Children and Teenagers ISSN 2576-3709 (Print) ISSN 2576-3717 (Online) Vol. 5, No. 2, 2022 www.scholink.org/ojs/index.php/ct 22 Original Paper Psychosocial Implications of COVID-19 on Children in Nigeria Abiodun Adewole1 , Kayode Anthony Ogedengbe2, Oluwagbemiga Oyinlola2, & Oyebade Olanike2 1 Department of Social Work, University of Ibadan, Ibadan 2 Medical Social Services Department, University College Hospital, Ibadan * Oyinlola Oluwagbemiga, Medical Social Services Department, University College Hospital, Ibadan Received: August 7, 2021 Accepted: October 21, 2022 Online Published: November 21, 2022 doi:10.22158/ct.v5n2p22 URL: http://dx.doi.org/10.22158/ct.v5n2p22 Abstract There has been a plethora of research since the emergence of COVID-19 around the world but several of these studies have not focused on the psychosocial implication of the novel Coronavirus on children in Nigeria. Though the psychosocial impact of the virus is huge, there is paucity of literature addressing the needs of the Nigerian children during the pandemic. The paper explored the psychosocial implications (health, poverty issues, safety needs and learning) of COVID-19 on children in Nigeria. The study recommends the expansion of social assistance for children of families in extreme poverty, and there is a need to adapt standard physical distancing protocols to reflect the characteristics of children in different settings. Also, the Government of Nigeria should prioritize child-centred services. Training parents and caregivers on how to talk to their children about the pandemic, managing their mental health and providing tools to help children’s learning will be crucial. Keywords psychosocial, children, covid-19, social work 1. Introduction The COVID-19 pandemic has caused one of the most significant tests the world has experienced since the Second World War leading to the formation of the United Nations. The Coronavirus diseases-2019 has affected over 200 countries worldwide; containment measures, including lockdowns adopted by various countries, have led to a significant curtailment of the virus in the day -to -day lives of citizens in the respective countries. These measures have addressed the spread of the virus, but this comes with unexpected adverse outcomes among vulnerable groups, including children (World Health Organisation, 2020). COVID-19 affects every child directly or indirectly as this is a public health problem which has affected the economic situation of every country and also complicates the growing needs of children in most developing countries where there are limited resources to help cope with the psychosocial www.scholink.org/ojs/index.php/ct Children and Teenagers Vol. 5, No. 2, 2022 23 Published by SCHOLINK INC. experiences during the pandemic (Defence for Children International, 2020). The disproportionate representation of children among vulnerable families makes them experience shock because available support for young children is primarily outside their formal system and might be overlooked (World Bank, 2020). Very few pieces of literature explicitly focused on the psychosocial implication of COVID-19 on children. Therefore, this paper will focus on the experience and psychosocial implications of the pandemic on children in Nigeria. 2. Experience of COVID-19 among Children The global COVID-19 pandemic continues to increase and unfold all over the world, young children are more vulnerable, and the experience of children during the pandemic has been related to fear, promiscuity, insecurity, reorganization of the family system, and unprecedented dimension presented by the pandemic have had negative impacts on the right of the child in the country (Committee on Rights of the Child, 2020). Children are also deprived of liberty and participation in social activities due to lockdowns across the country, which negatively impacts children’s physical and mental wellbeing in most developing countries (Chan, Yuan, & Kok, 2019). The importance of getting facts and information would assure the safety and protection of every child and their family members in the society in Nigeria, but, unfortunately, there is much information out there that is incorrect (UNICEF, 2020). Moreso, there is much misinformation during misinformation which has left individuals and their families unprotected and seriously vulnerable to the diseases (UNICEF, 2020) and also have tendencies to experience stigma among friends and family members (Chan et al., 2019) Children around the world in most hospitals are presented with symptomatic reactions, which are equally shared among older persons to date because the World Health Organisation has categorized them as one of the most vulnerable groups to the pandemic around the world (WHO, 2020). However, most cases of child mortality have now been succumbed to by COVID-19 as this is a likely reaction of prior medical conditions in most regions in Nigeria (Logie & Turan, 2020). Most common occurrences have been related to children tragically losing their parents, family members or caregivers to COVID-19; hence, the psychological impact should not be overlooked. Before the pandemic, the world has failed to provide adequate care and support for children; a situation where children who are below the age of 15 dies every second, one in every five children is been malnourished and more than 53% of the 10year old children in low and middle-income countries finds it difficult to read and understand stories (UNICEF, 2017). There is paucity of literature focusing on the psychosocial experience of children and their families, which is practically problematic for the development of children in Nigeria (Cao & Feng, 2019; Lin & Li, 2020). This indicates that, the longer the COVID-19 pandemic, the more dramatically the negative impact on these vulnerable children across the country (UNICEF, 2020). There are possibilities for an increase in the number of children negatively affected by the virus, but the economic struggles and the restriction on government spending keep www.scholink.org/ojs/index.php/ct Children and Teenagers Vol. 5, No. 2, 2022 24 Published by SCHOLINK INC. lingering in the country (WHO, 2020). 