The disruption to child and maternal health services can put the lives of children at stake, threatening to undo 30 years of ‘remarkable progress’ in reducing deaths of children under the age of five, according to UN agencies.

UN agencies have called on countries to ensure vital health services for children and women do not falter amid the global crisis, reports UN news.

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. However, there are fears the numbers could go up on back of COVID-induced disruptions to health services, new estimates released on Wednesday indicate.

Services experiencing disruptions include health checkups, vaccinations, and prenatal and post-natal care. Reasons include resource constraints and a general uneasiness with using health services due to a fear of getting COVID-19, according to UN agencies.

Over the past 30 years, health services to prevent or treat causes of child death such as preterm, low birth weight, complications during birth, neonatal sepsis, pneumonia, diarrhoea and malaria, as well as vaccination, have played a large role in saving millions of lives, the agencies said.

The estimates contained in the report ‘Levels and Trends in Child Mortality: Report 2020’ were issued by UN Children’s Fund (UNICEF), UN World Health Organization (WHO), the UN Department of Economic and Social Affairs, and the World Bank Group.

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WHO chief Tedros Adhanom Ghebreyesus outlined the challenges.

“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,” he said.

“Now, we must not let the COVID-19 pandemic turn back remarkable progress for our children and future generations. Rather, it’s time to use what we know works to save lives, and keep investing in stronger, resilient health systems.”

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UNICEF and WHO surveys

Surveys conducted by UNICEF and WHO in 77 and 105 countries, respectively, found high numbers of countries reporting disruptions in health services critical to prevent new-born and child deaths. 

The UNICEF survey found that almost 68 percent of the countries faced disruptions in health checks for children and immunisation services; 63 percent had disruptions in antenatal check-ups; and 59 percent in post-natal care.

WHO findings showed 52 percent of countries had disruptions in health services for sick children; and 51 percent in services for management of malnutrition – equally important to safeguard healthy lives.

Challenges included parents avoiding health centres for fear of infection, transport restrictions, suspension or closure of services and facilities, fewer healthcare workers or shortage of personal protective equipment (PPE), and greater financial difficulties.

Afghanistan, Bolivia, Cameroon, the Central African Republic, Libya, Madagascar, Pakistan, Sudan and Yemen are among the hardest hit countries.

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‘Come too far to stop’

UNICEF Executive Director Henrietta Fore called for urgent investments to restart disrupted health systems and services.

“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 said.

“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,” she said.

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Urgent action needed

The surveys also highlighted 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.

Muhammad Ali Pate, Global Director for Health, Nutrition and Population at the World Bank, underlined the need to protect the vital, life-saving services that are key to reducing child mortality.

“The COVID-19 pandemic has put years of global progress to end preventable child deaths in serious jeopardy … It is essential to protect life-saving services which have been key to reducing child mortality. We will continue to work with governments and partners to reinforce healthcare systems to ensure mothers and children get the services they need,” he said.

John Wilmoth, Director of the Population Division of the UN Department of Economic and Social Affairs, drew attention to address inequalities within societies that impact health.

“The report demonstrates the ongoing progress worldwide in reducing child mortality … While it highlights the negative effects of the COVID-19 on interventions that are critical for children’s health, it also draws attention to the need to redress the vast inequities in a child's prospects for survival and good health,” he said.

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