A call to action:

Flooding and early

childhood development
Flooding is one of the most destructive consequences of climate change, harming both
families and children, while negatively affecting all the components of nurturing care.

As climate change intensifies, flooding has emerged as a

significant health and environmental hazard. The impact of
flooding disproportionately affects people living in poverty, with
89% of the world’s flood-exposed people living in low- and
middle-income countries.1 Between 2000 and 2015, there was an
estimated 24% increase in the proportion of people exposed to 70%
floods.2

Today, 1.81 billion people—23% of the world’s population—are

Globally, ~70% of people
directly exposed to the risk of intense flooding, with 1.24 billion
exposed to flooding are
living in South and East Asia.3 In the coming years, the proportion located in South and
of people exposed to floods will increase due to land East Asia
subsistence, coastal development and climate change, affecting
years of progress in poverty reduction and development.

Figure 1: Absolute population exposure to risk of 15 cm or more of flood inundation at the country level (millions).
South and Southeast Asia is one of the most flood-vulnerable regions in the world. Image Source: World Bank 2020.3

1. Rentschler, J., Salhab, M., & Jafino, B. A. (2022, June 28). Flood exposure and poverty in 188 countries. Nature News.
https://www.nature.com/articles/s41467-022-30727-4

2. Tellman, B., Sullivan, J.A., Kuhn, C. et al. Satellite imaging reveals increased proportion of population exposed to floods. Nature 596,
80–86 (2021). https://doi.org/10.1038/s41586-021-03695-w

3. Rentschler, Jun; Salhab, Melda. 2020. People in Harm's Way: Flood Exposure and Poverty in 189 Countries. Policy Research Working
Paper; No. 9447. © World Bank, Washington, DC. http://hdl.handle.net/10986/34655 License: CC BY 3.0 IGO.World Bank, Washington,
DC. http://hdl.handle.net/10986/34655 License: CC BY 3.0 IGO.
1
 Top 10 Countries Vulnerable to Floods
China 329.3m (22.9%)
India 225.3m (16%)
Indonesia 76.0m (27.1%)
Pakistan 71.8m (31.1)
Bangladesh 51.9m (31.6%)
Vietnam 45.5m (45.8%)
Nigeria 38.8m (18%)
Philippines 29.1m (27.7%)
Egypt 28.9m (30.1%)
Japan 27.4m (21.8%)

Figure 2: Top 10 countries with the number of people exposed to significant flood risk (as a share of total flood
population). As can be seen from the chart, most of these countries are in Asia. Image Source: World Bank 2020.3

In a joint scoping study4 by ARNEC and partners across the region, extreme flooding emerged as the
biggest concern of survey and focus group respondents. Similarly, the ISEAS 2023 climate survey5
identified flooding as a top concern among its citizens in Southeast Asia.

Some people are disproportionately affected by floods. Children, elderly people, people with
disabilities and people living in poor communities often suffer the most. Children, with their special
physiological, psychological and social needs, are particularly vulnerable during and after flooding
events.6 With more than 400 million children living in areas with extremely high flood risk in the
Asia-Pacific region,3 protecting children from flood events and its consequences is a vital priority for
early childhood development.

Figure 3: Floods in Kampung Melayu, Jakarta, Indonesia in January 2014. Floods are a recurring
threat to the city due to both land subsidence and sea level rise. Image Source: Shutterstock

4. Most vulnerable to most valuable: A scoping study to put young children at the heart of Climate Actions and Environmental
Protection. ARNEC. (2022, December).
https://arnec.net/resources/arnec-resources/most-vulnerable-most-valuable-scoping-study-put-young-children-heart-0

5. Seah, S., Martinus, M., Huda, M. S., Ludher, E. K., & Jiahui, Q. (2023, September 21). The Southeast Asia Climate Outlook: 2023 Survey
Report. ISEAS - Yusof Ishak Institute.
https://www.iseas.edu.sg/articles-commentaries/southeast-asia-climate-outlook/southeast-asia-climate-outlook-2023-survey-report/

6. UNICEF, 2015, Unless We Act Now: The Impact of climate change on Children. ISBN: 978-92-806-4826-3
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Flooding is closely linked to climate change
Many factors contribute to flooding. Weather such as heavy or prolonged rains, storm surge or
sudden snowmelt can directly trigger flood events. However, human-driven elements, including
how we manage our waterways (via dams, levees and reservoirs) and the alterations we make to
land can also have a significant role. Increased urbanization, for example, adds pavement and other
impermeable surfaces, alters natural drainage systems, and often leads to more homes being built
on floodplains. Furthermore, under-maintained infrastructure within cities can increase the risk of
urban flooding.

