The number of global under-five deaths dropped to its lowest point on record in 2019 – down to 5.2 million from 12.5 million in 1990, according to new mortality estimates released by UNICEF; the World Health Organisation (WHO); the Population Division of the United Nations Department of Economic and Social Affairs and the World Bank Group.
Since then, however, surveys by UNICEF and WHO reveal that the COVID-19 pandemic has resulted in major disruptions to health services that threaten to undo decades of hard-won progress, WHO has reported.
According to UNICEF Executive Director Henrietta Fore, the global community has come too far towards eliminating preventable child deaths to allow the COVID-19 pandemic to stop us in our tracks. She noted: “When children are denied access to health services, because the system is overrun, and when women are afraid to give birth at the hospital for fear of infection, they, too, may become casualties of COVID-19.”
Fore argued that without urgent investments to re-start disrupted health systems and services, millions of children under five, especially newborns, could die.
WHO has explained that over the past 30 years, health services to prevent or treat causes of child death such as pre-term birth, low birthweight, complications during birth, neonatal sepsis, pneumonia, diarrhoea and malaria, as well as vaccination, have played a large role in saving millions of lives.
It said now countries worldwide are experiencing disruptions in child and maternal health services, such as health check-ups, vaccinations, and prenatal and post-natal care, due to resource constraints and a general uneasiness with using health services due to a fear of getting COVID-19.
WHO cited a UNICEF survey conducted recently across 77 countries which found that almost 68 per cent of countries reported at least some disruption in health checks for children and immunisation services. In addition, 63 per cent of countries reported disruptions in antenatal check-ups and 59 per cent in post-natal care.
Further, a recent WHO survey, based on responses from 105 countries, revealed that 52 per cent of countries reported disruptions in health services for sick children and 51 per cent in services for management of malnutrition.
According to WHO, health interventions such as these are critical for stopping preventable newborn and child deaths. For example, women who receive care by professional midwives trained according to international standards are 16 per cent less likely to lose their baby and 24 per cent less likely to experience pre-term birth.
Based on the responses from countries that participated in the UNICEF and WHO surveys, the most commonly cited reasons for health service disruptions included parents avoiding health centres for fear of infection; transport restrictions; suspension or closure of services and facilities; fewer healthcare workers due to diversions or fear of infection due to shortages in personal protective equipment such as masks and gloves; and greater financial difficulties. Afghanistan, Bolivia, Cameroon, the Central African Republic, Libya, Madagascar, Pakistan, Sudan and Yemen are among the hardest-hit countries.
According to WHO, with severe disruptions in essential health services, newborn babies could be at much higher risk of dying.
WHO has pointed to an initial modelling by Johns Hopkins University which showed that almost 6000 additional children could die per day due to disruptions as a result of COVID-19.
These reports and surveys, according to WHO, highlight the need for urgent action to restore and improve childbirth services and antenatal and postnatal care for mothers and babies, including having skilled health workers to care for them at birth. Working with parents to assuage their fears and reassure them is also important.
WHO Director General, Dr Tedros Adhanom Ghebreyesus pointed out: “The fact that today more children live to see their first birthday than any time in history is a true mark of what can be achieved when the world puts health and well-being at the centre of our response.”
All countries, including Guyana, must take the necessary action urgently to prevent the COVID-19 pandemic from turning back remarkable progress for our children and future generations. The WHO Head has urged that it is time to use what we know works to save lives and keep investing in stronger, resilient health systems.