Orphans & children lacking parental care

© UNICEF/UNI485717/El Babaa

Context

In 2019, the United Nations Resolution on the Rights of the Child focussed for the first time on the situation of children without parental care, recognising that children not living with their parents, such as orphans and foster children, are at elevated risk of negative health and developmental outcomes, as well as violence and exploitation.(1) Although these children may be likely to miss out on essential health and social services, their plight is often invisible.

Over the past 50 years, vaccination has made the single greatest contribution to improved infant survival.(2) Vaccination is critical for child health and an important indicator of the reach of health services.

We studied whether community-dwelling orphans (defined by the UN as children with one or both biological parents deceased(2) and children lacking parental care (defined by the UN as children not residing with any biological parents(3) were at risk of sub-optimal vaccination.

Findings

Based on 189 comparable, population-representative UNICEF MICS surveys from 82 countries and territories, our study found compelling evidence that community-dwelling orphans and children lacking parental care are more likely than their peers to miss out on the benefits of routine immunisation.(4)

Conclusion

💡To better support children at risk and uphold their rights, vaccination programmes should prioritise service delivery to orphans and children lacking parental care.(4)

Key recommendations

✔️ Adapt service delivery to prioritise orphans and children lacking parental care, through health worker sensitisation and training, effective case management, standardised tracking of vaccination indicators, and enhanced service coordination.

✔️ Tailor approaches to fragile and humanitarian settings

✔️ Conduct research to assess whether exclusion from vaccination may signal general barriers to access for other essential services.(4) 

References

1. United Nations General Assembly (UNGA). 2019 UN Resolution on the Rights of the Child (A/RES/74/133). New York, USA: The United Nations; 2019.

2. UNICEF. UNICEF Data: The State of the World’s Children 2024 – Statistical Compendium. New York, USA: UNICEF; 2024.

3. United Nations General Assembly (UNGA). Resolution on ‘Guidelines for the Alternative Care of Children’ (A/RES/64/142). New York, USA: The United Nations; 2009.