END OF CHILDHOOD
REPORT 2017

STOLENCHILDHOODSSTOLEN CHILDHOODS
CONTENTS
1

Stolen Childhoods

3

Introducing the End of Childhood Index

4

Preventable Causes Kill Millions of Children Each Year

6

Malnutrition Robs Children of the Future They Deserve

8

Lack of Education Traps Children in Poverty

10Children Forced into Exploitative and Hazardous Work

14

The Devastating Impacts of Child Marriage

18

The Perils of Teenage Childbearing

20

The Growing Crisis of Children Displaced by Conflict

22

Young Lives Cut Short or Deeply Scarred by Violence

26

Recommendations

29

End of Childhood Index Rankings

30

Complete End of Childhood Index 201736

Methodology and Research Notes

For at least 700 million children worldwide – andperhaps hundreds of millions more – childhood has
ended too soon. The major reasons included poor
health, conflict, extreme violence, child marriage, earlypregnancy, malnutrition, exclusion from education andchild labor.
When taken together, these factors have created a
global childhood crisis of massive proportions.
For nearly a century, Save the Children has beenfighting to save children from poverty and discrimination.
This new report – the first in an annual series – takes
a hard look at the events that rob children of theirchildhoods. These “childhood enders” represent anassault on the future of children.
Childhood should be a safe time of life for growing,
learning and playing. Every child deserves a childhood oflove, care and protection so they can develop to their fullpotential. But this is not the experience for at least aquarter of our children worldwide.
The majority of these children live in disadvantaged
communities in developing countries, where they havebeen bypassed by progress that has lifted up many of
their peers. Many suffer from a toxic mix of poverty anddiscrimination – excluded because of who they are: agirl, a refugee, from an ethnic minority or a child with adisability. These threats to childhood are also present inhigh-income countries. All countries, rich and poor, cando a better job of ensuring every child enjoys the right toa childhood.
In commemoration of International Children’s Day,
Save the Children is launching a unique index exploring
the major reasons why childhood comes to an earlyend. The End of Childhood Index focuses on a set of lifechanging events that signal the disruption of childhood.
It ranks 172 countries based on where childhood ismost intact and where it is most eroded. It shows
which countries are succeeding, and failing, to provide
conditions that nurture and protect their youngest
citizens. The indicators used to measure the end ofchildhood are: under-5 mortality, malnutrition thatstunts growth, out-of-school children, child labor, earlymarriage, adolescent births, displacement by conflict andchild homicide.
Which children survive or die, learn or don’t, areprotected or harmed, is no accident. Lost childhoods
are a result of choices that exclude particular groups ofchildren by design or neglect. Millions of children havetheir childhoods cut short because of who they are andwhere they live.
There have been major gains for children in the last
25 years, but recent progress in fighting extreme poverty
has often not reached those children who need it most– because of geography, gender, ethnicity, disability or
because they are victims of conflict.
Children's experience of childhood is largely
determined by the care and protection they receive, orfail to receive, from adults. Children have the right tosurvival, food and nutrition, health and shelter. They
also have the right to be encouraged and educated, bothformally and informally. And they have the right to live
free from fear, safe from violence and protected fromabuse and exploitation.
In 2015, world leaders gathered at the United
Nations to make a bold commitment – to end poverty
in all its forms by 2030 and protect the planet for
future generations. Taken together, the Sustainable
Development Goals they established envision a future inwhich all children enjoy their rights to health, educationand protection – in short, their right to childhood.1
Crucially, signatories to the new agreement promised toensure this would happen for all segments of society –regardless of income, geography, gender or identity. And
they promised that those who are furthest behind – themost excluded in society – would be reached first.
This pledge to leave no one behind must be upheld.
Only then will we realize its potential to transformthe lives of millions of children across the world,
guaranteeing every last child the childhood they deserve.

HUNDREDS OF MILLIONS* OF CHILDREN WORLDWIDE ARE MISSING OUT ON CHILDHOOD

Published by Save the Children

Rony, age 12, works six days a week in a factory making
lunch boxes in Bangladesh. The work brings him into
direct contact with carcinogenic materials and poses arisk to his health. He is now receiving an education thanks
to a Save the Children-supported project.

501 Kings Highway East, Suite 400
Fairfield, CT 06825
United States(800) 728-3843
www.SavetheChildren.org

168 MILLION

156 MILLIONABOUT 40 MILLION

children areout of school.

children are involvedin child labor. Half
(85 million) are doing
hazardous work.

children underage 5 havestunted growth.

girls (aged 15-19) are currently
married or in union. 15 million are
married as children each year (underage 18) and 4 million of those are
married under age 15.

NEARLY 28 MILLION

ROUGHLY 16 MILLION

AROUND 8 MILLION

75,000+children have been forced to flee
their homes (11 million are refugees
and asylum-seekers; 17 million areinternally displaced).

girls between the ages of 15
and 19 – and 1 million girls
under age 15 – give birtheach year.

boys and girls aged
0-19 die each year;
75% (6 million) arechildren under age 5.2

boys and girls under
the age of 20 weremurdered in 2015.

*Children often experience more than one childhood ender at a time. In total, some 700 million children worldwide are estimated to have experienced at least one ender. This estimate is conservative.
It likely underestimates the global number of children missing out on childhood. See Methodology and Research Notes for details.

© Save the Children Federation, Inc.
ISBN: 1-888393-32-7

Photo: Ken Hermann / Save the Children

263 MILLION

The Convention on the Rights of the Child (CRC) represents a global consensus on the terms of childhood. It recognizes childhood as a separate space fromadulthood defined by a specific set of rights. This report shows that for hundreds of millions of children, the promise of childhood that undergirds theConvention is a broken one. For more on the CRC’s role in defining the concept of childhood see UNICEF's The State of the World’s Children 2005.
2
WHO. Global Health Estimates 2015: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2015. (Geneva: 2016)
1

Page 1INTRODUCING THE END OF CHILDHOOD INDEX
Save the Children’s first annual End of Childhood Index
compares the latest data for 172 countries and assesses
where the most and fewest children are missing out
on childhood. Norway, Slovenia and Finland top the
rankings. The top ten countries attain very high scoresfor children’s health, education and protection status. The
United States ranks 36th. Niger ranks last among thecountries surveyed.
The 10 bottom-ranked countries – seven from West
and Central Africa – are a reverse image of the top,
performing poorly on most indicators. Children in thesecountries are the least likely to fully experience childhood,a time that should be dedicated to emotional, social andphysical development, as well as play. In these and manyother countries around the world, children are robbed ofsignificant portions of their childhoods.
Although challenges to childhood are mostpronounced in West and Central Africa, there aresome signs of progress. The region, for example, has
cut under-5 mortality in half since 1990. Despite theirrelative poverty, two countries (Liberia and Niger) have

reduced child mortality rates by more than two-thirds.
Nine other countries in the region have at least tripled
their pace of progress from the 1990s or reversed a trend
toward increasing child deaths: Burkina Faso, Cameroon,
Central African Republic, Congo, Côte d'Ivoire, Gabon,
Mauritania, Senegal and Sierra Leone.3 These successes
show that political choices can matter more than national
wealth, and poverty does not have to be a barrier toprogress.
Still, the data collected for the End of Childhood Index
document tremendous gaps between rich and poor
countries and the urgent need to accelerate progress
for the most vulnerable children. These statistics go
far beyond mere numbers. The human despair and lost
opportunities represented in these numbers demandchildren everywhere be given the basic services,protections and opportunities they need to survive
and thrive.
See the Complete End of Childhood Index, country
rankings and an explanation of the methodology,
beginning on page 29.

2017 END OF CHILDHOOD INDEX RANKINGS

TOP 10

BOTTOM 10

Where childhood is least threatened

Where childhood is most threatened

Rank

Country

Rank

Country

1

Norway163

Guinea1

Slovenia

163

Sierra Leone

3

Finland

165

Burkina Faso

4

Netherlands

166

South Sudan

4

Sweden

167

Chad

6

Portugal

168

Somalia7

Ireland169

Central African Republic

8

Iceland

170

Mali

8

Italy

171

Angola10

Belgium, Cyprus,
Germany, South Korea

172

Niger

Zeinabou, 9, from a remote village in Burkina Faso,
has a disability that prevents her from attending
school. Her family cannot afford the medical careshe needs and there is no system to help families
that cannot pay. She spends her days at thefamily home looking after her little brother andmaking straw brooms to sell for income.
3

Page 2

Photo: Clement Tardif / Save the Children

United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Levels and Trends in Child Mortality: Report 2015. (New York: 2015)

Page 3

PREVENTABLE CAUSES KILL MILLIONS OF CHILDREN EACH YEARWorldwide, half as many children under age 5 now diefrom preventable causes compared to the year 1990,
thanks to global action that has improved coverage andquality of maternal and child health care, immunizations,
treatment of pneumonia, diarrhea, malaria and otherdeadly diseases. Improved nutrition and access to familyplanning have also saved many lives.

Every day, more than 16,000
children die before reaching their
5th birthday, mostly frompreventable or treatable causes.
Yet many of the poorest children are still vulnerable toall of these conditions and more. Lack of universal healthcoverage, inadequate diets and unsafe water put the mostdisadvantaged children at the highest risk of death. Birthcomplications and newborn infections also factor heavily.
Of the estimated 5.9 million child deaths in 2015, almost 1
million occurred on the day of birth, and close to 2 million
took place in the first week.4
Growing numbers of children now live in countries
affected by fragility and conflict, 5 where they face nearly
twice the risk of dying before their fifth birthday as
children in non-fragile contexts.6 These deaths are more

LEADING CAUSES OF DEATH
FOR CHILDREN UNDER AGE 5

often caused by disease, malnutrition and inadequate
health care than by bombs or bullets.7 The conflict inYemen, for example, has directly claimed the lives ofover 1,500 children since March 2015,8 and indirectly
contributed to the deaths of 63,000 in 2016 alone.9
The End of Childhood Index shows that the highest rates
of child mortality are found in sub-Saharan Africa, where
basic medical care is often unavailable, too far away or
too expensive. In Angola, Central African Republic, Chad,
Mali, Nigeria, Sierra Leone and Somalia, more than 10
percent of children do not live to see their fifth birthday.
That is at least 40 times the rate found in Finland, Japan,
Norway and Singapore, where less than 0.3 percent ofchildren die before age 5.
Within countries, higher rates of child mortality areusually found among disadvantaged groups, especiallypoor families and ethnic minorities.10 In Indonesia,
Philippines and Senegal, for example, the poorest children
are 3 times as likely to die before age 5 as the wealthiest.
And in Cambodia, the poorest are 4 times as likely to dieas the wealthiest.11 In Vietnam, under-5 mortality rates
among ethnic minorities are more than 4 times thosefound among the majority Kinh ethnic group (53 vs. 12
deaths per 1,000 live births).12
Children born to mothers with low levels of education
also die at higher rates.13 For example, in Nigeria, childrenof mothers with no formal education are about 3 times as
likely to die before age 5 as children whose mothers havehigher than a secondary education. 14

5%
Malaria
Other*

Amina is from a very remote village in northeast Nigeria. She
is 30 years old and had no formal education. She lost two ofher four children to illnesses that are preventable and treatablewith medical care, good nutrition and healthy practices such as
hygiene and breastfeeding.
“My first child died due to ill health in 2009 when he was 6
months old,” said Amina. “I don’t know why he died, but he wassuffering from severe diarrhea and was very malnourished. I
had no idea how to help him because our village had no clinic,
hospital or dispensary. When he died I felt so sad. My second
child, a little girl, died four years ago.”
Amina and her family had to flee their village three years ago
when it was attacked by insurgents. “We grabbed what we could
and ran to another village. We have been there ever since. We
are too scared to go back to our own homes. The insurgentsstole all our food and livestock so we have nothing to return to.”“I have two daughters now. Aisha is the youngest. Once aweek I get food for my children at a Save the Children clinic.
They weigh the children and check their health.” A few weeks
ago, Aisha became very sick and Amina worried she might lose
yet another child. “Save the Children brought me here [to its
child stabilization center] so they could treat her properly. We’ve
been here for five days now and she has improved a lot. I’m sohappy to be here. I am given three meals a day and drugs for mybaby. I am very grateful Aisha is still alive.”

9%

Congenital
anomalies

9%*Includes newborn sepsis, meningitis/
encephalitis, HIV/AIDS, measles,
pertussis, tetanus and others
Source: WHO-MCEE estimatesfor child causes of death, 2015.

6%
Injuries

CASE STUDY: NIGERIA

Diarrhea

12%18%

Prematurity

15%

Birth
complications

Pneumonia

Ibid.
World Bank. Population total: Fragile and conflict affected situations. http://data.worldbank.org/indicator/SP.POP.TOTL?locations=F1&view=chart
6
UNICEF. Committing to Child Survival: A Promise Renewed. Progress Report 2015. (New York: 2015)
7
Save the Children. State of the World’s Mothers 2014: Saving Mothers and Children in Humanitarian Crises. (Westport, Connecticut: 2014)
8
UNICEF, Yemen Monitoring and Reporting Mechanism figures, from March 10, 2015 to February 3, 2017 confirmed via correspondence with
UNICEF on March 14, 2017
9
UNICEF press announcement by Meritxell Relano, Sana’a, Yemen, January 11, 201710
Save the Children. The Lottery of Birth: Giving All Children an Equal Chance to Survive. (London: 2015)11
ICF International, 2015. The DHS Program STATcompiler. Funded by USAID. http://www.statcompiler.com. March 25, 2017
12
General Statistics Office and UNICEF. Viet Nam Multiple Indicator Cluster Survey 2014, Final Report. (Hanoi, Vietnam: 2015)13
UNICEF. Committing to Child Survival: A Promise Renewed. Progress Report 2015.
14
National Population Commission (NPC) [Nigeria] and ICF International. 2014. Nigeria Demographic and Health Survey 2013. (Abuja, Nigeria andRockville, Maryland: 2014)
4
5

Page 41-year-old Aisha almost
became the third child in
her family to die, but timely
medical care saved her life.

Photo: Mike Sunderland / Save the Children

Page 5

MALNUTRITION ROBS CHILDREN OF THE FUTURE THEY DESERVE

156 million children underage 5 have stunted growth
due to malnutrition –that's
about a quarter of all children
in that age group.
Stunted growth is caused by chronic malnutritionin the first 1,000 days of a child’s life (from the start ofpregnancy to age 2). Chronic malnutrition at this stageof life is largely irreversible, and stunted children facea lifetime of lost opportunities in education and work.
They are also more likely to succumb to illness anddisease, and can die as a result. Nearly half of all deathsin children under 5 are attributable to undernutrition.15
Chronic malnutrition is often referred to as “hidden”
hunger because it doesn’t garner headlines in the same
way that severe acute malnutrition does in a food crisis.
Undernourished children do not engage in play orinteract with caregivers as much as well-nourishedchildren do. Thus, stunting undermines the healthy
development of their brains as well as their bodies.
Children with inadequate diets are deprived of thecritical interactions that lead to stimulation andlearning.16
Stunting is caused by, and contributes to, vicious
intergenerational cycles of poverty. Mothers who areundernourished are more likely to have undernourishedchildren. Stunted children often perform poorly in schooland have fewer professional opportunities later in life, sothey earn less, and perpetuate poverty in their families.
Low income, lack of health care and reduced access toproper nutrition will continue to impact their children.
156 million children under age 5 in the world arestunted.17 In Kenya, 26 percent of children are stunted, in
Uganda 34 percent, in Malawi 37 percent, in India 39
percent and in Yemen 47 percent. Malnutrition costs
countries billions of dollars in lost productivity18 andcreates serious economic challenges for developing
countries like these that struggle to compete with large
portions of their workforces stunted.
The prevalence of stunting among children underage 5 worldwide is steadily declining – from 40 percent
in 1990 to 23 percent in 2015. But children from poorfamilies remain much more likely to be stunted than theirwealthiest counterparts.19 For example, in Myanmar,
29 percent of children under age 5 are suffering fromstunted growth (1.3 million children). But the highest
rates are found in the poorest areas, mostly populatedby ethnic minority groups, where up to 40 percent ofchildren are stunted.20
In almost all countries with available data, stunting
rates are higher for boys than for girls.21 But cultural
factors – such as a preference for the eldest son in
many South Asian countries – can lead to differencesin the nutritional status of older girls. Up to half of alladolescent girls are stunted in some countries.22 In India,
one-third of girls aged 15-19 are stunted. In Bangladesh,it’s 44 percent. And in Guatemala, 52 percent.
Looking at worldwide trends, stunting inequalities
persist or are increasing in most countries. An analysis ofdeveloping countries with comparable trend data since2000 shows that gaps between the poorest 20 percent
and richest 20 percent of children under 5 have widenedin 21 out of 35 countries.23

Saida is 18, but looks more
like an 8-year-old. Her familysays she was undernourishedwhen she was very young andher growth was stunted. Her
nutrition improved after that,but when the war started in
Yemen two years ago she
became malnourished again.
She is being treated at the
Save the Children-supported
Al-Sabeen hospital in Sana’a.