3. The Psychosocial Implication of COVID-19 on Children Since there are multiple channels through which the pandemic affects children psychosocially, they are highly susceptible to falling into poverty, learning problems, survival and health problems and poor safety of children in their communities (World Bank, 2020). -Falling into poverty: The result of physical distancing and measures resulting from lockdown to save lives and curtail the transmission of the spread of the virus has led to a significant reduction in activities across the economies while also leading to the global recession. The impact of the recession remains and is seen to have a significant socio-economic impact on families of children in developing countries (World Economic Outlook, 2020). In most households, the collapse in income hurts the livelihood of millions of homes where children reside around the world. These inputs to the forecasts of IMF reported that there are possibilities for an increase in extreme poverty ($1.90 per day) this year from the current poverty rate of 84 to 132 million people, with approximately more than half of whom are children living in low and middle-income countries as compared to before the pandemic scenario (International Monetary Fund, 2020). This implies that a global downturn on poor households impacts breadwinners as they are forced to look for shelters or even migrate to rural settlements. However, most countries have adopted social protection measures focusing on support for families and children (Gentiini, 2020). The lockdown of public spaces is still unclear as there might be a possible lockdown in the future outbreak of COVID-19 or related pandemic worldwide. -Difficult learning new things: The worldwide closure of schools has affected more than 1.5 billion children and youth worldwide (UNESCO, 2020), in contrast to the previous outbreak of diseases. Most schools plan to extend lockdown, with over 58 countries having to reschedule their exams, while over 11 countries have to cancel their exams (UNESCO, 2020). These have potential losses on the developing human capital among young people. However, several schools have to develop distance learning programs for their pupils. However, this is only available to very few children; where the majority of the children reside in low-income countries where there are no facilities to achieve learning for children (UNESCO, 2020). There is less access to digital technologies for the girl child than for boys, possibly reducing participation in online learning (UNICEF, 2020). For children residing in resource -constrained environments like informal settlements, internally displaced camps have limited access to internet facilities and are significantly impacted. More importantly, children with disabilities are finding it very hard to access distance education programmes in the country. Therefore, the possibility of school drop-out might be higher when the pandemic is over in all of this sub-group of children (Evans & Miguel, 2013). -The health of the children: The direct health impact of COVID-19 on children has been milder than other age groups like older persons with comorbidities. Data from most affected regions, like China and www.scholink.org/ojs/index.php/ct Children and Teenagers Vol. 5, No. 2, 2022 25 Published by SCHOLINK INC. the United States of America, indicated that the hospitalization rate for symptomatic children is between 9 to 20 times lower than for middle-aged and can be 25 and 100 times lower than for older persons (Centre Disease Communication, 2020). For example, 1 in 25,000 children in China is lost to COVID-19, which is more than 30 times less than the middle-aged and over 3,000 times less than older persons. It must be noted that the impact of the virus in terms of epidemiological impacts should be expected to differ over time in different contexts. The broader impact of the virus on child health is significant. It can impact household income as low-income families are forced to cut their food expenditures and essential health care (UNICEF, 2020). Based on the IMF forecast, there are possibilities for hundreds of thousands of additional child deaths in 2020 compared to before the pandemic scenario; this hurts the progress of the 2 to 3years target of reducing infant mortality within a single year (International Monetary Fund, 2020). The estimation only focused on the effect of this year’s global recession and not on several ways there has been a disruption in health services across the country during the pandemic. This includes reduced access to essential child health services like vaccination and immunization, as these have been suspended in over 23countries around the world (UNICEF, 2020). In Nigeria, over 2 million children rely on school meals as a reliable source of daily nutrition, which has to stop while they look for other sources due to the lockdown in schools (World Food Programme, 2020). Also, the close-down of schools has a higher possibility of increasing the number of teenage pregnancies in the years ahead. There is a negative impact of physical distancing measures and restriction of movement on children’s mental health as it causes concerns and anxiety about the pandemic's negative impact on their lives and their communities. -Safety concerns: Several children see the homes as a form of safety and security, but for some, it is a tragic experience as they experience violence from caregivers, one of the most common forms of violence children experience (United Nations on Women, 2020). Children are witnesses of domestic violence;, the rates have possibilities of being higher in several countries (UNWomen, 2020). The act of domestic violence is more likely in most families during confinement at home as they experience intense anxiety and fear. Over 60% of children worldwide are in full or partial lockdown somewhere (UNICEF, 2020). This presents opportunities for child abusers to harm children as they rarely report the act because they have no access to their teachers, while social protection and legal instruments are scaled back in most countries (Global Social Service Workforce Alliance & International Federation of Social Workers, 2020). Very significantly, children are exposed to online predators and inappropriate content due to the introduction of distance learning. The high level of digitalization magnifies the vulnerability of children to harm (American Academics of Child and Adolescent Psychiatry, 2020). Since there is practically no data in Nigeria available in the literature regarding the psychosocial implications of COVID-19 among children, caution should be taken among this population as non-available data suggest an increased risk of severe infection has not been demonstrated among this population. As social workers and other clinicians are thinking of innovative ways of helping children www.scholink.org/ojs/index.php/ct Children and Teenagers Vol. 5, No. 2, 2022 26 Published by SCHOLINK INC. and families, it would be encouraging to consider new opportunities the pandemic has created for individuals and communities to recover better towards building a more robust system for children attending Nigerian hospitals. 