Increasingly, flooding is being linked to climate change. Climate change can alter meteorological
factors, such as precipitation patterns and temperature, therefore increasing the likelihood of flood
events. Warmer oceans evaporate more water, and warmer air can hold more water vapor: With
every 1 degree Celsius of warming, there is a 7% increase in water vapor. In addition, rising sea levels
due to warming waters and glacier melting increases the vulnerability of coastal areas to flooding.
The Intergovernmental Panel on Climate Change (IPCC) noted in its special report on climate
extreme events and disasters that climate change “has detectably influenced” several of the
water-related variables that contribute to floods, such as rainfall and snowmelt.7 Asia and the Pacific
region suffer from the highest increase in extreme precipitation, which leads to flash floods and
river flooding.

The Main Types of Floods

Human-caused floods

Figure 4: Six main types of floods. Of these, river floods pose the biggest future risk and could displace almost 96
million children over the next 30 years. Image source: Adobe Stock

7. Seneviratne, S.I., N. Nicholls, D. Easterling, C.M. Goodess, S. Kanae, J. Kossin, Y. Luo, J. Marengo, K. McInnes, M. Rahimi,
M. Reichstein, A. Sorteberg, C. Vera, and X. Zhang, 2012: Changes in climate extremes and their impacts on the natural physical
environment. In: Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation [Field, C.B., V. Barros, T.F.
Stocker, D. Qin, D.J. Dokken, K.L. Ebi, M.D. Mastrandrea, K.J. Mach, G.-K. Plattner, S.K. Allen, M. Tignor, and P.M. Midgley (eds.)]. A Special
Report of Working Groups I and II of the Intergovernmental Panel on Climate Change (IPCC). Cambridge University Press, Cambridge,
UK, and New York, NY, USA, pp. 109-230. ipcc.ch/site/assets/uploads/2018/03/SREX-Chap3_FINAL-1.pdf
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 Impacts of Flooding
In this section, we describe how flooding affects
the lives of young children through the five
components of the nurturing care framework.

Figure 5: Components of the nurturing care

framework. Source: https://nurturing-care.org

Compromised Safety and Security

The most immediate influence of flooding on young children is that it endangers
their security and safety. Homes and schools may be destroyed and essential
services such as water and electricity may be interrupted. Floods can also pose a
direct danger to young children through drowning. Many young children lack
sufficient strength to stay on their feet when currents are fast, including in shallow
water. Even for those who know how to swim, strong currents and debris in the
water increase the likelihood of injuries and drowning. There may also be more
child abuse, exploitation8 and trafficking 9 during and after the chaotic time of
flood events. Young children, especially infants and toddlers, often lack the ability
to protect themselves.

A study conducted in Bangladesh revealed an increase in parental violence

against children following the 2007 floods.10 One proposed reason is that parents,
both mothers and fathers, become frustrated by the economic loss and hardship
and misdirect their anger toward the children. Increased violence toward children
is not limited to flooding events; it can occur during other natural disasters.11

Lack of Adequate Nutrition

Food shortages often occur during and after floods. Even when food is available,
the situation can make it hard to prepare safe and hygienic food for children. In
emergency situations, it is vital to continue feeding infants and toddlers with
breastmilk, but displacement and child-mother separations can make it difficult to
continue breastfeeding. All these circumstances increase the risk of malnutrition.