16

Page 6

Rank

Stunting prevalence

Estimated number of stunted children (millions)*

1

India

39%

48.2

2

Pakistan

45%

10.7

3

Nigeria

33%

10.0

4

Indonesia

36%

5

China

9%

7.4

6

Ethiopia

38%

5.7

7

DR Congo

43%

5.6

8

Bangladesh

36%

5.5

9

Philippines

30%

3.3

10

Tanzania

34%

3.2

8.8
These 10 countries are home tothe largest numbers of children
under age 5 who are moderately
or severely stunted.

*Figures estimated by Save the Children. Analysis was limited to countries with stunting data from 2010-onward. Sources: UNICEF/WHO/World Bank Joint Child
Malnutrition Estimates, September 2016 edition, updated with data from recent MICS and DHS (available as of March 1, 2017), and population data from UN Population
Division, World Population Prospects: The 2015 Revision.

CASE STUDY: PHILIPPINES

Photo: Save the Children

UNICEF. Committing to Child Survival: A Promise Renewed. Progress Report 2015.
Levinger, Beryl. Nutrition, Health and Education for All (New York: UNDP: 1994)
17
UNICEF/WHO/World Bank Joint Child Malnutrition Estimates, 2016 edition
18
Fink et al. "Schooling and Wage Income Losses Due to Early-Childhood Growth Faltering in Developing Countries: National, Regional, and Global
Estimates." American Journal of Clinical Nutrition. 2016. pp.104-112
19
UNICEF. Nutrition: Malnutrition. https://data.unicef.org/topic/nutrition/malnutrition/#
20
Ministry of Health and Sports (MOHS) and ICF International. Myanmar Demographic and Health Survey 2015-16: Key Indicators Report. (Nay Pyi Taw, Myanmar
and Rockville, Maryland: 2016); UN DESA, Population Division. World Population Prospects: The 2015 Revision (New York: 2015)
21
Save the Children, Groups-based Inequality Database (GRID). https://campaigns.savethechildren.net/grid22Black et al. “Maternal and Child Undernutrition and Overweight in Low-Income and Middle-Income Countries.” Lancet, vol. 382, no. 9890. 2013. pp.427-451
23
Save the Children. Unequal Portions: Ending Malnutrition for Every Last Child. (London: 2016)
15

OVER TWO-THIRDS OF THE WORLD'S STUNTED CHILDREN LIVE IN 10 COUNTRIESStunting is often impossible to correct, but it can beprevented. In the Philippines, where 30 percent ofchildren under 5 are stunted, it looked like baby
Janice was destined to fall short of her potential due
to undernutrition. Janice’s mother Jenelyn had a poor
diet during her pregnancy, and Janice was born frail
and underweight.
The family of five struggled to feed themselves due
to Jenelyn’s husband’s unsteady income. Baby Janiceremained sickly and lethargic. “My other two children
are also thin, but Janice is the only one who was always
sluggish,” said Jenelyn.
A Save the Children health worker diagnosed Janice’s
undernutrition during a community assessment. She
was immediately enrolled in a program that provided
regular rations of high-energy therapeutic food speciallyformulated to treat her condition. At the same time,
Janice’s parents were provided trainings on proper childcare, hygiene, nutrition and breastfeeding, among otherlifesaving practices. Jenelyn says she learned importantlessons from the sessions. “I learned that it’s importantto choose what’s nutritious. Don’t neglect your children.
Take care of them.”
A few weeks into the treatment, baby Janice’s health
had improved remarkably. Her appetite increased andher weight became normal. She was sharper and moreenergetic. “I didn’t expect that she would grow this muchand that she would still be alive today,” said Jenelyn.

Nutrition interventions
reached 1-year-old Janicejust in time to prevent
lifelong problems.

Photo: Save the Children

A young child who does not get enough food andnutrients cannot grow properly and can become too
short for his/her age. This condition is called “stunting”
and it prevents children from developing to their fullpotential, both mentally and physically.

Page 7

Educating children gives the next generation the tools tofight poverty and prevent disease. It builds confidence,
literacy and dignity. It builds a stronger foundation for
the future we all share. And it’s every child’s right.

263 million children are out ofschool– that's more than 1 in 6
school-aged children worldwide.
In 2000, there were 375 million children and youth outof school. Today, that number has been reduced to 263
million.24 Many children who are out of school come fromexcluded groups. They are children from disadvantaged
backgrounds, often girls, who live in conflict-afflicted
countries, in slums and in remote communities, who arefrom ethnic minority or lower caste families, or who aredisabled.
Some out-of-school children have attended schoolin the past but dropped out, some will attend school in
the future, and some will never go to school. Many who
are in school are not learning the basics of reading andmath. To fully address the global education crisis – andreap vast social and economic rewards – equal, quality
education must be made available to all.
Girls are more likely than boys to be excluded fromeducation. About 15 million girls will never have theopportunity to learn to read and write in primary school,
compared to about 10 million boys. Across sub-SaharanAfrica, 9 million girls will never attend school, comparedto 6 million boys. The gender gap is even wider in SouthAsia, where 4 out of 5 out-of-school girls will never enter
the formal education system, compared to 2 out of 5
out-of-school boys.25
Children with disabilities, especially girls withdisabilities, are less likely to start and stay in school
than their peers without disabilities. This pattern is more
pronounced in poorer countries.26
Refugee children are 5 times more likely to be outof school than non-refugee children. UNHCR estimatesthat half of refugee children and over three-quartersof refugee adolescents are not in school, compared to
9 percent and 16 percent of children and adolescents
globally.27 In Lebanon, which hosts over 1 million Syrian
refugees, over 60 percent of Syrian children – more than
225,000 – were not enrolled in school during the 2015/16
school year.28
Attacks on schools also prevent children fromaccessing education. In Syria, for example, there havebeen more than 4,000 attacks on schools over the courseof the conflict, 29 and 1 in 3 schools are out of use, having
been damaged by bombs, used as shelters for internallydisplaced people or occupied by armed groups.30
The highest rates of out-of-school children are foundin sub-Saharan African countries at the bottom of the
End of Childhood Index, where schools are often too
far away and families are too poor to support theirchildren’s education. In Chad and Somalia, about half ofprimary and secondary school-aged children are not inschool. In Niger 55 percent are out of school. In Djibouti
61 percent. In Eritrea 63 percent. And in South Sudan
two-thirds of children are out of school.31

Ruksana, 16, lives in a small shanty in aslum area of New Delhi, India. Like herparents, she did not attend school. Instead
she worked making shoes and helped hermother raise the family after her father died.
Two years ago, Ruksana began attendingclasses at a Save the Children learning
center called “Jigyasa” which means thequest for knowledge. In the mornings she
does academic work and three afternoons a
week she does vocational training.

Photo: CJ Clarke / Save the Children

UNESCO. Leaving No One Behind: How Far on the Way to Universal Primary and Secondary Education? Policy Paper 27 / Fact Sheet 37. July 2016
Ibid.
26
WHO and the World Bank. World Report on Disability 2011 (Geneva: 2011)27
UNHCR. Missing Out: Refugee Education in Crisis. (Geneva: 2016)28
Assessment includes primary and secondary school-aged children reached by formal education only. Inter-Agency Coordination Lebanon. Education
Jan-May 2016 Dashboard. data.unhcr.org/syrianrefugees/download.php?id=11514
29
UNICEF. Children in war-torn Syria risk their lives to go to school, news note 21 October 2016. https://www.unicef.org/media/media_92943.html
30More than 7,400 of the 22,000 schools that were running before the conflict are now closed or inaccessible. Source: OCHA. 2017 Humanitarian Needs
Overview – Syrian Arab Republic. (2016)31
Out-of-school rates for Chad, Somalia and South Sudan were estimated using attendance data from UNICEF's Multiple Indicator Cluster Surveys (MICS)
as recent enrollment data from UNESCO were not available. See Methodology and Research Notes for details.
24
25

THE HIGH ECONOMIC COST OF OUT-OF-SCHOOL CHILDREN
Economic cost
Country

Out-of-school
children 1

as a % of
GDP 2

in US$(millions) 3

Bangladesh

5%

1.5%

$2,830

Cambodia

11%

1.9%

$340

Côte d'Ivoire

21%

14.1%

$4,470Indonesia

7%

2.0%

$17,240

Lao PDR

7%

1.6%

$200

Mali

39%

14.2%

$1,810

Nigeria

34%

15.2%

$72,980

Pakistan

26%

5.4%

$14,500

Vietnam

2%

0.3%

$580

Yemen

15%

3.4%

$1,2701Out-of-school rate for children of primary school age,latest year available 2010-2015. Source: UNESCO Institutefor Statistics (UIS), 20172
GDP losses are reported on a macroeconomic scale and are
given for the cohort of primary school-aged children out ofschool. Estimates for Cambodia, Indonesia, Lao PDR and Vietnam
are from: Thomas and Burnett. The Economic Cost of Out-ofSchool Children in Southeast Asia. (Bangkok: UNESCO: 2015).
Estimates for all other countries are from: Thomas and Burnett.
Exclusion from Education: The Economic Cost of Out-of-SchoolChildren in 20 Countries. (Doha, Qatar: Educate A Child: 2014)
3
Estimates are rounded to the nearest 10 million. They areapproximated by multiplying the cost as a % of GDP by thecountry's total GDP in 2015 and are used for the purpose ofillustration only. Source: World Bank, World Development
Indicators, 2017

CASE STUDY: NIGER
Yassira’s brothers go to school, but their family is very
poor, so Yassira stayed home to help her parents sellbean curd for income. Her situation is not uncommon in
Niger, where an ongoing food crisis is stretching family
resources to the limit. When tough choices must be
made, many families decide to educate their sons andnot their daughters. Nationwide in Niger, 39 percent ofprimary school-aged girls are out of school, compared to
29 percent of boys.32
Save the Children staff became aware of Yassira’s
situation last year. They worked with the school director
and local leaders to convince Yassira’s father to enroll
her in school. He agreed, and Yassira entered third gradein October. But after a few months, Yassira had to leaveschool again and return to work helping the family. She
missed school and she missed her friends. “Now they areahead of me,” she said. “They have left me behind.”
To address the root of the problem keeping Yassiraout of school, Save the Children staff knew they had tohelp improve the family’s economic stability. Yassira wasgiven a scholarship to cover the remaining four monthsof the school year. To improve the family’s diet andincome-earning potential, they were given three goats
and Yassira’s mother joined a group of women growing
moringa (a drought-resistant tree with nutritious leaves).
Yassira returned to school in February, and she has atutor helping her at home to make up for the classes
she missed.
She is happy to be back in school, catching up
with academics and with friends. “My favorite subject
is reading,” she says. “When I grow up I want to bea teacher.”

32

Page 8Children who are excluded from primaryeducation will earn significantly less overtheir lifetimes than their educated peers.
The economic cost of not educating theseout-of-school children – estimated at 0.3 to15.2 percent of GDP in these countries – isfar greater than what it would cost to achieve
universal primary education.

11-year-old Yassira isback in school now
after she and herfamily got support fromSave the Children.

Photo: Talitha Brauer / Save the Children

LACK OF EDUCATION TRAPS CHILDREN IN POVERTY

Ministry of Primary Education of Niger, year 2015-2016 (Annuaire statistique MEP/A/PLN/EC 2015-2016)
Page 9

CHILDREN FORCED INTO EXPLOITATIVE AND HAZARDOUS WORKThe global number of child laborers has declined by
one-third since 2000, but an estimated 168 million
children are still trapped in child labor, compelled towork to support themselves and their families. Morethan half, some 85 million children, are doing hazardous
work that directly compromises their physical, mental,social and/or educational development.33

168 million children worldwide
are involved in child labor– that's more than all thechildren in Europe.
Children working to support their families don’t justmiss out on education. They also miss out on rest, play
and recreation. They lose opportunities to participate intheir community, religion, cultural activities and sports.
The loss of these rights means that, in effect, many
working children miss out on their childhood.

Poor children are much more likely to be forced into
work than their wealthier counterparts.34 In Nepal, forexample, 37 percent of children aged 5-17 are engaged
in child labor (some 3.2 million children),35 mostly inagriculture, but also in industry and commercial sex work.
The highest rates of child labor are found among thepoorest Nepali children, where rates exceed 60 percent,with nearly 9 out of 10 child laborers working underhazardous conditions.36
Higher rates of child labor are often found in rural
areas. In Haiti, 22 percent of children in the Port-auPrince metropolitan area are involved in child labor,
compared to 61 percent in rural areas.37
The highest national rates of child labor are found in
sub-Saharan Africa. In Cameroon, 47 percent of children
are engaged in child labor. In Somalia, 49 percent are
working. In Guinea-Bissau and Benin, it’s 51 and 53
percent, respectively. And in Mali, it’s 56 percent. Not
surprisingly, these countries have some of the lowest
scores on the End of Childhood Index.

Monzu works as agarbage collector in
Dhaka, Bangladesh.

Photo: Ken Hermann / Save the Children

At 12 years old, Omar* suddenly found himself
responsible for his family and having to work to
support his mother and younger brother after
his father was killed in the Syrian conflict and hiselder brother joined an armed group.
* name changed to protect identity

Photo: Ahmad Baroudi / Save the Children

EXAMPLES OF HAZARDOUS FORMS OF CHILD LABORInternational Labour Organization, International Programme on the Elimination of Child Labour (IPEC). Marking Progress Against Child
Labour - Global Estimates and Trends 2000-2012. (Geneva: 2013)34
In 55 of 59 countries with available data, child labor rates are higher among the poorest 20 percent of children compared to the richest 20 percent
of children. In 38 of these 55 countries, the poorest children are at least twice as likely to be engaged in child labor as the richest children. Source:
UNICEF, data.unicef.org/topic/child-protection/child-labour/# (Accessed March 26, 2017)35
Calculated using 2015 population estimates for Nepali children aged 5-17 from UN DESA, Population Division. World Population Prospects:
The 2015 Revision.
36
Central Bureau of Statistics [Nepal] and UNICEF Nepal. Nepal Multiple Indicator Cluster Survey 2014, Final Report. (Kathmandu, Nepal: 2015)37
Cayemittes, Michel, et al. Enquête Mortalité, Morbidité et Utilisation des Services, Haïti, 2012. (Calverton, Maryland: ICF International and MSPP, IHE: 2013)33

Domestic servitude

Cotton picking

MiningMilitary service

Stone quarrying

Waste site scavenging

Deep water fishing

Construction

Brick making

Textile factory work

Carpet weaving

For specific tasks, hazards, injuries and potential health consequences associated with this work for children, see: ILO. Children in
Hazardous Work: What We Know, What We Need to Do. (Geneva: 2011).
Page 10

Page 11

Alhaji, 11, doesn’t go to school but instead
works as an ironmonger to help support his
family in Kroo Bay, Freetown, Sierra Leone.
About 37 percent of children aged 5-14
in Sierra Leone are engaged in child labor(some 621,000 children).38

CASE STUDY: INDIA
Kamal was forced to leave school at age 11 because ofpoverty. His father is an addict, and Kamal grew up in aviolent environment where physical and verbal abuse
were common.
His parents forced him to take a job in a roadsiderestaurant. For two years, Kamal endured 24-hour shifts
and an unending cycle of cooking, cleaning and waitingtables. The $73 a month he earned was his family’s only
income.
A Save the Children-supported group called “Lucky”
became aware of Kamal’s situation. Children from thegroup confronted Kamal’s parents and urged them to let
him go back to school. They met stiff resistance, as thefamily needed the money Kamal was earning.
So the children turned to the community’s Child
Protection Committee, which is also supported by a Save
the Children initiative. It took a month of discussions with

Kamal’s parents and his employer, but eventually they
were persuaded. The next hurdle was convincing school
authorities, who were reluctant to accept him back.
Kamal’s advocates pointed to a 2009 right to education
law, and Kamal was re-enrolled.
Kamal is now 14 and thriving in school. The children’sgroups and a few motivated teachers continue to ensure
he has equal opportunities. The school discovered his
athletic potential and trained him in running. Kamal has
begun winning races and recognition from his school. His
talent was spotted by local authorities who asked him torepresent his area in an inter-district championship, where
he won a trophy.
“I was working and never thought I could study
again or represent my district in sports,” said Kamal.
“Sometimes, I feel this is all a dream. I am lucky to havebeen found by the Lucky children’s group.”

