Ethiopia (2016) to 70.9% in Tunisia (2018)
- In 50 of 56 countries, fewer than 50% of young children lived in prepared households
- Children in rural areas and poorest households were significantly less likely to live in prepared homes than wealthier and urban counterparts
- Preparedness included space for quarantine, adequate toilets and hand hygiene, weekly media exposure, and phone ownership
Limitations
This is a cross-sectional assessment using survey data rather than a direct measure of pandemic outcomes or actual infection rates. The study cannot tell us whether household preparedness as defined actually prevented COVID-19 transmission or improved health outcomes for young children during the pandemic.
Abstract
BACKGROUND: The COVID-19 pandemic and governments' attempts to contain it are negatively affecting young children's health and development in ways we are only beginning to understand and measure. Responses to the pandemic are driven largely by confining children and families to their homes. This study aims to assess the levels of and associated socioeconomic disparities in household preparedness for protecting young children under the age of five from being exposed to communicable diseases, such as COVID-19, in low- and middle-income countries (LMICs). METHODS: Using data from nationally representative household surveys in 56 LMICs since 2016, we estimated the percentages of young children under the age of five living in households prepared for communicable diseases (e.g., COVID-19) and associated residential and wealth disparities at the country- and aggregate-level. Preparedness was defined on the basis of space for quarantine, adequacy of toilet facilities and hand hygiene, mass media exposure at least once a week, and phone ownership. Disparities within countries were measured as the absolute gap in two domains-household wealth and residential area - and compared across regions and country income groups. RESULTS: The final data set included 766,313 children under age five. On average, 19.4% of young children in the 56 countries lived in households prepared for COVID-19, ranging from 0.6% in Ethiopia in 2016 to 70.9% in Tunisia in 2018. In close to 90% of countries (50), fewer than 50% of young children lived in prepared households. Young children in rural areas or in the poorest households were less likely to live in prepared households than their counterparts. CONCLUSIONS: A large portion of young children under the age of five in LMICs were living in households that did not meet all preparedness guidelines for preventing COVID-19 and caring for patients at home. This study highlights the need to ensure all families in LMICs have the means to prevent the spread of the pandemic or other communicable illnesses to young children during pandemics.