8. Thurston, A. M., Stöckl, H., & Ranganathan, M. (2021). Natural hazards, disasters and violence against women and girls: a global
mixed-methods systematic review. BMJ global health, 6(4), e004377. https://doi.org/10.1136/bmjgh-2020-004377

9. Stoklosa, H., Burns, C. J., Karan, A., Lyman, M., Morley, N., Tadee, R., & Goodwin, E. (2021). Mitigating trafficking of Migrants and children
through disaster risk reduction: Insights from the Thailand Flood. International Journal of Disaster Risk Reduction, 60, 102268.
https://doi.org/10.1016/j.ijdrr.2021.102268

10. Biswas, A., Rahman, A., Mashreky, S., Rahman, F., & Dalal, K. (2010). Unintentional injuries and parental violence against children during
flood: a study in rural Bangladesh. Rural and remote health, 10(1), 1199.

11. Cerna-Turoff, I., Fischer, H. T., Mansourian, H., & Mayhew, S. (2021). The pathways between natural disasters and violence against
children: a systematic review. BMC public health, 21(1), 1249. https://doi.org/10.1186/s12889-021-11252-3
41
 A study12 conducted in the Jagatsinghpur district of Odisha, India, one year after the heavy floods
in 2008, found that among repeatedly flooded communities, cases of severe wasting in children
aged 6-59 months were 3.37 times more prevalent than for children in non-flooded communities
and nearly twice more prevalent relative to those flooded only once. Particularly striking was the
difference among children under 1 year of age during previous floods in 2006, who exhibited the
largest difference in wasting prevalence compared to their non-flooded counterparts.

Impacts on Good Health

Besides the direct risk of drowning and injury from debris, flood events can
affect young children’s health in multiple ways. They can cause damage to
water and sanitation facilities including the release of or exposure to
infectious agents and to toxic substances, which subsequently increases the
risk of infections, allergies and respiratory diseases among children. For
example, floodwater can become contaminated with sewage and other
pollutants, and can also damage water, sanitation and hygiene (WASH)
systems, increasing the risks of waterborne diseases such as diarrhea,
cholera and hepatitis A. Young children’s immune systems are less
developed, making them more susceptible to infections and waterborne
diseases. This can also create a vicious cycle: A child deprived of adequate
water and sanitation before a crisis will be more affected by a flood or
severe storm, less likely to recover quickly, and at even greater risk when
faced with a subsequent crisis.13 Diarrheal infections and fever are the two of
the most commonly found waterborne diseases14 in young children detected
during and after a flood. Other common waterborne diseases include skin
infections and upper respiratory infections caused by the growth of mold.
Receding floodwater can provide ideal breeding sites for mosquitoes
transmitting diseases such as malaria and dengue.

Flooding can also have a profound impact on children’s mental health.

Children may lack safe spaces to play during or after floods, and also in flood
relief camps. The trauma and distress associated with displacement, loss of
homes, and disruption of routines can lead to anxiety, depression, and
post-traumatic stress disorder (PTSD). Floods and other catastrophic events
can lead to disturbed sleep patterns, regressive behaviors, hostility and
pessimistic thoughts.15

12. Rodriguez-Llanes JM, Ranjan-Dash S, Mukhopadhyay A, Guha-Sapir D. Flood-Exposure is Associated with Higher Prevalence of Child
Undernutrition in Rural Eastern India. Int J Environ Res Public Health. 2016;13(2):210. Published 2016 Feb 6. doi:10.3390/ijerph13020210

13. Collins TW, Jimenez AM, Grineski SE. Hispanic health disparities after a flood disaster: results of a population-based survey of
individuals experiencing home site damage in El Paso (Texas, USA). J Immigr Minor Health. 2013;15(2):415-426.
doi:10.1007/s10903-012-9626-2

14. Timothy J. Wade, Sukhminder K. Sandhu, Deborah Levy, Sherline Lee, Mark W. LeChevallier, Louis Katz, John M. Colford, Did a Severe
Flood in the Midwest Cause an Increase in the Incidence of Gastrointestinal Symptoms?, American Journal of Epidemiology, Volume 159,
Issue 4, 15 February 2004, Pages 398–405, https://doi.org/10.1093/aje/kwh050

15. Kousky C, Impacts of natural disasters on children. Future Child. 2016; 26: 73-92
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 How Floods Affect Birth Outcomes
Floods can have a significant impact on birth outcomes, posing risks to both
pregnant women and newborns. These impacts can be both direct and indirect and
vary depending on the severity of the flood and the quality of health care
infrastructure in the affected area. Floods can interrupt access to pre- and
post-natal care, medical supplies, clean water and sanitation, resulting in unsafe
labor and delivery conditions. Moreover, disruptions to the food supply can lead to
malnutrition, which increases the risk of adverse birth outcomes, such as stillbirth
and low birthweight.

