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The number of under-five deaths worldwide fell to its lowest point on record in 2019: to 5.2 million from 12.5 million in 1990, according to new mortality estimates released by UNICEF, the World Organization for Health (WHO), the Population Division of the United Nations Department of Economic and Social Affairs and the World Bank Group.
However, since then, surveys by UNICEF and WHO reveal that the COVID-19 pandemic has led to major disruptions in health services that threaten to undo decades of hard-won progress.
“The global community has gone too far in eliminating preventable child deaths to allow the COVID-19 pandemic to stop us in our tracks,” said Henrietta Fore, UNICEF Executive Director. “When children are denied access to health services because the system is invaded, and when women are afraid to give birth in hospital for fear of infection, they too can become victims of COVID-19 . Without urgent investments to restart interrupted health systems and services, millions of children under the age of five, especially newborns, could die ”.
During the last 30 years, health services to prevent or treat the causes of infant death, such as prematurity, low birth weight, complications during delivery, neonatal sepsis, pneumonia, diarrhea and malaria, as well as vaccination, have played a important role in saving millions of people. lives.
Now, countries around the world are experiencing interruptions in maternal and child health services, such as checkups, vaccinations, and prenatal and postnatal care, due to resource constraints and general discomfort with the use of health services. due to fear of contracting COVID-19.
A UNICEF survey conducted over the summer of 77 countries found that nearly 68 percent of countries reported at least some interruption in children’s health checkups and immunization services. Furthermore, 63% of the countries reported interruptions in prenatal checkups and 59% in postnatal care.
A recent WHO survey based on responses from 105 countries revealed that 52% of countries reported interruptions in health services for sick children and 51% in services for managing malnutrition.
Health interventions like these are critical to stopping preventable newborn and child deaths. For example, women who receive care from professional midwives trained according to international standards are 16% less likely to lose their baby and 24% less likely to experience preterm birth, according to the WHO.
“The fact that more children are living to see their first birthday today than at any other time in history is a true mark of what can be accomplished when the world puts health and wellness at the center of our response.” said Dr. Tedros Adhanom Ghebreyesus. , Director-General of WHO. “Now, we must not allow the COVID-19 pandemic to set back remarkable progress for our children and future generations. Rather, it is time to use what we know works to save lives and continue to invest in stronger and more resilient health systems. “
According to responses from countries that participated in the UNICEF and WHO surveys, the most commonly cited reasons for health service interruptions included parents avoiding health centers for fear of infection; transportation restrictions; suspension or closure of services and facilities; fewer health workers due to diversions or fear of infection due to a shortage of personal protective equipment such as masks and gloves; and greater financial difficulties. Afghanistan, Bolivia, Cameroon, Central African Republic, Libya, Madagascar, Pakistan, Sudan and Yemen are among the worst affected countries.
Seven of the nine countries had high infant mortality rates of more than 50 deaths per 1,000 live births among children under the age of five in 2019. In Afghanistan, where 1 in 17 children died before their fifth birthday in 2019, the Ministry of Health reported a significant reduction in visits to health facilities. In fear of contracting the COVID-19 virus, families are prioritizing prenatal and postnatal care, increasing the risk faced by pregnant women and newborns.
Even before COVID-19, newborns had the highest risk of death. In 2019, a newborn baby died every 13 seconds. Furthermore, 47% of all deaths in children under five occurred in the neonatal period, up from 40% in 1990. With severe interruptions in essential health services, newborns could be at a much higher risk of dying. For example, in Cameroon, where 1 in 38 newborns died in 2019, the UNICEF survey reported approximately 75% interruptions in essential neonatal care, prenatal checkups, obstetric care and postnatal care.
In May, the initial Johns Hopkins University model showed that nearly 6,000 additional children could die each day due to disruptions due to COVID-19.
These reports and surveys highlight the need for urgent action to restore and improve delivery services and prenatal and postnatal care for mothers and babies, including having trained health workers to care for them from birth. It is also important to work with parents to calm their fears and reassure them.
“The COVID-19 pandemic has seriously jeopardized years of global progress to end preventable child deaths,” said Muhammad Ali Pate, Global Director of Health, Nutrition and Population at the World Bank. “It is essential to protect life-saving services, which have been key to reducing infant mortality. We will continue to work with governments and partners to strengthen health systems and ensure that mothers and children get the services they need. “
“The new report demonstrates continued progress around the world in reducing infant mortality,” said John Wilmoth, Director of the Population Division of the United Nations Department of Economic and Social Affairs. “While the report highlights the negative effects of the COVID-19 pandemic on interventions that are critical to children’s health, it also draws attention to the need to correct large inequalities in the prospects for survival and good health of child”.
