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The Multi-level Impact of Infectious Disease Outbreaks—Introducing the Socio-ecological Model

The socio-ecological model is introduced as the foundational model that provides the context to analyze child protection risks and protective factors.
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Hi, this is Hani Mansourian again here with you. I’m here to speak to you about the socio-ecological model and its relevance to protection of children in the context of COVID-19, but also other infectious disease outbreaks. As you’re aware, the socio-ecological model is a framework that helps us better understand the environment of the child and how the environment interacts with the child in terms of its protection but also potentially putting the child at risk. Each layer of the socio-ecological model plays a role in children’s protection and well-being, and the layers also interact with each other in a dynamic manner.
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For example, let us look at the issue of responsive care giving, which is an element at the family level of the socio-ecological model. Responsive caregiving is a crucial component of children’s healthy development, particularly at a young age; this can become a risk factor for a child when a young child is deprived from it for any reason. This could be death of a caregiver, risky behavior on the part of parents, such as drug abuse or alcohol abuse, or violence perpetrated by the caregivers or parents. So the same protective factor, which is responsive caregiving, becomes potentially a risk factor for a child.
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At the same time, responsive caregiving can be protective against other adversities as well. So if a child is exposed to violence outside of the home, one of the things that can help the child remain resilient in the face of that violence or atrocity outside of the home, is in fact that responsive care. Also it has a function within the family, but it also has a function outside of the family.
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During the time of crisis, most of the layers of the socio-ecological model are negatively impacted. This often leads to a multiplication of the impact of crisis on children. And that is why many advocates often claim that the biggest victims of crisis are children. Because it’s not only that they’re affected directly by the crisis itself, now in this case we’re talking. about an infectious disease outbreak, but they’re also affected because other people in their environment are effected. So they’re effected in two distinct ways. Infectious disease outbreaks, such as Ebola or COVID-19, normally requires strict control measures to limit their spread. As we all have experienced during the COVID-19 pandemic, such measures often impact children and families more than the virus itself.
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They make the damage at every single layer of the social ecology of a child. So if you talk about the first layer of the socio-ecological model, which is the children themselves, or the core of the model, control measures can lead to significant amount of distress among children, not only because of the fear of virus or directly being impacted by virus, but because they cannot play or see their peers
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because their routines are disrupted, because their ability to play and interact with the environment is much more limited. Now if you look at the second layer which is the Family level. Families are often distressed not only again because of the virus itself, of course that’s a huge stressor, but they’re also distressed because of the economic pressure, lack of access to family and community support, being cramped in a small space for prolonged periods
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and sometimes uncertainty about their own future or the future of the children are all impacting them negatively and affecting their psycho-social well-being. Now you’re looking at the third layer of the socio-ecological model which is the Communities. They’re also often distressed and fearful. Resources are often more limited because of the restrictions put in place, therefore competition becomes higher among community members for limited resources. They’re also potentially fearful of contracting the virus through other community members. So if a community member is going in and out of the community, that individual might be seen as a source of threat.
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They’re often no longer in the position to play a protective role that they normally play, because they do not necessarily have the same access to children. <v 0>For example,</v> if a child was abused or beaten up by a drunk father, a lot of the time it would be the neighbor who would step in. Or if there is an uncle or aunt who lives next door, those were the ones who would step in and try to
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intervene. But in this situation because of the outbreaks now, if we talk about COVID, because of the fear of coronavirus or other viruses that may be in play, they may not be able to or willing to intervene and even have contact with the neighbor or the neighbor’s child. Now if you look at the fourth layer, which is the Societal level,
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societies are also impacted massively by the outbreak and the control measures of outbreaks. As we have seen during COVID-19 for example, resources become much more limited and societies have to prioritize
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the type of services that they provide. Governments are often in a really difficult position to define what the highest priorities are. In many cases, when we talk about infectious disease outbreaks, governments naturally fall on to prioritizing health over everything else, sometimes economy becomes prioritized. So it’s sometimes, I mean, we saw that during COVID for example, that some of the restrictions were much more strict around, for example, schools, which are protective environment for children, as opposed to businesses. So businesses remain open much longer than than schools remain open, for example. So, and again, these are very difficult decisions that governments have to make.
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But we know that well-being of children remains extremely important and there’s no going back on it. If you have a whole year of a child deprived of healthy development, you’re not going to gain that back very easily.
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Poverty and economic insecurity often rise during infectious disease outbreaks and of course we have seen an extreme version of that during COVID-19; hopefully future infectious disease outbreaks will not be as extreme as COVID but we never know. For example, the international labor organization ILO has projected that due to COVID and the related control measures, 66 million children will be joining the ranks of children in extreme poverty. That’s a huge number and we all know how poverty is a risk factor for many other negative child protection outcomes, such as family separation, child labor, forced marriage, forced migration, recruitment to armed forces and groups and