A 2024 study revealed that floods have heightened the risk of pregnancy loss in 33
developing countries. It is estimated that between 2010 and 2020, approximately
107,888 excess pregnancy losses occurred across these countries each year due
to floods.15

Decline in Responsive Caregiving

During and after flooding events, parents will be less able to care for their
children as normal during and post flood events. The loss of their homes and
livelihoods can cause immense stress to parents, who are struggling with food,
shelter and other basic needs.17 Responsive care will become more difficult or
even impossible. There will also be cases when a child may lose their parent(s)
or caregivers because of flooding, leaving them without care. Childcare
facilities and service providers may also not be able to provide usual services
to complement childcare during this most needed time. The lack of responsive
caregiving has a detrimental effect on children's brain development as it causes
a dangerous neuro-biological “toxic stress” response. This can result in
long-term poor health and developmental outcomes.18

Figure 6: Depok, Indonesia - July 16, 2022: Rescue officers on Figure 7: Bajali, India, June 16, 2022. National Disaster Response
patrol to evacuate flood victims at Villa Pamulang, Pondok Force personnel rescue residents from flood-affected areas, at
Petir Subdistrict. Image Source: Shutterstock a village in Bajali district of Assam. Image Source: Shutterstock

16. He, C., Zhu, Y., Zhou, L. et al. Flood exposure and pregnancy loss in 33 developing countries. Nat Commun 15, 20 (2024).
https://doi.org/10.1038/s41467-023-44508-0

17. Hrabok, M., Delorme, A., & Agyapong, V. I. O. (2020). Threats to mental health and well-being associated with climate change. Journal
of Anxiety Disorders, 76, 102295. https://doi.org/10.1016/j.janxdis.2020.102295

18. Dooley, B., & Bassett, L. (n.d.). Childcare in Humanitarian Crises. Humanitarian Collaborative.
https://www.unicef.org/media/120366/file/ Childcare in Humanitarian Crisis.pdf
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 Reduced Opportunities for Early Learning
Flood events can affect a child’s learning and education in different ways.
Poorer households are less resilient to financial hardships when climate
shocks hit, which can increase the risk of interrupted education. Reduced
household income (e.g., due to crop failures) has a direct impact on the
amount of time children spend in school. Hunger can also affect a child’s
ability to concentrate. Families without savings or access to affordable
credit spend less on their children’s education during periods of crisis,
for example, on school fees, learning materials or transportation. Families
are also more likely to temporarily withdraw children from school, with
less learning time available at home, leading to significant interruptions in
education and loss of opportunities in early learning. Disruption in
education along with displacement can result in long-lasting mental and
cognitive effects.19

The closure of schools and early childhood care and development

centers due to floods is also a significant factor, with school buildings and
materials destroyed, and other services being disrupted. In addition,
many early childhood teachers are ill-equipped to handle the crisis and
subsequent recovery process.

In Vietnam, children in households that are affected by flooding do significantly less well in
mathematics and vocabulary tests, are less likely to complete grades, and less likely to be
enrolled in school.20

Figure 8 : June 2022, Heavy rains in Bangladesh have caused floods and landslides that left entire communities
devastated. In in Kurigram district, the situation has been exacerbated after major rivers broke their banks, leaving
low-lying areas of the district completely under water. Due to the floods, 200,000 people in nine regions of Kurigram
district were made homeless. Photo credit: Plan International

19. UNICEF, 2021: The Climate Crisis is a Child Rights Crisis: Introducing the Children’s Climate Risk Index.

20. Young Lives Policy Brief 54 (September 2022): Protecting the Most Vulnerable People in Vietnam from Climate Shocks
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 IMPACTS OF FLOODING ON EARLY CHILDHOOD DEVELOPMENT

Lack of safe spaces and

Damage to schools Loss of livestock Crop failure
opportunities for play
Access to nutritious food
Decreased school attendance