Photo: Nilesh Nikade / Save the Children

38

Page
Page 1412

Calculated using 2013 population estimates for children aged 5-14 in Sierra Leone sourced from UN DESA, Population Division. World
Population Prospects: The 2015 Revision. Custom data acquired via website (https://esa.un.org/unpd/wpp/DataQuery/)Photo: Jonathan Hyams / Save the Children

Kamal used to work 24-hour shifts
in a roadside restaurant. Now heis 14, back in school, and excellingas an athlete. He earned a trophy
for his district in a 400 meter
race, making his parents, school,community and district proud.

Page 13

THE DEVASTATING IMPACTS OF CHILD MARRIAGE
Marriage before age 18 is a violation of children’s rights,
and illegal in a growing number of countries. Yet about
40 million girls aged 15-19 worldwide are currently
married or in union.39 Each year, some 15 million moregirls marry before reaching age 18.40 Of those, 4 million
are married before age 15.41 Many are forced into
marriage by their parents and are wed to men who are
significantly older.

Globally, one girl under 15 getsmarried every seven seconds.
Early marriage has devastating consequences for a
girl’s life, effectively ending her childhood by forcing her
into adulthood and motherhood before she is physicallyand mentally ready. Child brides are often isolated,with their freedom curtailed. They frequently feeldisempowered and are deprived of their rights to health,education and safety.
Child brides are at greater risk of experiencing
dangerous complications in pregnancy and childbirth,
contracting HIV/AIDS and suffering domestic violence.
With little access to education and economic
opportunities, they and their families are more
likely to live in poverty.42
Child marriage is a global problem that cuts acrosscountries, cultures, religions and ethnicities. Child brides
can be found in every region in the world, from theMiddle East to Latin America, South Asia to Europe andNorth America. Many factors interact to place a girl at
risk of marriage, including poverty, the perception thatmarriage will provide “protection,” family honor, socialand religious norms, and inadequate legal protections.
Girls from poor families are more likely to be forced
into early marriage. In Vietnam and the Philippines, girls
are at least 7 times more likely to be married if they arepoor than if they come from the richest families.43 Childmarriage tends to be more prevalent in rural areas.
For example, in Indonesia, 25 percent of rural girls are
married before age 18, compared to 10 percent in urban
areas. And in Peru, 35 percent of rural girls are married,compared to 14 percent of urban girls.44
The highest rates of child marriage are foundin sub-Saharan Africa and South Asia. In Mali, 39
percent of girls aged 15-19 are married. In South Sudan,
40 percent are married. In Bangladesh, 44 percent. In
Central African Republic, 55 percent. And in Niger, 60
percent. In these countries, disparities are also great.
In Niger, for example, 1 in 3 girls in the capital Niamey
are married by 18, compared to nearly 9 in 10 in thepoorest regions.45
Child marriage also affects boys, but to a much lesser
degree than girls. Data on the share of boys marriedby age 18 are limited, but suggest some of the highest
rates are found in: Central African Republic (28 percent),
Madagascar (13 percent), Lao PDR (13 percent),
Honduras (12 percent), Nepal (11 percent) andCuba (11 percent).46

Majerah saw ﬁrsthand the challenges
women in her community faced because
there was no female doctor. Her dream
to become a doctor and help other
women was shattered at age 14 when
she was married against her will to aman 10 years older.

In Bangladesh, Save the Children is ﬁghting child marriage through awareness campaigns and advocacy.

Calculated by multiplying the global share of girls 15-19 currently married or in union (14%) by the total number of girls aged 15-19 worldwide (285 million). Sources:
data.unicef.org/topic/child-protection/child-marriage/; UN DESA, Population Division. World Population Prospects: The 2015 Revision
40
UNICEF. Ending Child Marriage: Progress and Prospects. (New York: 2014)41
According to the latest global estimates, 25.9 percent of girls are married by age 18 and 7.5 percent are married by age 15. If 29 percent of girls who marry are marriedby 15 (7.5/25.9), then around 4.3 of the 15 million girls who marry each year are under age 15. Sources: Ibid and SDG Indicators Global Database, Indicator: 5.3.1 –Proportion of women aged 20-24 years who were married or in a union before age 15 and before age 18 (Accessed March 22, 2017)42
Girls Not Brides. http://www.girlsnotbrides.org/what-is-the-impact/
43
Save the Children, Groups-based Inequality Database (GRID). https://campaigns.savethechildren.net/grid
44
Ibid.
45
Ibid.
46
UNICEF. Child protection: Child marriage. https://data.unicef.org/topic/child-protection/child-marriage/
39

Page 14Majerah, now 17, was forced into early marriage three years ago. “I was studying and working hard with the hope
to become a doctor,” she said. “I wanted to be able to help other women. Even though my family was poor, I always
focused on my studies, disregarding the difficulties of my life. I never had a chance to enjoy my childhood. I was forced
into an adult life way too early.”
She had to leave school when she got married. She was in 8th grade and earned the highest scores in her class.
“When my father decided to marry me off, I was heartbroken. Nobody asked or cared.”
Majerah’s husband is 10 years older. She lives with him and a large number of his family members in a small house.
Her in-laws treat her like a slave, making her do all the housework. The family disrespects her because she has notbeen able to have a child. She has been hit by her husband several times. He tells her if she is unable to have a baby
within the next couple of months, he will remarry.
“All my dreams have been shattered forever,” said Majerah. “I feel I am not alive anymore. One cannot live without
hopes and dreams.”
About 20 percent of Afghan girls aged 15-19 are married or living in union. Afghanistan’s legal age of marriage is 16
for girls and 18 for boys, but there is limited enforcement of this law.47

47

Photo: Save the Children

CASE STUDY: AFGHANISTAN

WHO. Global Status Report on Violence Prevention 2014. (Geneva: 2014)
Page 15

Tulasa, 14, was married when she
was 13 and gave birth to a stillborn
baby about a year later. She lives ina remote village in Nepal.

CASE STUDY: SOMALIA
Amal grew up in a rural village and never attended
school. When she reached 13, her father told
her he had accepted a dowry from a man who
wanted to marry her. “I tried to refuse, but I wasforced to accept it,” said Amal. “I had no choice.”
Preparations began for the wedding.
Amal was sent to the home of the man, who
was more than 30 years older. After two daysof wedding celebrations, she began to fear what
was in store for her. “I decided to leave. Everyone
in his family was around, but I ran away anyway.
They all shouted after me, but I just kept running. I
walked for two hours to the nearest village. Finally I
boarded a bus full of many other people and I got aride all the way to the city.”
Amal sought refuge with her aunt, a member ofa Child Welfare Committee that partners with Save
the Children. Her aunt says she will never force herniece back into that situation.
“I don’t want to go back. I want to stay here,”says Amal. “I will try to find some work here in thecity and I also want to go to school if it’s possible.
It’s wrong for parents to force young girls to marrymen who are older. Girls should not be forced
against their will, they should have a chance to go
to school.”

Photo: Suzanne Lee / Save the Children

ALARMING PERCENTAGES OF GIRLS ARE MARRIED AS CHILDREN
Percentage ofwomen aged 20 to 24
years who were firstmarried or in union
before age 15 andage 18, by region
Married by 18
Married by 15

50
40

42

30

39

41

36

20

23

10
0

* Excluding China

45

18

17

14

12

10

5

3

South
Asia

West andCentralAfricaSubSaharanAfricaEasternandSouthern
AfricaLatin
Americaand
Caribbean

MiddleEast
and North
Africa15

East Asia
andPacific*

11
1

13

CEE/CIS**Leastdeveloped
countries** CEE/CIS: Central and Eastern Europe and the Commonwealth of Independent States

Note: Graphic adapted from data.unicef.org and based on DHS, MICS and other nationally representative surveys, 2008-2014. Global estimates, regional averages for South Asiaand the share of women married before age 15 in East Asia and the Pacific were not available as of the last online update (February 2017). For this reason, data for South Asia
was pulled from: UNICEF. The State of the World's Children Report 2015 Satistical Tables. (New York: 2014)

Page 16

Amal was 13 when her family
decided to marry her off to a manin his 40s. She managed to escapeand is working to rebuild her life.

Photo: Colin Crowley / Save the Children

Page 17

THE PERILS OF TEENAGE CHILDBEARING

Every two seconds,
a girl gives birth.
Childbearing at a young age, when a girl’s body
is not physically mature enough to deliver withoutcomplications, often leads to devastating consequences.
Complications from pregnancy and childbirth are thesecond leading cause of death for adolescent girls
between the ages of 15 and 19 globally.50 And babies
born to adolescent mothers face a substantially higher
risk of dying than those born to women aged 20 to 24.51
Young mothers are less likely to be in school andmore likely to struggle economically. This puts themand their children at risk of exploitation, ill health andperpetuating cycles of poverty.
Early childbearing also severely impacts the
economies of communities and nations. For example,
if all adolescent girls in Kenya completed secondary
school, and if the more than 200,000 adolescentmothers there were employed instead of having become
pregnant, $3.4 billion could have been added to theeconomy. This is equivalent to the value of Kenya’s
entire construction sector. If adolescents in Brazil andIndia had been able to wait until their early 20s to
become mothers, those countries would have greater
economic productivity equal to over $3.5 billion and$7.7 billion, respectively.52
Most teenage girls in developing countries do notwant to have babies, 53 but many are unable to avoid
getting pregnant. They may lack knowledge about
contraception, or be afraid to seek contraception
services. Contraceptives may be too expensive or not
widely or legally available. Girls may also be unable torefuse unwanted sex or resist coerced sex, which tends
to be unprotected.
While very early childbearing (before age 15)
appears to be declining in all regions, childbearing
among older adolescents (ages 15 to 17) has
remained steady. 54
The proportion of births that take place duringadolescence is about 2 percent in China, 18 percent in

Latin America and the Caribbean and more than 50
percent in sub-Saharan Africa. 55
Half of all adolescent births occur in just sevencountries: Bangladesh, Brazil, Democratic Republic of theCongo, Ethiopia, India, Nigeria and the United States.56
The End of Childhood Index shows how the contexts ofthese births differ. The link between early marriage andearly motherhood is strong in Asia and parts of Africa,
but having a child outside of marriage is not uncommon
in many high-income or Latin American and
Caribbean countries.
Adolescent pregnancies are more common in poor,
uneducated and rural communities. The poorest 20
percent of girls in Indonesia have birth rates 6 times
those of the wealthiest 20 percent. Similar povertyrelated disparities are found in Nigeria and Peru.57 Girlsin Rwanda with no formal education have birth rates
5 times those of girls with at least some secondary
education. And in Tanzania, uneducated girls give birthat 8 times the rate of those with secondary education. 58
In rural areas of many countries, adolescent birth rates
are double those seen in urban areas. In Cambodia andEthiopia, birth rates in rural areas are 3 and 5 times
those in urban areas, respectively.59

Page 18

Photo: Jonathan Hyams / Save the Children< 15
15 to < 50
50 to < 100
100 to < 150>150
Data not available

Marta, 16, with her 1-monthold son Carlo in Sinaloa,
Mexico. Teenage pregnancy
is common in this agriculturalarea, as is poverty. Marta
met her baby’s father while
she was working in the ﬁelds
harvesting vegetables andhay. She had to leave school
during her pregnancy. “I worry
about going back to schooland leaving my child alone,”she says. “I do not know how I
would be able to feed him."

Photo: Jonathan Hyams / Save the Children

Of the approximately 17 million girls that give birth each year, 16 million are aged 15-19 and 1 million are under age 15. Source: WHO.
Adolescent Pregnancy Fact Sheet. Updated September 2014. http://www.who.int/mediacentre/factsheets/fs364/en/
49
UNFPA. State of World Population 2013: Motherhood in Childhood: Facing the Challenge of Adolescent Pregnancy. (New York: 2013)
50
WHO. Health for the World’s Adolescents: A Second Chance in the Second Decade. (Geneva: 2014)
51
WHO. Adolescent Pregnancy. http://www.who.int/maternal_child_adolescent/topics/maternal/adolescent_pregnancy/en/
52
UNFPA. State of World Population 2013: Motherhood in Childhood: Facing the Challenge of Adolescent Pregnancy.
53
Ibid.
54
UNICEF. Maternal Health. https://data.unicef.org/topic/maternal-health/adolescent-health/55
WHO. Adolescent Pregnancy. http://www.who.int/maternal_child_adolescent/topics/maternal/adolescent_pregnancy/en/ (Accessed March 26, 2017)
56
Ibid.
57
WHO, Health Equity Monitor Database, apps.who.int/gho/data/node.main.nHE-1550?lang=en (Accessed March 26, 2017)
58
Ibid.
59
National Institute of Statistics, Directorate General for Health and ICF International. Cambodia Demographic and Health Survey 2014. (Phnom Penh,
Cambodia and Rockville, Maryland: 2015) and Central Statistical Agency (CSA) [Ethiopia] and ICF International. Ethiopia Demographic and Health
Survey 2016: Key Indicators Report. (Addis Ababa, Ethiopia and Rockville, Maryland: 2016)48

Adolescent birth rate
(births per 1,000 girls
aged 15-19 years)

Source: World Bank, World Development Indicators, 2017

CASE STUDY: SIERRA LEONE
Tawa* dropped out of school because she couldn’t
afford the fees, which was around the time of the Ebola
outbreak in Sierra Leone. During the outbreak, all theschools were closed. Towards the end of the outbreak, ateenage boy started visiting her.
Tawa didn’t have much support from her parents, as
her father died when she was young and her mother iselderly. She refused the boy's advances at first, but was
eventually persuaded to have sex with him. They had sex
just one time and Tawa became pregnant.
When the boy heard about the pregnancy, he fled to
Liberia and she has not seen or heard from him since.
During the pregnancy, people in the community
would mock her and gossip about her. They would say:“Look at this child who is so small and already pregnant.
She will not be able to deliver the baby on her own.”
Tawa delivered her baby by Cesarean section at
the hospital.
She does not want another pregnancy until she
finishes her education, but paying for school is achallenge. “I am really stressed, sometimes when mychild is sick, even money to take her to the hospitalis hard to come by. Even to have food to give her
is difficult.”

Asked if she has a message for other girls, Tawa
said: “Education is the key to success. Let us focus oncontinuing school. And let us become nurses, doctors
and engage in any other good types of jobs available inthis world.”