4. Case Reports of COVID-19 among Children in Nigeria Although there are very few reported cases of COVID-19 among children in Nigeria because most children are not allowed to go out with peers or mingle with anyone within their environment as a result nationwide lockdown (Park et al., 2020; Nadeem et al., 2020), however, among the few reported cases of COVID-19 among children is a case report of three children from the same parent whose age is between 3months to 8years they were managed in an isolation and treatment centre in Katsina. These children were admitted to the isolation and treatment centre between 16th April and 15th May 2020; they had a confirmatory test at the National Reference Laboratory in Abuja through the Polymerase chain reaction. Their father was previously diagnosed with COVID-19, and the second child was symptomatic with mild cough and nasal discharge cases, with an X-Ray showing pericardiac and paratracheal region. These children were isolated in the isolation centre, separated from their parents and other close family relations (Ibrahim et al., 2020). The children could not see the face of doctors, nurses and social workers providing treatment as they were wearing Personal Productive Equipment, there was reduced level of confidence and trust from these children. The implication of this psychosocial wellbeing of these includes total exclusion from their parents and other social environments. In another case report from UNICEF, (2020) from Lagos, Nigeria, there was a reported case of violence against children. This is a 13year old female, Rose (Name not real) was sexually and physically abused by her father several times. She grew up in a separated family because her mother had left when she was still very young. Her father resides in a one-room apartment in the suburb of Lagos State. Her neighbour alerted the owner, and the case was reported to the State Ministry of Women’s Affairs and Social Welfare for justice. The emergence of COVID-19 worsened the case due to the closure of schools and the compulsory implementation of social distancing; this gave her father an avenue to rape her every night, and she was often tied and physically harassed when trying to stop him. Rose's consistently stifled cries during nights arose the attention of her neighbour, and she was finally rescued. There was an immediate provision of medical and psychosocial support services to Rose; her father was taken into police custody while she underwent a medical examination to ascertain there was pregnancy and other traces of sexually transmitted infection in the child (UNICEF, 2020). This implies that her case has led to an over 50 percent increase in the number of cases of sexual violence during the lockdown, with more than 85% of cases relating to children and adolescents (Partnership for Justice, 2020). There is every possibility that cases of sexual and physical violence have been underreported during the COVID-19 lockdown. There is a very possibility that when children are allowed to go back to school freely, they will hopefully meet people they can confide in and there will be an influx of cases (Partnership for Justice, 2020). Restriction www.scholink.org/ojs/index.php/ct Children and Teenagers Vol. 5, No. 2, 2022 27 Published by SCHOLINK INC. in movement, loss of income, isolation, and high-stress levels are the main predisposing factors for children to experience psychosocial problems at home as they have made it extremely difficult for the victims – children to avoid their abusers (UNICEF, 2020). From Oyo State, Nigeria, there was a reported case of a COVID-19 patient that gave birth, delivered at the Infectious Disease Centre of the University College Hospital, Ibadan. This was the first COVID-19 patient to have a delivery at the isolation centre. Although, Mother was symptomatic while the baby was asymptomatic. (Punch Healthwise Corner, 2020). 5. Conclusion and Recommendations The impact of COVID-19 on children’s poverty, survival and health cannot be neglected. However, this impact is unequal, as some children will bear the consequences without appropriate interventions. The potential negative psychosocial impact for several children worldwide can be catastrophic as it slows down the progress of many sustainable development goals targeting children while also putting the ambitious target out of sight. In conclusion, information to address multiple psychosocial risks to save most at-risk children is very important as the rapid accumulation of data on the impact on children and their families. COVID-19 has shown a test of solidarity within communities, the scientific community and the nation, which will build a sense of unity among people. However, there is a wide range of activities by the government around the world to mitigate the pandemic by developing best practices to prevent psychosocial issues arising from the pandemic among children. The paper recommends immediate expansion of social assistance for families and universal child grants to protect children from extreme poverty. There is a need for an urgent supply of food chain to prevent children from food security crisis. In urban settings, the adaptation of standard physical distancing is essential in low-income settings by following preventive guidelines by the government authorities while also reflecting on the characteristics of children in different settings. The Government of Nigeria should prioritize child-centred services which focus on equity of access like schooling, nutrition programme, maternal and immunization services, sexual and reproductive health services, mental health services and psychosocial services for children. Protection services for vulnerable children, including children with disabilities and settlements like banning the arrest and detention of children that violates COVID-19 directives. Training parents and caregivers include how to talk to their children about the pandemic, how they can manage their mental health and themselves, and tools to help their learning. 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