OR EARL TE NUTR
YF UA
OPPORTUNIT

ORTUNIT

IT I
ADEQ
YL

ON
EARNIN
Y FOR EARLY

PP
G
Increase in water borne and O
infectious diseases Child labour, trafficking
D HEALT ND SEC
OO Components YA
Lack or no access to of Nurturing

UR
T
Breakdown in social,
H
G

SAFE
Care

IT Y
healthcare political, institutional and
communication systems
Skilled health professionals IVE CARE
NS
displaced or killed G IV Damage to property, roads
RESPO

ING and bridges

Drowning, injuries, disability
and death Temporary displacement,
loss of shelter, homelessness
Destruction of health facilities
and medical supplies Separation from the
Caregivers go into debt,
family - lack of adult
Emotional trauma loss of income, loss of jobs,
protection
no access to cash/markets
Distruption of water
and sanitation services Caregiver emotional trauma

Figure 9: An infographic that summarizes how floods can impact early childhood development, as laid out through
the five components of the nurturing care framework. This infographic as well as other resources are available for
use by ARNEC members. Image Source: Vital Strategies and ARNEC

Acknowlegements
Authors: Lynn Tang, Yue Zhang (Vital Strategies), Peck Gee Chua (ARNEC)
Advisors: Dan Kass, Sumi Mehta (Vital Strategies), Rowan Ainslie (Save the Children), Evelyn Santiago, Neelima Chopra (ARNEC), Nicole
Rodgers (Plan International), Kristy Kyungah Bang and Catherine Wilczek (UNESCO), Nusrat Jahan, Pratibha Pandey (Childfund), Syifa
Andina (Plan International and HI-ECD, Indonesia)

Design and Editing: Vital Strategies

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Focus:
The After-Effects of Floods in Pakistan
It was the middle of the night when 4-year-old Naila woke up screaming
to the sound of gunshots. The shots had been fired to alert the village
that the nearby dam had broken, unleashing floods that would ultimately
destroy her home and her school. Together with other villagers, in a state
of chaos and panic, Naila’s family was forced to evacuate to the nearby
city of Ghotki. This unexpected event was extremely traumatizing for
young Naila, who had trouble sleeping for several nights afterward. Naila
is not alone: Other parents reported that their children displayed signs of
distress including unusual clinginess, disrupted sleep and appetite,
reduced interest, and mood swings.

After a few weeks, Naila’s family returned

to the village and attempted to adjust back
to daily life. Since Naila’s school had been
destroyed, a temporary learning center was
established to provide educational and
play-based activities for the children.
Naila’s teacher, Dost Mohammad, had
survived the floods and remained
dedicated to providing education, support
and routine care for the children.

Even though all the schoolbooks and

supplies were destroyed in the flood,
Mohammad improvised with low- or no-cost
materials and innovative teaching methods.
However, the trauma lingered, as seen in the
behavior of the children: Many were
disturbed, fearful, cranky and unable to
concentrate in the new makeshift school
setting. As a result, many children, including
Naila, ended up mostly absent from school.

This story was contributed by ARNEC member Idara-e-Taleem-o-Aagahi(ITA),

https://itacec.org
If you have your own story to share, please email us at
[email protected]
91
What can we do?

Parents, caregivers and supporters of early childhood development can:

Talk about the issue among your family, community, peers and networks.
The more people know about the impact of flooding on children, the more
we can work together to drive change. A simple way of doing this is by
forwarding this factsheet or sharing our social media material with your
contacts.

Understand the risk of flooding in the neighbourhood, community or city

where you and your child live. If you live somewhere that has flooded before,
it is likely that it can happen again. Even if you have not experienced a flood,
you can pay attention to cues (e.g. increasing rainfall, changes in geographical
features) that indicate the risk may be increasing in your area.

Parents, caregivers and supporters who live in a flood-prone area can:

Be prepared for a flooding emergency. Develop an emergency plan, with

evacuation routes, emergency contacts and a supply bag of essential items
including identity documents, food, water and medication. This should include
knowing where to look for reliable updates and announcements. During the
flood, prioritize the safety of young children and be mindful of child traffickers
immediately after the flooding. Seek higher ground or designated shelters as
advised by authorities.