Tawa, 17, andher 10-month-olddaughter Mary*.
Photo: Michael Duff / Save the Children

Every year, around 17 million girls give birth, forcing
them to assume adult responsibilities and putting
their health, education and economic prospects at
risk.48 Most births to adolescents (95 percent) occur
in developing countries, and 9 in 10 of these births
occur within marriage or a union.49

ADOLESCENT BIRTH RATES WORLDWIDE*names changed to protect identities

Page 19More people are fleeing war and persecution than everin history. Worldwide, nearly 28 million children havebeen forcibly displaced. This number includes some 10
million child refugees, approximately 1 million asylumseeking children and an estimated 17 million children
displaced within their own countries by violence
and conflict.60

Conflict has forced nearly
1 child in 80 from their homes,
and some even onto
the front lines.
These children are often denied their rights to health,education, protection and freedom from fear. Many
will spend their entire childhoods away from home,sometimes separated from their families. They may havewitnessed or experienced violent acts and are at riskof abuse, neglect, violence, exploitation, trafficking or
military recruitment.

Though many communities and people around theworld have welcomed refugee and migrant children,
xenophobia, discrimination and exclusion pose serious
threats to their lives and futures. Language barriers
often make it difficult for children and their families toreceive the help they need. Legal barriers can prevent
them from accessing education, health care andother services.
In too many cases, children are subject toimmigration detention while their status is being
assessed and resolved. This has a devastating impact on
their psychological, social and educational development.
In addition, policies around family reunification andreturns are becoming more restrictive with a potential
negative impact on children.
Many of the youngest refugees have known only
conflict and deprivation in their short lives. To recoverand contribute positively to their societies, they musthave opportunities for education and help to overcome
traumatic experiences. If the world community fails toprovide this, we will pay an enormous collective price.

Photo: Gabriele Casin / Save the Children

THE GROWING CRISIS OF CHILDREN DISPLACED BY CONFLICT

Ahlam (second from left) and her family havebeen forced to flee twice. They left their homein Baiji – in northern Iraq – for the ﬁrst time
three years ago when IS took over the town.
Two years later, they had to escape again
when IS spread their control to Hawija.

10 COUNTRIES WHERE CHILDREN SUFFER MOST FROM CONFLICT
Estimated % of population forcibly displaced*
0%

10%

20%

30%

40%

50%

60%

70%

Total population
displaced§ (millions)

Syria

12.1

South Sudan

2.8

Somalia

2.3

Central African Rep.

1.0

Colombia

7.5

Afghanistan

4.5

Iraq

5.0

Yemen

3.1

Sudan

3.9

Eritrea

0.5*Number of persons of concern to UNHCR,§ by origin, as a share of their country of nationality's population, mid-2016. Calculations by Save the Children. Sources: UNHCR. Mid-Year
Trends 2016. (Geneva: 2017); UN DESA, Population Division. World Population Prospects: The 2015 Revision. (New York: 2015). For the purpose of this analysis, 2016 population projections have been used.
§

Includes refugees, people in refugee-like situations, asylum-seekers, returned refugees, IDPs protected/assisted by UNHCR, including those in IDP-like situations, returned IDPs andothers of concern to UNHCR.

60

Page 20CASE STUDY: IRAQ
Ahlam* and her family endured months of airstrikes andhunger before they fled their home in northern Iraq. “Mychildren have had psychological problems,” says Ahlam’s
mother. “Ahlam wouldn’t sleep. She would tell me `mom,take me out.’ But we had nowhere to go. War was
everywhere.”
The family stayed in Hawija for about two years
before they were displaced by conflict a second time.
“We walked for seven hours in the night through themountains,” says 12-year-old Ahlam. “We were on theroad and there were explosions. There were landminesthat exploded. We saw them.”“We were scared all the time,” says her mother.
“Worried and exhausted. We spent two days without
eating or drinking anything.”
During this time, Ahlam was out of school for two
years. She and her family now live in a displacement

camp in Qayyara, about 40 miles south of Mosul. “I left
behind my toys…. My school…. I had everything. Here I
don’t have toys. I prefer to go back home. It has been along time since we saw our home…. I also had a swing.
We had a TV at home. I used to watch cartoons.”
Despite her trauma and losses, Ahlam’s mother says
the girl “has now gained some freedom and comfort.”
She enjoys going to a school supported by Save theChildren, where she is now in fifth grade. “Today welearned about creatures,” said Ahlam. “The places where
creatures live and fill their needs for water, oxygen andnutrients.
“I like to go to school to learn,” she added. “I want tobecome an engineer or a doctor. I should read and write
to become a doctor.”*name changed to protect identity

UNICEF. Uprooted: The Growing Crisis for Refugee and Migrant Children. (New York: 2016)

Page 21

YOUNG LIVES CUT SHORT OR DEEPLY SCARRED BY VIOLENCE

Every day, more than 200
boys and girls aroundthe world are murdered.
Physical violence against children can be committed
by anyone, although adults in positions of trust andauthority (such as caregivers and teachers) are often
cited as perpetrators. Acts of physical force againstchildren are also common among peers. Chronic
community violence – frequent and continual exposure
to the use of weapons, drugs and random violence –is most common where government protections forchildren are weak.
Exposure to violence may disrupt a child’s normal
development and affect well-being in both the shortand long term. Consequences may include behavioral
disorders such as aggression and an inability to relate
to others, emotional disorders such as depression andanxiety, and health-related disorders such as sleep
disruption and nightmares.
Child homicide and child abuse exist in every country,
rich and poor, but child homicide rates are highest in
Latin America and the Caribbean, where violent criminal
activity has been on the rise for the past decade. The
surprisingly low End of Childhood Index rankings for some
Latin American countries, especially considering theirrelative national wealth, are a reflection of high levels ofsocietal violence.
In communities where gang activity is prevalent,fear of gangs can prevent students from going to schooland young people from holding jobs. According to one
report, nearly 40,000 children in El Salvador dropped outof school in 2015, primarily out of concern for theirown safety.62

In every region of the world, homicide rates among
boys are higher than those among girls. The difference
between the two sexes is especially striking in Latin
America and the Caribbean, where boys are almost 7
times more likely to be murdered than girls.63
Violence against children also inflicts damage at thesocietal level, including direct and indirect costs due toincreased social spending and lost economic productivity.
A recent study estimated the lifetime economic costsof new cases of child abuse in the United States at $124
billion. The calculation included lifetime costs of $210,012
per abuse victim who survived and $1.3 million per victim
who died.64 The same authors estimated the economic
cost of child abuse in East Asia and the Pacific to exceed$160 billion based on economic losses due to death,disease and health risk behaviors attributable tochild abuse.65

62

Page 22

Venezuela
El Salvador

Rates calculated by Save the Children. Data sources:
WHO. Global Health Estimates 2015: Deaths by Cause,
Age, Sex, by Country and by Region, 2000-2015.
(Geneva: 2016); UN DESA, Population Division.
World Population Prospects: The 2015 Revision

Colombia
BrazilGuatemalaTrinidad and Tobago
Dominican Republic
PanamaBelizeWorld Average
10

20

30

Homicide rate

A relative cries during the burial of 13-yearold Maria Eduarda Alves de Conceicao, who
was killed by a stray bullet during a shootout
between police and alleged drug trafﬁckers in
Rio de Janeiro, Brazil.

WHO. Global Health Estimates 2015: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2015. (Geneva: 2016)
Madeleine Schwartz. "El Salvador: A Town Without Violence?" NYR Daily, January 27, 2017. nybooks.com/daily/2017/01/27/
el-salvador-a-town-without-violence/
63
UNICEF. Hidden in Plain Sight: A Statistical Analysis of Violence Against Children. (New York: 2014)
64
Fang, X., et al. “The Economic Burden of Child Maltreatment in the United States and Implications for Prevention.” Child Abuse& Neglect, vol. 36, no. 2, 2012, pp. 156-165
65
Fang, X., D. Brown and P. Corso. Analytical Report for the Project “Development of Regional Costing Model to Estimate the Economic
Burden of Child Maltreatment in the East Asia and Pacific Region.” Bangkok, 2013 (unpublished) cited in: UNICEF. Hidden in Plain Sight:
A Statistical Analysis of Violence Against Children.
61

Estimated number of homicide victims
among children and adolescents aged
0-19, per 100,000 population in 2015.

Honduras

0

CASE STUDY: EL SALVADORAP Photo / Leo Correa

Suffering violence, witnessing violence or fearing violence
should not be part of growing up. In 2015 alone, morethan 75,000 boys and girls under the age of 20 weremurdered – 59 percent were adolescents aged 15 to19.61 Each of these deaths represents hundreds or eventhousands more children who are living in violent orabusive environments where they face repeated threats
to their survival and healthy development.

THE 10 COUNTRIES WITH THE HIGHEST CHILD HOMICIDE RATES ARE ALL IN
LATIN AMERICA AND THE CARIBBEAN

Thirteen-year-old Juan* lost his cousin to gang
violence just over a year ago. "He was like my brother,"says Juan. "It brings me misery and a feeling I cannot
express, to know that from one day to the next, he's
not here.
"I came home and found another cousin and mybrother crying and I had a strange feeling, my mind
was racing. I asked my cousin what was going on andshe did not answer, she only cried. My cousin told me,'They killed him.' I felt that my heart was crushed very
badly, in the cruelest way. I began to remember manytimes spent with him. I couldn't believe that it had only
been a few hours since I had last seen him alive. That
day I sat alone, far away, in a place that only I know.
"I had never known this pain. Sometimes I would see
in the news that someone was killed – that's normal
these days. I hope I'm forgiven for saying this, but that's
the cruel joke, that every day there are dead people –young people disappear or they kill them.
"I have dreamed of him three times. He hugs me inthe dream and tells me that he will always be with me.
He arranges a suitcase, takes a bath, and tells me that
he is going on a long journey from which he will not
return. I woke up from that dream and felt I wanted toshare my sorrows. I decided I would never self-harmlike others do when they have problems, because I
think it's not good."

Juan believes he will never fully recover from thepsychological impact of his cousin's death, but by
participating in Save the Children art therapy andyouth development programs he has found help inprocessing his feelings and finding hope for the future.
"The teacher makes us relax, tells us to feel the wind
and imagine a cloud touching our skin. We painted
there too. I drew two masks. One laughing and one
crying. I explained that I've had to laugh and I am
funny, but I have also cried. With my happiness, I hide
my sadness."*name changed to protect identity

Photo: Angie Montes / Save the Children

Page 23

Above: A small memorial marks the
spot where 15-year-old Estuardo
Samuel Ochoa was killed outside
his school in Guatemala City. The
school is located in the notorious
gang-run neighborhood of Canalitos
and has seen rising drop-out rates.
Two teachers and three students havebeen killed since 2010.
At right: With support from Save theChildren, students in the same schoolorganize peace-building workshops.
The sign behind them says "Peace is inyou. Pass it on."Photos: Souvid Datta / Save the Children

16-year-old Rosy had escaped her abusive
past. She was living in a shelter, caring forher baby, attending night classes and was
optimistic about her future. A few months
later she was murdered.

CASE STUDY: BOLIVIA
Rosy* ran away from home when she was 13 to escape alife of abuse. With nowhere to go, she ended up living on
the streets. “I was always scared and I was always cold,”she said. Eventually, she got a job in construction, which
was hard work for a young girl, but it was better than
the alternatives.
By age 15, she was pregnant. A caring doctor helped
her get off the street and mobilized social services toplace her in a shelter for pregnant teens that Save theChildren supports with complementary programs.
There, she and her baby got the support they needed.
Her son Diego* became her inspiration. “My baby makes
me smile and gives me strength,” she told an interviewer
at the shelter in October 2015. Rosy, who was 16 at thetime, was building the foundation of a brighter future,eating well, nursing her baby, and studying hard to
get ahead. “I hope I will be able to have a house and anormal life,” she said.

Page 24

Photo: Susan Warner / Save the Children

A few months later, Rosy left the shelter, eager tobegin her new life. She moved in with the father of her
baby. Many details about what happened next are
unknown. In August 2016, television news reported
Rosy was dead after being thrown from a minibus byher boyfriend. Her friends confirmed this story. Save theChildren staff have been unable to learn what happened
to Rosy’s son Diego. It is also unclear if an investigationis underway, or if charges were brought against Rosy’s
boyfriend. The lack of follow-up is sadly common in cases
like Rosy’s. Too often, the most vulnerable children are
also the most invisible.
*names changed to protect identities

Page 25

RECOMMENDATIONSIn September 2015, world leaders came together
and agreed on an ambitious global framework forending poverty called the 2030 Agenda for Sustainable
Development, which includes 17 Sustainable Development
Goals (known as the SDGs or the Global Goals). The
SDGs promise a future in which all children have afull childhood – free from malnutrition and violence,with access to quality health care and education – andreinforces obligations to children set out in the UN
Convention on the Rights of the Child. Most importantly,
this is a future in which no child is left behind.
As this report shows, we have a long way to go torealize this vision. Millions of children around the world
are left behind, either by design or neglect. They are
missing out on quality health care and basic learning
simply because of who they are or where they live.
Girls, child refugees, street children, children fromcertain ethnic or religious backgrounds, children withdisabilities and from poor and disadvantaged regions
within countries, and children affected by crisis, conflictor fragility – all face discrimination that prevents themfrom fulfilling their full potential. Leaving children behind,especially the most excluded, will hinder the world’s
ability to meet the SDGs within a generation.
That is why Save the Children committed to workwith governments and other stakeholders to ensure
progress is made on meeting the SDGs. Save theChildren is committed to reaching every last child bytackling the obstacles that exclude millions of children
from surviving, learning and being protected. As per the
Global Goals pledge to leave no one behind, the rights ofchildren from all segments of society must be upheld, andthose furthest behind must be reached first. All children
deserve a childhood.
We call on world leaders to value children and theirright to survive, thrive and be protected by following
through on the commitments made under the SDGs, andby taking immediate steps to implement the pledge toleave no one behind, especially not children. This pledge
is a commitment to ensure that the SDG targets shouldbe met for all nations, all people and all segments ofsociety.
This will require governments to make three key
guarantees to children:
1. Investing in children
To achieve the SDGs and ensure that all children haveaccess to quality basic services, including protection
and social protection services, governments (including
donors) need to raise the necessary resources.
Governments must ensure these resources reachexcluded children in keeping with the focus on public
investment in children outlined by the UN Committee
on the Rights of the Child. Improved public investment in
excluded children must go hand in hand with the removalof cost barriers to services and measures to ensure
minimum financial security for all children through childsensitive social protection.

2. Ensuring all children are treated equally
End discriminatory policies, norms and behaviors suchas preventing girls from accessing health services or
denying education to a child because of her or his
ethnicity or gender. To facilitate children accessing
quality services, governments must also put in placesystems to register every child at birth.
3. Counting and including all children, regardlessof who they are or where they are from
Governments need to ensure that all children, especiallyexcluded children, are counted in data that are used tomeasure progress on the SDGs. Data should be collectedby age, economic group, gender, sex, race, ethnicity andgeography or migratory status, and be reported publicly
in accessible formats. Governments should set steppingstone equity targets to help children who are furthest
behind catch up to their peers. In addition, excluded
children – girls and boys – should participate in policy
making and budgeting, and be supported to monitor
progress and hold governments to account.
In addition to these cross-cutting global guarantees,
specific actions are needed to address each of thechildhood “enders” examined in this report, making
every effort possible to follow through on commitments
made under the SDGs. We therefore call on all
governments to ensure:
No child dies from preventable
or treatable causes:• Governments need to prioritize essential
services for women’s, children’s andadolescents’ health in their efforts toachieve universal health coverage as a key
component of their national health systems
by 2030. Donor governments should
support countries in achieving universal
health coverage.

No child is robbed of a future due
to malnutrition:• For those governments without nationaltargets in place, national governments
and donor governments need to developthese targets to demonstrate progress
towards meeting the globally agreed
World Health Assembly nutrition targets.
All children have access toquality education:• Government plans should ensure that all
girls and boys complete free, equitable, safeand quality basic education leading torelevant and effective learning outcomes.
• All girls and boys should have access toquality early childhood development, careand pre-primary education so that they are
ready for primary education.
• Governments must work together
to ensure that no child’s learning stops
because he or she is caught up in acrisis situation.
• Governments should guarantee that norefugee or migrant child is out of schoolfor more than 30 days and upholdcommitments made in the 2016 New York
Declaration on Refugees and Migrants andthe summit on refugees hosted by theUnited States.

