Around 1.2 billion children live under the bread line and almost 153 million children live in areas affected by what researchers identified as the three main threats affecting children’s wellbeing: poverty combined with violence and high levels of discrimination against girls.

“This report is in its second year, and this year we were able to look at factors which threaten childhood through specific lenses,” said spokesperson Bhanu Bhatnagar.

“This data is extensive and will really help paint a picture of where work needs to be done to protect children worldwide.”

The research, released ahead of International Children’s Day on Friday 1 June, uses indicators of poor health, malnutrition, lack of education, child labour, marriage, early pregnancy and violence to rank 175 countries according to where childhood is most and least threatened.

The report, titled ‘The Many Faces of Exclusion’, found that the top three countries where childhood is protected are Singapore, Slovenia and Norway. Despite their wealth, the US (36th), Russia (37th) and China (40th) all trailed behind Western European countries in the new index.

Azerbaijani children were also affected by the conflict between Armenia and Azerbaijan. As a result, 194 children were killed and 61 went missing and 27 are still in captivity. Despite the announcement of a ceasefire in 1994, 14 Azerbaijani children were killed, 20 others were injured and 29 are in captivity in the wake of Armenian terrorism.

2-year-old Zehra Guliyeva, killed by Armenian fire, was buried by her relatives and fellow villagers in 2017

The bottom countries were all in Africa: Niger, Mali, the Central African Republic, Chad, South Sudan, Somalia, Nigeria, Guinea, Sierra Leone and the Democratic Republic of Congo.

Despite the immediate threat to life and limb from violence in war zones, the report found malnutrition and disease – coupled with inadequate access to healthcare – killed 20 times as many children as violence related to the conflict.

Nour, 12, stands with his 10-year-old brother Mahmoud (not their real names) in the yard outside their one-room house in West Mosul, Iraq, on 16 April 2018. As the eldest, Nour feels responsible for his siblings since his father died last year (Sam Tarling/Save The Children)

And when the fighting ends, it can have long-lasting effects.

In Mosul, the city which formed the capital of the Iraqi half of Isis’ caliphate until the militants were defeated last year, many children are the struggling with trauma as well as crippling poverty in a town where rebuilding will take years.

Twelve-year-old Nour, whose name has been changed, was forced to care for his father who was dying of kidney failure during the gruelling US-backed Iraqi coalition offensive to retake the city.

He was forced to venture out into Mosul’s dangerous streets to sell crisps to feed his family and buy his father’s medication. He learnt to administer his father’s injections himself, but eventually he died in agony in the boy’s arms.

Nour now sees himself as the head of the household, responsible for his younger siblings.

The boy is unfortunately not the only Iraqi child forced to take on adult roles. The country placed 125th on the Save the Children index, in large part due to the fighting with Isis, which displaced 14 per cent of the population and has interrupted the schooling of almost a quarter of Iraqi children.

Six-year-old Thani (not her real name) sits with her father in their home in West Mosul on 16 April 2018. The little girl watched her mother die after a mortar shell hit their home last year (Sam Tarling/Save The Children)

“Both living under Isis and during the coalition offensive, these children have experienced things no child should have to. They have extreme emotional as well as physical scars,” said Save the Children’s Mr Bhatnagar, who recently returned from a field trip to Mosul.

“We have to act now to save this generation of Iraqi children.”

The charity is calling on governments to ensure no child is robbed of their health, education or a future stunted by mental distress, early marriage or forced labour.

“Over time I have seen how our caseworkers build relationships with displaced and traumatised children and their families,” Mr Bhatnagar added.

“The pain and the grief can be overcome. This work is vital if these children are to get some of their childhoods back, enjoy school and play again and become mentally fit members of society."

The Independent

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