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other harms to children. And all of these of course happen against
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the backdrop of the
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cultural and social norms. Social norms are often impacted by measures put in place to control an outbreak.
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In some situations, positive changes may occur: for example during COVID-19, in some societies norms around care-giving and caring for others became much stronger. At the same time in other societies, or sometimes pockets within societies, the contrary took place and a culture of selfishness and being just about yourself came out strongly and left a lot of vulnerable families in a very dire situation. I also want to emphasize on protective factors and,
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as you may have seen in the socio-ecological diagram. that we developed for the technical note on COVID-19 and child protection, there’s an emphasis on protective factors because we want to make sure. that we also address protective elements around children at each of those layers of socio-ecological model. Many children and families have positive ways to deal with stress, of course it depends on the level of the stress, but
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during COVID for example,
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because of all the lockdowns and restrictions there was a potential for a lot of parents, especially fathers who often end up spending less time inside the household with their children. I’m generalizing and I know a lot of fathers spend more time with their children. But in general it was an opportunity for a lot of fathers to be able to almost have forced time with their children which can help building bonds and connections between the parent and the child and it’s very protective for a child. And as a father, I can tell you that it’s also very protective for the father, because it is a very restorative interaction when,
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for example, schools were closed. I ended up spending many more hours with my child than I normally would because otherwise he would be in school for most of the day. It is extremely helpful and restorative, especially when you’re under this stress. Another example of a protective measure at family level is daily routine. Routines are extremely important for children and adolescents healthy development. Schools
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naturally provide some of that structure and routine that children need but, as we saw for example during COVID or during Ebola in West Africa, schools were closed for a lot of the period of the height of the pandemic or epidemic in the case of Ebola.
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So that routine is taken away
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and families can work together, with the parents working together but also including children themselves, to define new daily routines and it’s almost magical how well children, especially younger children, respond to routines and start feeling much more at ease and comfortable when there’s routine. At community levels, of course community members can organize check-ins with vulnerable families or organize food distributions and other type of support
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that can be provided to those that are in dire need.
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But in terms of social norms, which is also an element at the society level,
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promoting protective norms is very important in these situations. Sometimes some norms such as family visitation, which is a very positive and protective norm, is not possible during an infectious disease outbreak. We saw it during COVID that a lot of grandparents, because they were very susceptible to the virus, could not be visited by family members. So a lot of children basically spent over a year not being able to visit their grandparents. Now it is important, first of all - once the restrictions are over - to restore those but, at the same time, you can replace those with other protective norms such as trying to go outside more, trying to make contact with nature more for your children.
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Now having spoken about the socio-ecological model a bit and how it relates to infectious disease outbreaks with some examples from COVID and Ebola. I would really like to strongly suggest that you consider using the socio-ecological model as an analytical framework, to help you understand what elements - and at each level - are putting children at risk or protecting them, especially
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in the context of infectious disease outbreaks. This will inform your programming and it will help you address risk factors and strengthen protective factors at all levels of social ecology of the child. This means, that if one level fails, the other layers of the social psychology of the child can step in and prevent the child from falling into the cycle of adversity.
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I would like to close by encouraging you to discuss this further with your peers, through the discussion modalities that are available to you and analyze it in your own context. What in your context is helping children to stay safe and protected at each level of the social ecology of the child. And what are the elements that are putting children at risk at each of these levels. That analysis will help you be more responsive to the needs of children and protect them from potential harm. Thank you very much and best of luck.

Listen to Hani Mansourian introducing the socio-ecological model as the foundational model for providing a context for analysis of child protection risks, protective factors and response through all stages of COVID-19 and other IDO’s.

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Your Task

After listening to Hani introduce the socio-ecological model reflect and answer the following question.

Thinking about the contexts in which you live and work, what is helping children to stay safe and protected? Use the comment box below to share your thoughts on this question with other learners and the course hosts.

What helps children stay safe during COVID-19 or other IDOs:

  • At the individual level?
  • At the family level?
  • At the community level?
  • At the society level?

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Protecting Children during COVID-19 and other Infectious Disease Outbreaks

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