No child is robbed of childhood due
to marriage or pregnancy:• Governments should develop andimplement necessary legal reforms, suchas increasing the legal age to marry, andtackle harmful social norms and poverty,
which drive child marriage.
• Governments, as a part of universal healthcoverage, should include access togood quality sexual and reproductive healthinformation and services as a part ofnational health plans and systems.
No young life is cut short due toviolence or forced labor:• Governments should develop andimplement laws, policies, services and otheradministrative measures to prevent andrespond to all forms of violence, abuse andneglect against all children.
• Governments should foster incomegenerating activities for families andcommunities to increase household andcommunity resources, and guarantee
minimum financial security for all children.

• In fragile, disaster-prone and humanitariansettings, governments need to guarantee
the provision of an essential package ofhealth and nutrition services that saves
lives, and protects and promotes the healthof women, children and adolescents, taking
into account their particular contexts andspecific needs and vulnerabilities.
• Governments should guarantee, in theirnational health plans, an essential packageof good-quality reproductive, maternal,
newborn and child health and nutrition
services including access to quality care,
medicines and vaccines, accessible to theirwhole population and free at the point ofuse, with a strong focus on primary
health care.

Children race on the rooftop of
a community school for Syrian
refugees in the Obour districtof Cairo, Egypt.
Page 26

Photo: Sima Diab / Save the Children

Page 27

END OF CHILDHOOD INDEX RANKINGS
Rank

Sanjana, 5, collects rubbish to be soldfor recycling in a slum on the outskirts
of New Delhi, India. Save the Children
provides help to this community throughits Mobile Health Unit.

Country

Score

1
1
3
4
4
6
7
8
8
10
10
10
10
14
14
16
16
18
18
18
21
21
23
24
25
26
26
28
29
30
31
32
33
34
35
36
37

NorwaySlovenia
FinlandNetherlands
SwedenPortugal
Ireland
Iceland
Italy
Belgium
CyprusGermany
Republic of Korea
FranceSpain
Japan
Switzerland
Australia
GreeceLuxembourg
Denmark
IsraelUnited Kingdom
Lithuania
Croatia
Estonia
PolandNew Zealand
Hungary
LatviaMalta
BelarusSingapore
Qatar
Bosnia & Herzegovina
United States
Russian Federation

985
985
983
982
982
981
980
979
979
978
978
978
978
976
976
974
974
973
973
973
972
972
971
970
969
967
967
964
962
956
953
951
949
947
942
941
940

38
39
40
41
41
43
44
45
45
47
48
49
49
51
52
53
54
54
56
56
58

KuwaitUkraineKazakhstan
China
SerbiaOman
Montenegro
LebanonTunisia
Saudi Arabia
Maldives
Bulgaria
Mauritius
JordanRomania
Chile
Armenia
BahamasTfYR Macedonia
Tonga
Samoa

938
937
935
928
928
927
926
924
924
922
920
917
917
915
914
913
912
912
910
910
909

Rank

Country

Score

59
59
61
61
61
64
65
66
67
67
67
70
71
71
73
74
74
76
77
78
78
80
81
82
83
84
85
85
87
88
89
90
91
92
93
94
95
96
96
98
99
100
101
102
103
103
105
105
107
108
109
109
111

Barbados
TurkeyAlgeria
Cuba
Sri Lanka
Brunei Darussalam
Malaysia
Costa Rica
Argentina
FijiSaint Lucia
Mongolia
Albania
Trinidad & Tobago
Jamaica
Seychelles
Uruguay
Moldova
Turkmenistan
DPR Korea
Uzbekistan
Iran
SurinameState of Palestine
MoroccoThailandCabo Verde
Georgia
Azerbaijan
Egypt
BrazilMexicoKyrgyzstan
VietnamBhutanTajikistan
EcuadorPhilippines
Vanuatu
BelizePanamaBotswana
Indonesia
Paraguay
Peru
South Africa
Namibia
Swaziland
Gabon
GuyanaNicaragua
Solomon Islands
Ghana

905
905
903
903
903
896
894
892
883
883
883
880
877
877
872
871
871
867
865
862
862
860
859
858
853
852
851
851
835
830
821
819
816
815
813
812
808
807
807
801
800
796
793
790
788
788
777
777
775
771
766
766
761

112
112
114
114
116

Myanmar
RwandaBolivia
Sao Tome & Principe
India

757
757
756
756
754

Index scores reﬂect the average level of performance across a set of eight indicators related to child health, education, labor, marriage,
childbirth and violence. The only reason a country was not included in this analysis was insufficient data (e.g., the country was missing
values for three or more indicators). To see the underlying dataset, including data gaps, turn to pages 30-34. Performance bands reﬂect
the extent to which children are missing out on childhood. For details, see Methodology and Research Notes.
*Data collection in times of conﬂict is difficult and dangerous. Latest available data for conﬂict-affected countries often predate
escalations of violence and do not capture the harsh realities for children in these settings. In Syria, for example, recent evidence
suggests rates of child labor and child marriage have risen. These trends are not reﬂected in the data or index ranking.

Page 28

Photo: CJ Clarke / Save the Children

Rank

Country

Score

117
118
119
120
121
122
123
124
125
126
127
128
129
130
130
132
132
134
134
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153

Cambodia
Colombia
Kenya
Dominican Republic
Haiti
Timor-Leste
Iraq
Congo
Venezuela
El Salvador
Djibouti
SenegalComoros
Lao PDR
Togo
Liberia
UgandaBangladesh
Nepal
Papua New Guinea
Syrian Arab Republic*
Zimbabwe
Ethiopia
Yemen*
BurundiHondurasGambiaSudan
Tanzania
ZambiaGuatemalaPakistan
MalawiLesothoEritrea
Afghanistan
Equatorial Guinea

753
752
750
741
733
732
730
728
724
723
715
699
688
684
684
681
681
680
680
674
668
664
657
653
650
648
645
639
635
633
624
621
619
611
608
602
601

154
155
156
157
158
159
160
160
162
163
163
165
166
167
168
169
170
171
172

Benin
Mauritania
Guinea-Bissau
Madagascar
Côte d'Ivoire
Cameroon
Mozambique
Nigeria
DR Congo
GuineaSierra Leone
Burkina Faso
South Sudan
Chad
Somalia
Central African Rep.
Mali
Angola
Niger

592
591
589
587
586
585
578
578
558
546
546
541
488
473
470
428
414
393
384

Few children missing out on childhood
Some children missing out on childhood
Many children missing out on childhood
Most children missing out on childhood
Page 29

COMPLETE END OF CHILDHOOD INDEX 2017
Child
Dies

Child isSeverely
Malnourished

Under-5
mortality rate
(deaths per
1,000 live
births)2015

Childhood Ender

Indicator

Child Begins
Work LifeChild
Marries

Child Hasa ChildChild
stunting(% children
aged 0-59
months)Out-of-school
children ofprimary andsecondaryschool age(%)

Childrenengaged inchild labor(% ages
5-14)

Adolescentscurrently
married orin union(% girls aged
15-19)

Adolescentbirth rate
(births per
1,000 girls
aged 15-19)

Population
forcibly
displaced by
conﬂict(% of total)Childhomicide rate
(deaths per
100,000
population
aged 0-19)

2011-2016+2011-2016+2011-2016+2011-2016+

2015

2016

2015

28.0

29.4

y

19.7

71.2

13.5

8.3

5.1

x,y

6.5

x

21.8

1.3

…

5.0

3.1

a,b

10.5

0.0

…

…

161.9

…

…

91.1

40.9

Albania

14.0

23.1

25.5

11.7

Angola

156.9

37.6

Antigua and Barbuda

8.1…

Argentina

12.5

8.2

x

3.1

Armenia

14.1

9.4

a

7.8

Australia

3.8

2.0

x

2.8

Austria

3.5…

Azerbaijan

31.7

BahamasAlgeria

Child is a Victim
of Extreme ViolenceChild is Out
of School

Afghanistan

x
a

31.1

x

11.0

COMPLETE END OF CHILDHOOD INDEX 2017
End ofChildhoodIndex 2017

Score

4.9

0.0

9.7

0.0

1.8

903

61

24.9

27.9

15.0

…

0.3

0.5

0.0

0.2

4.2

393

171

Democratic People's
Republic of Korea

43.9

0.1

1.6

–

–

Democratic Republic of
the Congo*

98.3

42.6

18.1

21.3

122.3

3.0

Denmark

3.5

…

4.2

3.5

4.0

Djibouti

65.3

33.5

60.5

Dominican Republic

30.9

7.1

Ecuador

21.6

Egypt

18

…

…

2.7

6.8

0.0

0.4

–

–

18.0

6.4

6.5

12.1

…

5.7

Bahrain

6.2…

Bangladesh

37.6

Barbados

9.9

x

61.0

6.4

0.9

835

87

…

2.4

x

28.7

0.1

6.6

912

54

…

…

5.3

b,x

13.4

0.0

0.2

–

–

36.1

28.0

4.3

44.2

a,b

82.6

0.0

1.6

680

134

13.0

7.7

5.5

1.9

2.4

39.4

0.1

6.2

905

59

Belarus

4.6

4.5

1.9

1.4

7.5

17.6

0.1

0.6

951

32

Belgium

4.1

…

0.8

…

2.2

8.1

0.0

0.4

978

10

Belize

16.5

15.0

10.8

3.2

y

20.8

a

65.1

0.1

11.1

801

98

Benin

99.5

34.0

24.1

52.5

a

16.0

a

81.8

0.0

2.2

592

154

Bhutan

32.9

33.6

16.3

2.9

x

15.2

x

20.2

2.0

0.7

813

93

Bolivia (Plurinational State of)

38.4

18.1

12.1

26.4

x,y

11.6

70.4

0.0

6.4

756

114

Bosnia and Herzegovina

5.4

8.9

…

5.3

x

0.7

8.2

4.6

0.7

942

35

Botswana

43.6

31.4

x

…

9.0

x,y

…

31.0

0.0

2.1

796

100

Brazil

16.4

7.1

x

7.3

8.1

y

3.9

66.7

0.0

18.2

821

89

Brunei Darussalam

10.2

19.7

x

9.6

…

…

20.8

0.0

0.2

896

64

Bulgaria

10.4

…

8.6

…

8.4

36.8

0.0

0.4

917

49

Burkina Faso

88.6

32.9

42.0

39.2

x

31.5

107.2

0.0

4.9

541

165

Burundi

81.7

57.5

25.4

26.3

x

8.6

x

27.9

4.9

2.3

650

141

Cabo Verde

24.5

…

11.6

6.4

y

8.1

x

73.2

0.0

3.0

851

85

Cambodia

28.7

32.4

22.8

19.3

y

15.6

a

52.2

0.1

0.9

753

117

Cameroon

87.9

31.7

24.1

47.0

y

20.1

a

102.4

0.9

4.9

585

159

Canada

4.9

…

…

…

9.5

0.0

0.8

–

–

Central African Republic

130.1

40.7

48.4

28.5

x

54.9

x

90.7

19.3

5.0

428

169

Chad*

138.7

39.9

48.7

26.1

x

38.3

a

129.8

0.8

4.8

473

167

Chile

8.1

1.8

5.6

6.6

y

5.7

47.5

0.0

2.6

913

53

China*

10.7

9.4

x

11.6

0.6

928

41

Colombia

15.9

12.7

x

7.3

9.7

22.1

752

118

Comoros

73.5

32.1

26.9

22.0

Congo*

45.0

21.2

10.4

Costa Rica

9.7

5.6

Côte d'Ivoire*

92.6

29.6

38.4

Croatia

4.3

…

Cuba

5.5

…

x

y

c

3.1

b

7.3

0.0

13.7

x

48.7

15.4

67.1

0.1

2.2

688

129

116.1

0.4

3.2

728

124

16.1

a

c

4.1

9.0

56.0

0.0

3.4

892

66

26.4

20.7

135.6

1.7

3.8

586

158

4.3

…

2.0

9.2

0.9

0.2

969

25

9.5

…

15.8

45.1

0.1

1.4

903

61

6.7

… Data are unavailable or outdated (i.e., pre-2005)
x Data refer to the most recent year available during the period 2005-2010.
y Data differ from the standard definition (interpret with caution).
z Data are from the secondary source (interpret with caution).
§ Includes Eastern and Southern Africa, West and Central Africa, Djibouti, Sudan‡ Central and Eastern Europe and the Commonwealth of Independent Statesza+ Data refer to the most recent year available during the reference period.
a Estimate from recent MICS or DHS (pending reanalysis)b Estimate does not include consensual unions.
c There is evidence of recruitment and use of children (e.g., as child soliders).
d Includes displaced populations from Serbia and Kosovo** Excludes China*To include as many countries as possible in the rankings, school attendance data for these 27 countries were pulled from surveys because recent enrollment data were not available.
Note: For indicator definitions, primary and secondary data sources, prevalence thresholds and regional classifications, see Methodology and Research Notes.
Page 30

2015

0.9

973

23.3

2016

3.1

0.3

z

2015

…

0.0

16.4

2011-2016+

…

13.8

y

2011-2016+

…

b

…

2011-2016+
3.0

0.5

x,z

2011-2016+

…

…

x,z

Child
homicide rate
(deaths per
100,000
population
aged 0-19)

…

54

x

Population
forcibly
displaced by
conﬂict(% of total)

3.4

67

2.2

Adolescentbirth rate
(births per
1,000 girls
aged 15-19)

2.7

912

x

Adolescentscurrently
married orin union(% girls aged
15-19)

Czech Republic883xChildrenengaged inchild labor(% ages
5-14)

Cyprus0.3b,xOut-of-school
children ofprimary andsecondaryschool age
(%)

71

2.0

x

Child
stunting(% children
aged 0-59
months)

152

0.7

a

Child is a Victim
of Extreme Violence

877

0.0

x

Child Hasa Child

602

22.5

y

Child
Marries

1.3

63.8

x

2015

Child Begins
Work Life

2.1

c

x

x,y

Indicator

Rank

x

x

Under-5
mortality rate
(deaths per
1,000 live
births)Child is Out
of School(out of 172)

7.9

3.9

Child isSeverely
Malnourished(out of 1,000)

12.7

4.4
x

Child
Dies

Childhood Ender

Shading reﬂects
prevalence:
ModerateHigh
Very High

z

38.4

y

…

b,x

End ofChildhoodIndex 2017

Score

Rank

(out of 1,000)(out of 172)