Be alert to mold after a flood. Moisture on walls, floors, furniture, curtains and
other household items and surfaces can lead to mold growth. Exposure to
mold can lead to allergies and other respiratory conditions. Thoroughly clean
and dry all affected surfaces and discard items that cannot be cleaned or that
are made of absorbent materials. These include stuffed toys, paper, carpets
and clothes.

Improve your knowledge about water, sanitation and hygiene during and
after a flood. Floodwater may contain high levels of raw sewage or other
hazardous substances. Early symptoms from exposure to contaminated
floodwater may include upset stomach, intestinal problems, headache and
other flu-like discomfort. Do not allow children to play in floodwater. Wash
hands frequently with soap, especially before drinking and eating. Know where
you can get clean and safe drinking water after a flood and take precautions
that may be needed, such as boiling water before drinking it.

Eliminate standing water where mosquitos can breed. Mosquito

populations can sharply increase after a flood, due to the abundance of
standing water. Mosquitoes can breed even in very small amounts of water.
As floodwaters recede, be sure to drain or empty areas with water—no matter
how small—to reduce mosquito breeding areas and help reduce the spread of
mosquito-borne diseases.

Observe signs of mental and emotional distress in your child and provide
emotional support by proactively engaging with your children through talking,
singing and playing. Seek professional help if necessary.

Manage your own stress during an emergency. Seek professional help

if necessary.21

21. 4 ways parents can protect their mental well-being during a crisis. UNICEF South Asia. (2023, July 11).
https://www.unicef.org/rosa/stories/4-ways-parents-can-protect-their-mental-well-being-during-crisis
10
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Early childhood development advocates, such as parent advocacy groups,
youth activists, managers in early childhood development settings, civil
society and local governments can:

Advocate for child-centered measures for flood preparation, response

and mitigation. Climate action planning and policies must prioritize the
holistic needs of children throughout all stages of flood events.
Climate-responsive planning needs to be child focused and child centered.
Strengthening health systems and facilities will be crucial to managing and
improving resilience to severe floods. Schools, early childhood development
centers and other learning environments must ensure safety and continuity of
education. Community infrastructure needs to prioritize safety, and relief and
reconstruction interventions should aim to reduce both future and current
risk. Robust child protection systems will also be necessary to prevent abuse,
neglect, trafficking and other related harms exacerbated by floods and their
impacts. In general, disaster preparedness systems need to be child-centered
and create safe spaces for children considering their physical and emotional
needs.

Incorporate flood education in schools and communities. Children

experience fear and anxiety when they do not know what is happening.
Provide resources to help children understand flood risk, learn about flood
warnings, know how to make a flood plan and know how to cope with its
consequences. Communities can be empowered to keep children safe during
and after floods. Practice drills will also be useful.

Provide training or programs related to disaster preparedness, education in

emergencies and mental health and psychosocial support in emergencies for
parents and early childhood development teachers.

Influential stakeholders: Development partners, private sector funders,

philanthropists and policymakers can:

Reduce inequity among children to promote their future resilience to

flooding and climate change. Marginalized and vulnerable communities,
already disadvantaged, will be the hardest hit by flood events. They also have
fewer social and financial resources to help them cope with shocks. As
climate change makes crises more common, these repeated shocks will make
it increasingly harder to recover. Reducing these inequities now will give
disadvantaged children a better basis for coping with the effects of climate
change. This entails providing the poorest children with access to safe water,
adequate sanitation, good hygiene, good nutrition and food security. Children
also need strong and accessible health systems and well-functioning child
and social protection systems. Addressing inequities now will also make it
less likely that today’s inequities are exacerbated by climate change.

Advocate for greater financing and investments toward flood prevention

and recovery, including the development of infrastructure for disaster
prevention and rapid government support systems for disaster recovery.

Strategically collaborate with civil society, government and the private

sector to advance change, and to harness the reach and resources of all
partners to maximize collective influence. This includes working with multiple
actors working in health and nutrition and child development as well as city
and town planners and climate change experts.

Work to ensure that young children’s rights are considered during climate
and environmental negotiations. This is in line with the U.N. Convention on the
Rights of the Child’s adoption of General Comment 26 affirming children’s
rights to a clean, healthy and sustainable environment. Climate and action
plans should include children’s priorities at all levels, local and national.

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