0.2

978

10

0.1

–

–

2.5

862

78

6.6

558

162

0.0

0.4

972

21

c

7.7

x

4.2

b,x

21.2

0.2

2.3

715

127

14.6

12.8

y

27.5

a

97.3

0.0

11.8

741

120

25.2

6.2

3.0

y

20.0

x

75.6

0.1

3.3

808

95

24.0

22.3

7.2

7.0

y

14.4

b

51.3

0.0

2.9

830

88

El Salvador

16.8

14.0

10.1

19.0

y

21.0

a

64.9

1.1

22.4

723

126

Equatorial Guinea

94.1

26.2

x

…

…

22.0

107.5

0.0

1.2

601

153

x

63.1

…

…

53.0

9.2

2.2

608

151

3.7

…

4.4

12.4

0.0

0.5

967

26

27.4

19.0

56.6

0.2

3.0

657

139

45.2

0.1

1.2

883

67

x

Eritrea

46.5

50.3

Estonia

2.9…

Ethiopia*

59.2

38.4

Fiji

22.4

…

7.8

…

7.6

Finland

2.3

…

2.0

…

0.5

6.4

0.0

0.6

983

3

France

4.3

…

0.3

…

2.7

8.8

0.0

0.4

976

14

Gabon*

50.8

17.5

9.3

z

13.4

13.5

97.7

0.0

2.7

775

107

Gambia*

68.9

24.5

34.5

z

19.2

x

23.8

112.5

1.3

4.6

645

143

Georgia

11.9

11.3

x

4.0

18.4

x

10.6

38.3

7.2

1.6

851

85

Germany

3.7

1.3

x

…

…

6.4

0.0

0.5

978

10

Ghana

61.6

18.8

14.5

21.8

66.1

0.1

4.8

761

111

Greece

4.6

…

3.6

…

1.8

7.2

0.0

0.4

973

18

Grenada

11.8

…

6.2

…

…

29.6

0.3

0.5

–

–

Guatemala

29.1

46.5

22.5

25.8

80.1

0.3

16.0

624

147

Guinea

93.7

31.3

39.9

28.3

139.6

0.3

4.5

546

163

Guinea-Bissau*

92.5

27.6

34.5

Guyana

39.4

12.0

15.0

Haiti*

69.0

21.9

9.9

Honduras

20.4

22.7

19.0

15.3

Hungary

5.9

…

5.3

Iceland

2.0

…

India

47.7

Indonesia
Iran (Islamic Republic of)

a

34.8

z

b,x

x

2.0
y

y

6.4

19.8

a

a

33.2

51.1

a,y

11.4

a

87.5

0.2

5.3

589

156

18.3

y

13.3

a

87.6

0.1

5.3

771

108

12.1

38.9

0.5

10.7

733

121

22.6

64.3

2.6

32.8

648

142

…

0.6

17.7

0.0

0.3

962

29

6.4

…

0.6

5.7

0.0

0.0

979

8

38.7

18.6

11.8

x

21.1

23.3

0.0

1.0

754

116

27.2

36.4

14.3

6.9

x,y

12.8

49.2

0.0

1.8

793

101

15.5

6.8

11.9

11.4

x,y

21.1

b

26.3

0.2

1.2

860

80

Iraq

32.0

22.6

22.0

4.7

20.7

b

84.8

13.2

6.0

730

123

Ireland

3.6

…

0.8

…

1.1

10.1

0.0

0.3

980

7

Israel

4.0

…

2.0

…

2.8

9.3

0.0

0.8

972

21

Italy

3.5

…

2.8

…

1.5

5.9

0.0

0.2

979

8

Jamaica

15.7

5.7

…

3.3

3.4

58.8

0.1

10.3

872

73

Japan

2.7

7.1

1.1

…

0.6

4.0

0.0

0.2

974

16

x

… Data are unavailable or outdated (i.e., pre-2005)
x Data refer to the most recent year available during the period 2005-2010.
y Data differ from the standard definition (interpret with caution).
z Data are from the secondary source (interpret with caution).
§ Includes Eastern and Southern Africa, West and Central Africa, Djibouti, Sudan‡ Central and Eastern Europe and the Commonwealth of Independent States

x,z
z

x

24.4
y

b

b

b,x

c

+ Data refer to the most recent year available during the reference period.
a Estimate from recent MICS or DHS (pending reanalysis)b Estimate does not include consensual unions.
c There is evidence of recruitment and use of children (e.g., as child soliders).
d Includes displaced populations from Serbia and Kosovo** Excludes China*To include as many countries as possible in the rankings, school attendance data for these 27 countries were pulled from surveys because recent enrollment data were not available.
Note: For indicator definitions, primary and secondary data sources, prevalence thresholds and regional classifications, see Methodology and Research Notes.

Shading reﬂects
prevalence:
ModerateHigh
Very High
Page 31COMPLETE END OF CHILDHOOD INDEX 2017
Child
Dies

Child isSeverely
Malnourished

Under-5
mortality rate
(deaths per
1,000 live
births)2015

Childhood Ender

Indicator

Child is Out
of School

Child Begins
Work LifeChild
Marries

Child Hasa ChildChild
stunting(% children
aged 0-59
months)Out-of-school
children ofprimary andsecondaryschool age(%)

Childrenengaged inchild labor(% ages
5-14)

Adolescentscurrently
married orin union(% girls aged
15-19)

Adolescentbirth rate
(births per
1,000 girls
aged 15-19)

Population
forcibly
displaced by
conﬂict(% of total)Childhomicide rate
(deaths per
100,000
population
aged 0-19)

2011-2016+2011-2016+2011-2016+2011-2016+

2015

2016

2015

Jordan

17.9

7.8

10.2

1.6

x,y

5.9

Kazakhstan

14.1

8.0

1.0

2.2

x

4.6

Kenya

49.4

26.0

13.2

…

Kiribati

55.9

…

…

Kuwait8.6

5.8

Kyrgyzstan

21.3

Lao People's
Democratic Republic

66.7

Latvia

7.9

…

4.5

…

Lebanon

8.3

…

20.1

1.9

Lesotho

90.2

33.2

24.1

…

Liberia*

69.9

32.1

18.8

Libya

13.4

21.0

Lithuania

5.2

Luxembourgb

COMPLETE END OF CHILDHOOD INDEX 2017Child is a Victim
of Extreme Violence

End ofChildhoodIndex 2017

Score

Child
Dies

Child isSeverely
Malnourished

Under-5
mortality rate
(deaths per
1,000 live
births)2015

Childhood Ender

IndicatorRank(out of 1,000)(out of 172)Child is Out
of School

Child Begins
Work LifeChild
Marries

Child Hasa ChildChild
stunting(% children
aged 0-59
months)Out-of-school
children ofprimary andsecondaryschool age(%)

Childrenengaged inchild labor(% ages
5-14)

Adolescentscurrently
married orin union(% girls aged
15-19)

Adolescentbirth rate
(births per
1,000 girls
aged 15-19)

Population
forcibly
displaced by
conﬂict(% of total)Childhomicide rate
(deaths per
100,000
population
aged 0-19)

2011-2016+2011-2016+2011-2016+2011-2016+

2015

2016

2015

14.8

Rank

(out of 172)

0.1

1.2

915

51

Papua New Guinea

57.3

49.5

…

…

54.4

0.0

4.4

674

136

0.0

0.9

935

40

Paraguay

20.5

10.9

15.4

27.6

y

…

56.9

0.0

2.3

790

102

90.2

0.0

2.4

750

119

Peru

16.9

14.6

7.6

33.5

x,y

11.3

48.4

0.0

6.2

788

103

4.3

5.2

11.1

y

2.7

x

x

11.9

a

…

15.8

x

16.4

0.0

–

–

Philippines

28.0

30.3

9.7

62.7

0.3

807

96

9.0

…

4.9

b,x

9.4

0.0

0.7

938

38

Poland

5.2

…

5.0

…

1.2

13.1

0.0

0.2

967

26

12.9

11.0

25.8

y

13.9

a

39.2

0.1

1.9

816

91

Portugal

3.6

…

1.2

…

0.6

b

9.4

0.0

0.3

981

6

43.8

21.2

10.1

x,y

24.8

63.7

0.1

3.7

684

130

Qatar

8.0

…

4.0

…

4.0

a,b

10.5

0.0

2.9

947

34

Republic of Korea

3.4

2.5

3.4

…

0.4

b,x

1.6

0.0

0.9

978

10

Republic of Moldova

15.8

6.4

17.9

16.3

9.9

22.0

0.2

0.4

867

76

Romania

11.1

…

12.1

…

6.7

34.0

0.0

0.5

914

52

Russian Federation*

9.6

…

1.3

z

…

7.5

22.7

0.1

1.3

940

37

Rwanda*

41.7

37.9

16.1

x,z

28.5

25.6

2.6

1.6

757

112

Saint Lucia

14.3

2.5

10.8

x

3.9

5.0

53.4

0.7

6.9

883

67

18.3

…

4.9

x

…

…

50.3

1.8

1.7

–

–

z

20.8

2.6
x
x

13.3

0.0

0.8

956

30

3.3

b,x

12.2

0.2

1.7

924

45

17.7

a

93.2

0.0

8.8

611

150

14.3

107.1

0.2

4.1

681

132

x

x

x

3.1

a

x
a

…

6.2

7.1

0.9

–

–

…

2.1

…

2.1

10.4

0.0

0.6

970

24

1.9

…

8.8

…

1.0

5.7

0.0

0.1

973

18

St. Vincent and
the Grenadines

Madagascar*

49.6

49.2

x

28.7

22.9

y

33.7

x

114.8

0.0

5.5

587

157

Samoa

17.5

…

8.4

…

Malawi

64.0

37.1

a

14.5

39.3

y

23.5

a

135.3

0.0

0.4

619

149

Sao Tome and Principe

47.3

17.2

7.2

26.0

Malaysia

7.0

17.7

17.0

…

6.0

b,x

13.7

0.0

1.1

894

65

Saudi Arabia

14.5

9.3

x

5.6

Maldives*

8.6

20.3

x

1.6

…

5.0

b,x

6.2

0.0

1.2

920

48

Senegal

47.2

20.5

a

43.3

Mali

114.7

30.4

a

47.3

55.8

38.9

a

173.7

1.3

6.2

414

170

Serbia

6.7

6.0

3.9

Malta

6.4

…

10.4

…

0.5

16.4

0.0

0.3

953

31

Seychelles

13.6

7.9

7.4

Marshall Islands

36.0

…

22.7

…

21.1

x

85.0

0.0

…

–

–

Sierra Leone*

120.4

37.9

28.2

z

Mauritania

84.7

27.9

36.7

37.6

27.8

a

77.9

1.1

5.2

591

155

Singapore

2.7

…

20.8

x

Mauritius

13.5

…

8.5

…

28.3

0.0

0.6

917

49

Slovakia

7.3…

Mexico

13.2

12.4

15.2

10.4

a

15.4

a

62.2

0.1

5.5

819

90

Slovenia

2.6…

Mongolia

22.4

10.8

8.6

x

15.2

y

5.3

a

15.0

0.2

2.0

880

70

Solomon Islands

28.1

32.8

x

31.2

Montenegro*

4.7

9.4

3.3

z

12.5

y

2.1

12.0

0.4

0.7

926

44

Somalia*

136.8

25.9

x

Morocco

27.6

14.9

15.9

8.3

x

11.0

31.4

0.0

0.6

853

83

South Africa

40.5

23.9

78.5

43.1

27.1

22.2

x

136.9

0.0

0.9

92.6

31.1

29.4

…

12.5

16.2

1.8

1.5

757

112

Spain

4.1

…

0.7

…

8.3

…

5.4

76.2

0.1

3.7

777

105

Sri Lanka

9.8

14.7

10.1

2.5

x,y

9.0

x

14.2

18.9

…

18.3

0.0

…

–

–

State of Palestine

21.1

7.4

14.3

5.7

x

9.3

a,b

25.0

24.9

y

21.2

13.8

4.1

x

7.3

x

x

a
a

a

x,z

x,z

Myanmar

50.0

29.2

Namibia

45.4

23.1

Nauru

35.4

24.0

Nepal

35.8

37.4

13.4

37.4

Netherlands

3.8

…

1.0

New Zealand

5.7

…

2.0

Nicaragua

22.1

23.0

95.5

43.0

14.9
x

x

10.4

x

x

a,y

a,y

7.0

y

b

37.1
b
x

105.3

z

z

c

c

160

578

South Sudan*

x

24.3

0.0

1.0

909

58

15.3

a

83.5

0.0

3.6

756

114

…

4.5

b,x

8.4

0.0

2.5

922

47

14.5

21.3

a

76.9

0.2

3.5

699

128

3.1

18.7

3.3

0.3

928

41

…

…

56.9

0.0

1.4

871

74

37.4

18.8

116.7

0.2

7.3

546

163

…

0.4

3.8

0.0

0.9

949

33

…

…

1.6

19.9

0.0

0.3

–

–

2.8

…

0.5

3.6

0.0

0.0

985

1

x

…

12.5

x

47.4

0.0

1.3

766

109

48.8

x,z

49.0

24.6

b,x

102.6

20.8

2.5

470

168

x

14.4

x

3.3

44.4

0.0

9.0

788

103

x

67.5

x,z

40.1

63.4

22.2

1.7

488

166

0.0

0.2

976

14

0.9

0.9

903

61

58.1

2.2

2.5

858

82

a,b

72.1

9.6

3.3

639

144

11.8

x

45.7

0.0

4.5

859

81

4.3

x

67.2

0.0

4.1

777

105

0.4

5.7

0.0

0.6

982

4

0.4

2.8

0.0

0.3

974

16

38.9

65.4

1.0

668

137

37.8

0.0

0.3

812

94

44.6

0.0

0.9

852

84

17.3

0.5

0.5

910

56

24.2

71.3

0.1

1.8

680

134

Sudan*

70.1

38.2

…

1.9

3.9

0.0

0.3

982

4

Suriname

21.3

8.8

…

0.5

b,x

23.3

0.0

0.7

964

28

Swaziland

60.7

25.5

19.7

…

24.2

x

88.1

0.1

6.3

766

109

Sweden

3.0

…

2.1

201.2

0.8

6.7

3.9

…

6.9

4.9

54.6

30.5
24.7

59.8

172

384

Switzerland

x

9.5

x,z

y

x

…
…

…
…

Nigeria*

108.8

32.9

32.0

28.8

109.3

1.4

578

160

Syrian Arab Republic

12.9

43.1

4.0

Norway

2.6

…

2.3

…

0.1

5.9

0.0

0.2

985

1

Tajikistan

44.8

26.8

10.5

10.0

x

13.2

Oman

11.6

14.1

3.7

…

3.3

a,b

7.5

0.0

1.4

927

43

Thailand

12.3

16.3

10.1

8.3

x

16.3

Pakistan

81.1

45.0

42.9

…

13.1

b

38.3

0.7

5.4

621

148

5.5

4.9

13.1

Panama

17.0

19.1

7.7

5.6

14.1

a

73.7

0.0

11.1

800

99

The former Yugoslav
Republic of Macedoniax… Data are unavailable or outdated (i.e., pre-2005)
x Data refer to the most recent year available during the period 2005-2010.
y Data differ from the standard definition (interpret with caution).
z Data are from the secondary source (interpret with caution).
§ Includes Eastern and Southern Africa, West and Central Africa, Djibouti, Sudan‡ Central and Eastern Europe and the Commonwealth of Independent Statesyc+ Data refer to the most recent year available during the reference period.
a Estimate from recent MICS or DHS (pending reanalysis)b Estimate does not include consensual unions.
c There is evidence of recruitment and use of children (e.g., as child soliders).
d Includes displaced populations from Serbia and Kosovo** Excludes China*To include as many countries as possible in the rankings, school attendance data for these 27 countries were pulled from surveys because recent enrollment data were not available.
Note: For indicator definitions, primary and secondary data sources, prevalence thresholds and regional classifications, see Methodology and Research Notes.

Shading reﬂects
prevalence:
ModerateHigh
Very Highx… Data are unavailable or outdated (i.e., pre-2005)
x Data refer to the most recent year available during the period 2005-2010.
y Data differ from the standard definition (interpret with caution).
z Data are from the secondary source (interpret with caution).
§ Includes Eastern and Southern Africa, West and Central Africa, Djibouti, Sudan‡ Central and Eastern Europe and the Commonwealth of Independent States

x

12.5

b,x

x

3.5

x

z

c

7.0
y

27.5

Page 32

Score(out of 1,000)

27.2

…

Niger

End ofChildhoodIndex 2017

22.6

…

MozambiqueChild is a Victim
of Extreme Violence

9.7

4.3

b,x
a

d

c
c

c

c

+ Data refer to the most recent year available during the reference period.
a Estimate from recent MICS or DHS (pending reanalysis)b Estimate does not include consensual unions.
c There is evidence of recruitment and use of children (e.g., as child soliders).
d Includes displaced populations from Serbia and Kosovo** Excludes China*To include as many countries as possible in the rankings, school attendance data for these 27 countries were pulled from surveys because recent enrollment data were not available.
Note: For indicator definitions, primary and secondary data sources, prevalence thresholds and regional classifications, see Methodology and Research Notes.

z

Shading reﬂects
prevalence:
ModerateHigh
Very High
Page 33

COMPLETE END OF CHILDHOOD INDEX 2017
Child
Dies

Child isSeverely
Malnourished

Under-5
mortality rate
(deaths per
1,000 live
births)2015

Childhood Ender

Indicator

Child is Out
of School

Child Begins
Work LifeChild
Marries

Child Hasa ChildChild
stunting(% children
aged 0-59
months)Out-of-school
children ofprimary andsecondaryschool age(%)

Childrenengaged inchild labor(% ages
5-14)

Adolescentscurrently
married orin union(% girls aged
15-19)

Adolescentbirth rate
(births per
1,000 girls
aged 15-19)

Population
forcibly
displaced by
conﬂict(% of total)Childhomicide rate
(deaths per
100,000
population
aged 0-19)

2011-2016+2011-2016+2011-2016+2011-2016+

2015

2016

2015

…

7.7

Timor-Leste

52.6

50.2

9.5

Togo*

78.4

27.5

17.3

16.7

8.1

12.6

Tonga

z

27.9

y

…

Child is a Victim
of Extreme Violence

End ofChildhoodIndex 2017

Score

Rank

(out of 1,000)(out of 172)

45.5

0.0

3.4

732

122

12.7

92.1

0.2

3.9

684

130

4.6

14.9

0.1

0.9

910

56

877

71

x

Trinidad and Tobago*

20.4

…

5.4

x,z

Tunisia*

14.0

10.1

15.6

z

1.2

b

6.8

0.0

0.6

924

45

Turkey

13.5

9.5

9.0

5.9

y

6.6

b

26.8

0.1

0.9

905

59

Turkmenistan

51.4

11.5

a

…

0.3

a,y

6.0

a

16.0

0.0

1.3

865

77

Tuvalu

27.1

10.0

x

17.4

…

8.0

b,x

42.0

0.0

…

–

–

Uganda

54.6

34.2

20.3

Ukraine

9.0

…

2.7

6.8

…

…

United Arab Emirates

x

0.7
2.1

x

4.3

681

132

2.4

6.4

23.4

4.4

0.5

937

39

…

6.7

30.1

0.0

0.8

–

–

13.9

0.0

0.7

971

23

United Republic of Tanzania*

48.7

34.4

30.2

United States of America

6.5

2.1

5.1

…

Uruguay

10.1

10.7

8.5

7.9

Uzbekistan

39.1

19.6

5.0

…

Vanuatu

27.5

28.5

…

15.2

Venezuela (Bolivarian Republic of)

14.9

13.4

12.0

…

Vietnam*

21.7

24.9

13.3

16.4

y

Yemen

41.9

46.5

Zambia*

64.0

40.0

Zimbabwe

70.7

26.8

31.1
21.0
a

z

28.8

b,x

2.9

…

0.7

z

x,z

0.5

…

x

0.0

108.9

y

4.2

x

30.8

12.1

20.0

16.3

United Kingdom

x,z

6.3

x

y
x,y
y

23.0

a

117.7

0.0

2.6

635

145

5.8

x

21.2

0.0

2.5

941

36

7.4

a

55.8

0.0

3.7

871

74

4.9

x

17.6

0.0

0.7

862

78

11.5

x

42.7

0.0

0.6

807

96

79.1

0.1

27.0

724

125

39.1

0.3

1.5

815

92

60.7

11.4

2.7

653

140

87.9

0.0

2.5

633

146

108.9

0.4

3.0

664

138

…
10.3

a

22.7

x

16.7

b

40.6

x,y

16.9

24.0

…

19.6

a

c

Global and Regional Averages+
Sub-Saharan Africa§

83.1

35.2

29.0

27.5

24.0

122.0

1.8

4.2

596

–

Eastern andSouthern Africa

66.5

35.7

27.0

26.2

20.7

113.8

1.4

3.4

631

–

West and Central Africa

98.7

34.4

31.2

28.5

27.1

130.0

1.5

5.1

565

–

Middle East and North Africa

28.9

17.9

17.2

10.1

14.1

52.0

5.4

2.5

802

–

South Asia

52.5

36.2

22.4

12.4

z

29.0

44.3

0.3

1.7

715

–

East Asia and Pacific

17.8

10.2

12.5

10.0

**

5.9

22.3

0.1

1.1

887

–

Latin America andCaribbean

17.9

10.1

10.1

8.5

10.6

74.3

1.3

12.6

807

–

CEE/CIS‡

17.1

9.6

5.6

5.4

7.2

29.5

0.9

0.9

904

–

Developed regions

5.8

4.2

3.2

...

...

15.6

0.2

1.1

952

–

World

42.5

23.2

17.8

12.6

14.4

50.4

3.0

780

–

z

z
z**

z

z

0.9

z

The designations employed in this report do not imply the expression of any opinion whatsoever on the part of Save the Children
concerning the legal status of any country or territory or concerning the delimitation of its frontiers or boundaries.
… Data are unavailable or outdated (i.e., pre-2005)
x Data refer to the most recent year available during the period 2005-2010.
y Data differ from the standard definition (interpret with caution).
z Data are from the secondary source (interpret with caution).
§ Includes Eastern and Southern Africa, West and Central Africa, Djibouti, Sudan‡ Central and Eastern Europe and the Commonwealth of Independent States+ Data refer to the most recent year available during the reference period.
a Estimate from recent MICS or DHS (pending reanalysis)b Estimate does not include consensual unions.
c There is evidence of recruitment and use of children (e.g., as child soliders).
d Includes displaced populations from Serbia and Kosovo** Excludes China*To include as many countries as possible in the rankings, school attendance data for these 27 countries were pulled from surveys because recent enrollment data were not available.
Note: For indicator definitions, primary and secondary data sources, prevalence thresholds and regional classifications, see Methodology and Research Notes.
Page 34

Shading reﬂects
prevalence:

A few years ago, Remember* went to stay with her
uncle in Monrovia, Liberia, so she could go to school
there. But her uncle made her stay at home andwork as a servant. Four days after she arrived, he
raped her, and she became pregnant. She is now 17
and lives with her daughter at a home supported by
Save the Children.
* name changed to protect identity

ModerateHigh
Very High
Photo: Hannah Maule-Ffinch / Save the Children

Page 35METHODOLOGY AND RESEARCH NOTESEvery child has a right to childhood. The conceptof childhood is defined in the Convention on the
Rights of the Child (CRC).66 It represents a sharedvision of childhood: healthy children in school andat play, growing strong and confident with the loveand encouragement of their family and an extended
community of caring adults, gradually taking on the
responsibilities of adulthood, free from fear, safe fromviolence, protected from abuse and exploitation. This
ideal contrasts starkly with the childhood many children
experience.
Countries differ greatly in their ability to protect
childhood. The End of Childhood Index explores thisvariation across countries, revealing where and how
children are being robbed of the childhoods they deserve.
The hope is it will stimulate discussion and action toensure that every last child fully experiences childhood.
Childhood Enders
This index does not capture the full extent ofdeprivations or hardships affecting children. Instead, it
focuses on some key rights or "guarantees" of childhood:
life, healthy growth and development, education andprotection from harm. If a child experiences all of these,
his/her childhood is considered to be "intact."
The index tracks a series of events that, should any
one of them occur, mark the end of an intact childhood.
These events are called "childhood enders" and include:
child dies, malnutrition permanently impairs child'sdevelopment, child leaves or fails to enter school, child
begins work life, child marries, child has a child, and childis a victim of extreme violence.
Ender events erode childhood. Depending on thenumber and severity of enders experienced, the loss ofchildhood could be complete or only partial.67 But once achild experiences an ender, childhood becomes fractured
rather than complete.68 Each event represents an assault
on childhood. At some point, as the assaults mount up,
childhood ends.
Countries are scored and ranked according toperformance across this set of enders, revealing wherechildhood is most and least threatened.
Indicators, Definitions and Data Sources
The following 8 indicators were selected because they
best represent these enders, are available for a large
number of countries and are regularly updated.69 Data
were obtained from reliable and reputable sources,
almost exclusively UN agencies, and are publicly
available to those interested in doing additional analyses.
Under-5 mortality rate (U5MR): The probabilityof dying between birth and exactly 5 years of age,
expressed per 1,000 live births. Estimates are for 2015.
Source: UN Inter-agency Group for Child Mortality Estimation(childmortality.org).

Ender

Indicator

Child dies

Under-5 mortality rate

Child is severely malnourishedChild stunting (%)

Child is out of school

Out-of-school children, adolescents and youth (%)

Child begins work life

Child labor (%)

Child marries

Adolescents currently married or in union (%)

Child has a child

Adolescent birth rate

Child is a victim of extreme violence

Population forcibly displaced by conflict (%)

Child is a victim of extreme violenceChild homicide rate

Childhood means more than just the time between birth and adulthood. It refers to the state and condition of a child's life – to the quality of those years. As themost widely endorsed human rights treaty in history, the Convention on the Rights of the Child, adopted by the UN General Assembly in 1989 and ratified by
all but two countries, represents a global consensus on the terms of childhood. Although there is not absolute agreement on the interpretation of each and every
provision of the Convention, there is substantial common ground on what the standards of childhood should be. Source: UNICEF. The State of the World'sChildren 2005.
67
In some cases, enders unequivocally signal the end of childhood (e.g., death). Others (e.g., departure from school; child labor) may only chip away at childhood,especially if remedial action is taken (e.g., child re-enrolls in school; child stops working).
68
This does not mean that children who experience enders are not still children or that they cannot still enjoy some aspects of childhood. A child who is out ofschool, for example, may still learn other skills at home. Refugee children still play and may study if the right policies and programs are in place. And even though
they've taken on adult roles and responsibilities, child brides and teen mothers are still children entitled to protection and support.
69
Other selection criteria included: reliability, face validity, comparability, policy relevance, news-worthiness, contemporaneity and alignment with SDG targets.

Child stunting (moderate and severe): Percentage
of children aged 0–59 months who are below minus twostandard deviations from median height-for-age of the
WHO Child Growth Standards. Estimates are for themost recent year available 2005-2016. Sources: UNICEF,
WHO, World Bank Group. Joint Child Malnutrition Estimates2016 edition (data.unicef.org/topic/nutrition/malnutrition/#),updated with data from recent MICS and DHS surveys for
12 countries (see Complete End of Childhood Index).
Out-of-school rate (OOSC) for children,
adolescents and youth of primary and secondary
school age: The number of children, adolescentsand youth of official primary and secondary school
age who are not enrolled70 in primary, secondary or
higher levels of education, expressed as a percentageof the population of official school age. Children
and young people (about ages 6 and over) who areenrolled in pre-primary education are considered tobe out of school.71 Data are for the most recent year
available 2005-2016. Sources: UNESCO's UIS.Stat (data.
uis.unesco.org), supplemented with household survey datafrom UNESCO's World Inequality Database on Education(education-inequalities.org) for 27 countries (see Complete
End of Childhood Index). Note: Household survey data
were used to estimate OOSC rates only where official
data were unavailable or outdated (i.e., pre 2005).
Rates were derived by dividing the number of children,
adolescents and youth out of school (calculated as:
primary OOSC*primary population + lower secondary
OOSC*lower secondary population + upper secondary
OOS *upper secondary population) by the total
population of official primary and secondary school age.
Official school age population data were sourced fromUIS.Stat and refer to the same OOSC reference year.
Child Labor: Percentage of children aged 5-14 years
engaged in child labor.72 Data are for the most recent
year available 2005-2016. Sources: UNICEF (data.unicef.org/
topic/child-protection/child-labour), updated with data fromrecent MICS and DHS surveys for six countries(see Complete End of Childhood Index).
Adolescents currently married or in union:
Percentage of girls 15 to 19 years of age who havebeen married and are not either divorced, widowed or
separated. Data including consensual unions or othertypes of customary unions are prioritized. Where
unions have not been reported together with currently
married, this omission is marked with a "b" in the index
table. Data are for 2005-2016. Where more than one
data point was available for the same reference year,
the lowest value was used. Sources: United Nations,

Department of Economic and Social Affairs (UNDESA),
Population Division. World Marriage Data 2015, updatedwith data from recent MICS and DHS surveys for 38 countries(see Complete End of Childhood Index).
Adolescent birth rate: Births to women aged 15
to 19 per 1,000 women in that age group. Estimates
are for 2015 for all but three countries that have datafrom the most recent year available 2005-2015. Sources:
World Development Indicators, World Bank (data.worldbank.
org/indicator/SP.ADO.TFRT), supplemented with data forthree countries (see Complete End of Childhood Index) fromthe SDG Indicators Global Database (unstats.un.org/sdgs/
indicators/database/?indicator=3.7.2).
Population forcibly displaced by conflict orpersecution: Total population of concern to UNHCR,73
by country or territory of origin, expressed as apercentage of the country's or territory's population.
Data are for mid-2016. Sources: UNHCR. Mid-Year Trends
2016. (Geneva: 2017) and UNDESA, Population Division.
World Population Prospects: The 2015 Revision. Note: For
the purpose of this analysis, 2016 population projections
were used.
Evidence of child soldiers: Countries identified
as having parties to conflict that engaged in the
recruitment and use of child soldiers in 2015. The term
"child soldier" refers to any person below 18 years ofage who is, or who has been, recruited or used by anarmed force or armed group in any capacity, including
in a support role, such as a cook, porter, messenger,
medic, guard, spy or sex slave. Source: Children and Armed
Conflict: Report of the Secretary-General, Annex I and Annex II(childrenandarmedconflict.un.org/countries-caac). Note: This
indicator is not factored into the index score but has
been noted in the table.
Child homicide rate: Estimated number of deaths
caused by interpersonal violence among children andadolescents aged 0 to 19 years (from WHO or IHME),
expressed per 100,000 population in that age group(from UNDESA, Population Division). Estimates arefor 2015. Sources: WHO. Global Health Estimates 2015:
Deaths by Cause, Age, Sex, by Country and by Region, 20002015 and UNDESA, Population Division. World Population
Prospects: The 2015 Revision, supplemented with data forState of Palestine from Institute for Health Metrics and
Evaluation (IHME). Global Burden of Disease Study 2015
(ghdx.healthdata.org/gbd-results-tool).

66

Page 36
38

For the 27 countries where household survey data are used, the indicator represents the share of school-age children not attending school.
The current international standard is to treat children of primary age or older enrolled in pre-primary education as out of school because preprimary education does not meet the same education standards as formal primary or higher education. This may result in an overestimate of
the rate of children who are not in school, in particular in countries where pre-primary education is compulsory.
72
A child is considered to be involved in child labor under the following conditions: (a) children 5–11 years old who, during the reference week, didat least one hour of economic activity or at least 28 hours of household chores, or (b) children 12–14 years old who, during the reference week,
did at least 14 hours of economic activity or at least 28 hours of household chores. Many MICS now include data on child laborers aged 15-17:
at least 43 hours of economic or unpaid household services per week.
73
Includes refugees, asylum-seekers, internally displaced persons (IDPs), returnees (refugees and IDPs) and others of concern who do notnecessarily fall directly into any of the other groups but to whom UNHCR may extend its protection and/or assistance services.
70
71

Page 37

XN = (X – Worst)/(Best – Worst)
Where:
XN is the normalized value
X is the actual value
Worst is the highest observed value for the indicator
Best is the lowest possible value for the indicator
This technique ensures scores range between 0 and 1
and that all indicators are coded positively (i.e., higherscores indicate better performance).

All indicators are weighted equally. The overall index
score was calculated by summing across the normalized
scores for each indicator and then dividing by eight.
Scores were multiplied by 1,000 and rounded to three
digits. Countries were sorted from high to low by thisoverall index score (with 1,000 being the best possible
score) and then ranked from 1 to 172.
To help ensure index scores are comparable from year toyear and that countries can track progress over time, thebest (i.e., minimum) and worst (i.e., maximum) values andthe indicator weights will be fixed from this inaugural year
onwards as follows:

Ender

Indicator

Best

Worst

WeightChild dies

Under-5 mortality rate

0.0

156.9

1/8

0.0

57.5

1/8

Child is severely malnourished Child stunting (%)
Child is out of school

Out-of-school children, adolescentsand youth (%)

0.0

67.5

1/8

Child begins work life

Child labor (%)

0.0

55.8

1/8

Child marries

Adolescents currently married
or in union (%)

0.0

59.8

1/8

Child has a child

Adolescent birth rate

0.0

201.2

1/8

Child is a victim of
extreme violence

Population forcibly displacedby conflict (%)

0.0

65.4

1/8

Child is a victim of
extreme violenceChild homicide rate

0.0

32.8

1/8

Missing Values
The End of Childhood Index includes all 186 countries andareas with recent data (from 2005 and onwards) for atleast five of the eight indicators, but not all of them areincluded in the index rankings.
Countries missing homicide data were dropped
from the rankings.74 Countries missing up to any twoof the other seven indicators were allowed to remain in
the index. This was the only way to ensure a sufficientnumber of high-income OECD countries were included,
as most do not collect or publish data on stunting orchild labor.
In total, 172 countries had sufficient data to be
ranked. 92 countries have data for all eight indicators.
34 countries are missing one indicator. 46 countries are
missing two indicators, 33 are high-income countries.75

For countries lacking stunting, out-of-school orchild labor data, the normalized score for their under-5
mortality rate was used in place of the missing value(s).
Under-5 mortality is the leading indicator of childwell-being and is strongly correlated with these three
indicators.76 For countries lacking child marriage data,
the normalized score for their adolescent birth rate wasascribed. These two indicators are also high correlated.77
Ascribing fillers for these missing values helped
ensure countries weren't being rewarded for the lack ofdata and that data imputations for missing values werebased on a country's performance on another, strongly
correlated, childhood ender.

Nauru and Tuvalu
The End of Childhood Index table indicates the indicator(s) missing for these 80 countries.
76
Correlation coefficients are 0.68, 0.76 and 0.74, respectively.
77
The correlation coefficient is 0.81.
7475

Page 38

Indicator

Very low

Low

ModerateHigh

Very highUnder-5 mortality rate (per 1,000)< 10

10 to < 25

25 to < 50

50 to < 100≥ 100Child stunting (%)<5

5 to < 20

20 to < 30

30 to < 40

≥ 40

Out-of-school children andyouth (%)

<5

5 to < 20

20 to < 30

30 to < 40

≥ 40Child labor (%)<5

5 to < 20

20 to < 30

30 to < 40

≥ 40Child marriage (%)<5

5 to < 20

20 to < 30

30 to < 40

≥ 40

Adolescent birth rate (per 1,000)< 15

15 to < 50

50 to < 100

100 to < 150≥ 150

Population displaced byconflict (%)<1

1 to < 2

2 to < 5

5 to < 20≥ 20Child homicide rate (per 100,000)<1

1 to < 5

5 to < 10

10 to < 20

≥ 20

≥ 940

760 – 939

600 – 759

380 – 599

≤ 379

Performance Band

Prevalence Thresholds and Performance Bands
Country-level performance on each indicator wasassessed according to the thresholds in the table
above. Countries with "moderate," "high" or "very high"prevalence of enders were color-coded as shown.
To the greatest extent possible, indicator thresholds
were based on international standards. The classification
schemes used for U5MR and stunting are established.78
The same breakdowns for stunting were used for out-ofschool, child labor and child marriage. The breakdowns
for adolescent births were adapted from those used by
the World Bank and the WHO.79 Those for displacement
were based loosely on categories used by UNHCR fora related indicator.80 The homicide strata were adaptedfrom UNICEF and UNODC.81
To establish tiers or "performance bands," theboundary points between threshold levels werenormalized for each indicator and then indexed. Indexscores were rounded to two decimal places and thenmultiplied by 1,000 to give the cut-off points for each tier.
Countries were placed into one of 5 bands according totheir index score:Band

Calculations
As indicators are measured on different scales, each
was first normalized using a linear scaling technique:

Share of children missingout on childhood

Indexscores1

Relatively few children

≥ 940

2

Some children

760 to 939

3

Many children

600 to 759

4

Most children

380 to 599

5Nearly all children≤ 379Country Classification
The End of Childhood Index presents data for the world asa whole and for various country groupings. Regions areclassified as "developing" or "developed," as consistent
with the United Nations system.82 Developing regions
are further broken down into the subregions listed at thebottom of the index table on page 34. These groupings

are based on UNICEF's nomenclature and regionalclassification. For a list of countries and territories in eachregion, see: UNICEF, The State of the World's Children 2016,p. 112.
Regional data were sourced from the UN,83 with the
exception of out-of-school, forced displacement and childhomicide rates. Global and regional averages for thesethree indicators were calculated by Save the Children.
Each was calculated as a weighted average, with therelevant population used as the weights.84 All UNICEF
countries with available data were included in theseestimates.85 Population coverage was at or above 89
percent for all region-indicator pairs.86
The designations employed in this report do not imply
the expression of any opinion whatsoever on the partof Save the Children concerning the legal status of any
country or territory or concerning the delimitation of its
frontiers or boundaries.

See, for example, data.unicef.org/topic/child-survival/under-five-mortality/ anddata.unicef.org/topic/nutrition/malnutrition/
79
See gamapserver.who.int/mapLibrary/Files/ Maps/Global_AdolescentBirthRate_2015.png
and data.worldbank.org/indicator/SP.ADO.TFRT?view=map
80
UNHCR. Mid-Year Trends 2016. (Geneva: 2017), p.11
81
See UNICEF. Hidden in Plain Sight: A Statistical Analysis of Violence Against Children.
(New York: 2014), p.39 and UNODC. Global Study on Homicide 2013. (Vienna: 2014), p.12
82
This designation is made for the purpose of statistical analysis only. For the list of countries
belonging to "developed" and "developing" regions, see: unstats.un.org/sdgs/indicators/
regional-groups/
83
U5MR and stunting data were pulled from data.unicef.org. Data for developed regions
were pulled from the SDG Indicators Global Database (unstats.un.org/sdgs/indicators/
database/). All other world and developing sub-regional averages were pulled from SOWC
2016, with the exception of the global average for child labor, the CEE/CIS average forchild labor and child labor and child marriage rates for South Asia, which were all pulledfrom SOWC 2015; results for 2016 were not available.
84
The official primary + secondary school-aged population in 2015 (UIS.Stat), total national
population in 2016 (UN DESA) and child population aged 0-19 in 2015 (UN DESA) wereused as weights for out-of-school, displacement and child homicide averages, respectively.
The only exceptions were school-aged populations for Brazil (2014), Ukraine (2014) andSouth Korea (2016). Global aggregates were estimated in the same way for out-of-school
and child homicide (i.e., as weighted averages of country rates). But the rate of forced
displacement worldwide was calculated directly from the latest global count from UNHCR(unhcr.org/en-us/figures-at-a-glance.html) and world population data from UN DESA, bothfor the start of 2016.
85
Even if a country didn't have sufficient data to be included in the End of Childhood Index or
if it had indicator-level data, it was included in global and regional rates for that indicator.
86
Coverage exceeded 99% for all estimates except for school-age populations in developed
regions (89% coverage) and the Middle East and North Africa (90% coverage).
78

Page 39

Limitations and Caveats
It would be impossible to include all of the factors thaterode childhood in a single index. This index focuses only
on the most significant enders for which reliable andcomparable data are widely available. Some indicators(e.g., sexual violence, trafficking, hazardous work)
would have been included had there been sufficient data.
Others (e.g., incarceration, orphanhood, migration,bullying, corporal punishment, substance use) had data
but weren't included because they do not necessarily – inand of themselves – signal the end of childhood. A child
who is incarcerated, for example, can receive substantial
rehabilitation services including counseling, schoolingand a reliable network of caring adults. Many potential
indicators (e.g., child abuse) were also discarded due todata quality concerns.87
Save the Children has not independently verified thedata used in this report. To ensure the data are of thehighest quality, all data are from reputable internationalsources that closely review and adjust national data
to ensure that they are as accurate and comparable
as possible.
The index presents the most recent data available asof March 1, 2017. Data are not available for the samereference year for all indicators for all countries. Of the
172 countries ranked, 111 have very recent data (i.e.,
2010-2016) for all indicators. 61 countries have at least
one data point from 2005-2009.
For 19 countries without official education data, as
well as eight whose most recent official figures predate
2005, household survey data were used to give an
indication of the extent of exclusion from education.88
Technical Note on Global Estimate Calculation
Between 701 million and 734 million children are missingout on childhood (i.e., they have experienced one ormore childhood ender events).
These estimates include three discrete groups ofchildren: children aged 0-17 who have died (159 million89),
children aged 0-5 who are stunted (171 or 186 million90)
and children aged 6-17 who are out of primary or
secondary school (263 million91). They also include a

subset of child refugees and child IDPs (14 million92) and asubset of child laborers (94 or 112 million93) who are not
likely to already be accounted for in the other groups.
To reach this number, a series of reasonableassumptions were made based on evidence of overlap
between these groups of children, as outlined in thefootnotes and illustrated in the following graphic.
Unfortunately, avoiding the problem of double
counting leads to undercounting the number of children
missing out on childhood. This figure does not, forexample, include stunted school-aged children who arein school, young wives or mothers who are in schoolor children who have witnessed or survived extreme
violence. If and when these populations can be controlled
for, they will be added to the global estimate.
Major sources of overlap between childhood enders

Note: Population circles are to scale; the overlap between them is not.

Child is dead
159MChild is a
refugee or IDP

ACKNOWLEDGEMENTS
Child is stunted
156M+

28M
Child isout of school
263M
Child is marriedor has a child*

40M+

Child isworking+
198M*41 million girls aged 15-19 are currently married; many are already mothers.
Millions more are likely to be unmarried mothers. A majority of these girls areout of school. Once these overlaps can be reliably quantified, these populations
will be included in the global estimate.

A list of excluded indicators has been compiled and can be provided upon request.
Household surveys measure participation as attendance at any time during the preceding school year—a fairly generous approach that is not substantively dissimilar
to formal enrollment. Holding constant other reasons that survey and administrative data may differ (such as attendance in non-formal schools), one would expect
attendance to be slightly lower than enrollment since children may be officially enrolled but not attend. For the 8 countries with old enrollment data, attendance rates
are actually higher than enrollment figures, which produced a more favorable outcome.
89
Estimated by subtracting the total population aged 0-17 alive in mid-2015 from the total number of births mid-1997 to mid-2015. Source: UN DESA, Population Division.
World Population Prospects: The 2015 Revision.
90
Total includes 156 million children under age 5 and an estimated 15 or 30 million children aged 5. For the higher estimate, children aged 5 were assumed to be as
likely as children aged 0-4 to be stunted (i.e., the global under-5 stunting rate of 23.2% was applied to the 130 million children aged 5 worldwide). For the lower
estimate, children aged 5 were assumed to be half as likely to be stunted (i.e., a rate of 11.6% was used). Sources: UNICEF/WHO/World Bank Joint Child Malnutrition
Estimates, September 2016 edition; UN DESA, Population Division. World Population Prospects: The 2015 Revision91
Total includes 61 million primary school-aged children (6-11 years), 60 million lower secondary school-age children (12-14 years) and 142 million upper secondary
school-age children (15-17 years). Source: data.uis.unesco.org (Accessed April 2017)92
Total includes displaced children aged 0-5 who are not likely to be stunted (an estimated 7 million) and displaced children 6-17 who are likely to be in school (anestimated 7 million), or 14 million of the 28 million displaced children worldwide. To derive these figures, a number of assumptions were made: 1) IDP children wereassumed to have the same age breakdown as refugee children (i.e., 29% aged 0-4; 43% aged 5-11 and 29% aged 12-17); 2) Displaced children were assumed to be just as
likely to be stunted as children in their respective countries of origin (i.e., the stunting rate among displaced children was estimated as a weighted average of countrylevel stunting rates, with the total displaced population in each country used as the weight); 3) IDP children were assumed to be in school at the same rate as refugee
children are (i.e., 50% of primary school-age children; 25% of secondary school-age children). Sources: UNICEF. Uprooted: The Growing Crisis for Refugee and MigrantChildren. (New York: 2016); UNHCR. Global Trends 2015. (Geneva: 2016); popstats.unhcr.org/en/demographics (Accessed April 2017); UNICEF/WHO/World Bank
Joint Child Malnutrition Estimates, September 2016 edition; UNESCO and UNHCR. No More Excuses: Provide Education to all Forcibly Displaced People. (Paris: 2016)93
The higher estimate includes 100 million child laborers aged 5 to 14 and 12 million aged 15-17 who are likely to be in school, out of the 150 million (according
to UNICEF) and 48 million (according to ILO) laborers in these age groups, respectively. Two-thirds of laborers aged 5-14 were assumed to be in-school, as were
one-quarter of laborers aged 15-17. The lower estimate includes 82.5 million laborers aged 5-14 and 12 million aged 15-17, assuming a 55 and 25 percent in school
rate, respectively. These assumptions were based on the recent literature, including: UIS and UNICEF. Fixing the Broken Promise of Education for All: Findings fromthe Global Initiative on Out-of-School Children; Guarcello, Lyon and Rosati. "Child Labour and Out-of-School Children: Evidence from 25 Developing Countries," abackground paper for Fixing the Broken Promise of Education for All; Guarcello et al. Adolescents in Hazardous Work: Child Labour Among Children aged 15-17
years. (UCW: Rome: 2016); Understanding Children's Work. Evolution of the Relationship Between Child Labour and Education Since 2000: Evidence of 19 Developing
Countries. (UNESCO: Paris: 2015); US Department of Labor, Bureau of International Labor Affairs. 2015 Findings on the Worst Forms of Child Labor.
(Washington, DC: 2016)
87

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Page 40

This report was written and project-managed
by Tracy Geoghegan from Save the Children. The
researchers were Beryl Levinger and Nikki Gillette.
Production of this report would not have beenpossible without valuable inputs and feedback frommany colleagues across the global Save the Children
movement. Special thanks for substantive inputs andsupport at different stages to: Smita Baruah, Katri
Bertram, Patrick Crump, Laurel MacLaren, Susan Ridge,
José Manuel Roche, Sean Ryan and Patrick Watt.
We are grateful to colleagues from across
Save the Children for comments and inputs thathave helped improve and enrich the report: Ali Adamou,
Michel Anglade, Kitty Arie, Paul Butcher, Angelica
Cadavid, Wendy Christian, Ulrika Cilliers, Colin
Crowley, Penny Crump, Rob Doble, Gary Duffy, Line
Hegna, Alexis Le Nestour, Lysa John, Mike Kiernan,
Tamer Kirolos, Michael Klosson, Tom Krift, Nina Kühnel,
Kristen Lacey, Claire Leigh, Thiago Luchesi, Kirsty
McNeill, Carolyn Miles, Richard Morgan, Diana Myers,
Sara Neumann, Beatriz Ochoa, Nora O’Connell, Amado
Parawan, Devendra Singh Tak, April Sumaylo-Tesz,
Andrew Wainer, Kevin Watkins and Lisa Wise.
We thank colleagues who produced case studies
for this report who are based in country offices in
Afghanistan, Bolivia, El Salvador, India, Iraq, Niger,
Nigeria, Philippines, Sierra Leone and Somalia. Special
thanks to Natasha Dos Santos, Tracy Manners, Jess
Crombie, Alun MacDonald, Evan Schuurman andMike Sunderland for their leadership throughout the
production of the case studies, and to many others
across the movement who supported the process.
We are grateful to external reviewers for comments
on earlier drafts of the index and methodology: José
Cuesta (UNICEF Office of Research – Innocenti),
Elizabeth Stuart, Soumya Chattopadhyay and Maria
Quattri (Overseas Development Institute) and Fernando
De Paolis (Middlebury Institute of International Studies).
Many thanks to Catherine Bowden, Kandace Doyleand Charlotte Greene for project management. Thanks
also to Joe Ansah, Ian Carr, Lois Jensen and Susan
Warner for support on design and production.
Design by Gregory SmithSave the Children USA
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a healthy start in life, the opportunity to learn and protection fromharm. When crisis strikes, and children are most vulnerable, we arealways among the first to respond and the last to leave. We ensurechildren’s unique needs are met and their voices are heard.
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We do whatever it takes for children – every day and in times of crisis– transforming their lives and the future we share.

Page 44

ON THE COVER:
Seven-year-old Annie* lives with her 18-year-old
brother in a town in Liberia.Their mother and sisters
died from Ebola.They receive food assistance andpsychosocial support from Save the Children.
*name changed to protect identity
Photo: Aubrey Wade / Save the Children