Mothers, newborns, young children and adolescents are losing 20% of their health and social services because of the pandemic, according to a new report from a panel senior global health experts.
“Covid-19 is making a bad situation worse,” said Joy Phumaphi, co-chair of the United Nation’s Independent Accountability Panel (IAP) and former WHO Assistant Director-General.
The report, published today, compiled data from various surveys and studies to estimate the impacts from Covid-19 pandemic on mothers, newborns, young children and adolescents since January.
The early data found that women are experiencing a loss of various types of support and social safety nets and can’t access increased support, in contrast to men.
For example, one survey mentioned in the report found that 73% of health workers from the 30 countries surveyed cited shortages of sanitary products. Another 58% cited price hikes, and half reported reduced access to clean water to help manage menstrual hygiene.
The IAP report estimates that the disruptions of health systems along with the decreased access to food could contribute to over 56,000 additional maternal deaths in six months, with increases of up to 38.6% in maternal deaths per month.
The report projections also show a potential for more than a 1,000 million additional child deaths in six months, with an increase of 9·8 to 44·7% in under-5 child deaths per month.
“Health systems in both rich and poor nations are massively struggling and the services for mothers, newborns, young children and adolescents are crumbling,” said Elizabeth Mason, co-chair of the UN Secretary-General’s IAP.
“Especially worrisome are declines in access to life-saving vaccines for children and maternal health services due to closures and movement restrictions. Immunization campaigns are being halted and health workers are being diverted from maternity to Covid-19 units,” Mason added.
According to the report, more than 20 countries reported vaccine shortages caused by the pandemic and 13.5 million children missed vaccinations against life-threatening diseases.
The missed or delayed vaccinations could threaten herd immunity in populations, according to a study published in the Canadian Medical Association Journal last month.
“Delays in bringing children and young people to medical attention may be due to parental fears of exposure to COVID-19 in hospitals or on public transit, lack of childcare for other children, lack of access to primary care due to closures, or changes to hospital visitation policies,” Peter Gill, one of the study’s authors and a clinician-investigator in the Division of Paediatric Medicine at SickKids, explained in a press release.
He added that because families are skipping routine checkups they may also be missing important developmental milestones in their children that may warn them of underlying health conditions.
The IAP report also noted that disruption to contraceptive supplies could lead to 15 million unintended pregnancies in low- and middle-income countries. The figure is especially problematic with the increased challenges in accessing safe abortion care.
Médecins Sans Frontières (MSF) recently reported that Covid-19 is further discouraging women from seeking abortion care.
Anne-Cécile Trapy, MSF project coordinator in Colombia, explains that abortion is a time-sensitive service, but says women needing safe abortion care are facing appointment dates well into the future because of Covid-19.
“It can delay the date of the [abortion] and then it can become more complicated,” she said, explaining that in Colombia, if a woman needs a second-trimester abortion, she has to go to the capital, Bogotá.
She said that this is difficult in normal times, but since the pandemic there’s added challenges such as curfews, restricted transportation and financial limitations.
The IAP report further analyzed 193 nations looking at income as well as seven other key factors including maternal mortality, neonatal mortality, and under-5 mortality , among others to depict a country’s current status relative to global and country targets.
The findings showed that ethnic minority communities even in the wealthiest countries have large disparities of both rates of disease and death.
They also found that women, children and adolescents in countries with access to similar economic resources sometimes experience different health outcomes.
For example, the U.S. spends more than double what Japan or France do on health, yet children in America are more likely to die before their fifth birthday and women are more than twice as likely to die in childbirth.
“Critical gaps in quality health service delivery and financial protection require urgent remedy and action,” said Nicholas Alipui, M.D., a visiting scholar at Yale University and former UNICEF Director of Programmes. “These gaps are found between countries and within countries.”
“These new findings show how weak our health systems are at protecting mothers, newborns, young children and adolescents,” added Phumaphi. “We are at a point where decades of progress for this group could be easily reversed.”
Besides the loss of services due to the pandemic, IAP also found that globally we’re behind on the UN’s 2030 goals to reduce preventable deaths for mothers and children.
While there are still a host of basic problems blocking advancement of the health for mothers and children, the IAP’s 2020 report calls for leaders to fulfil their commitments and lays out several actions needed to get back on track, such as better health care data, additional health care workers and more accountability from leaders.
“A key element to sustainable progress is strong citizen voices which advocate for full accountability at all levels, community, state and national,” said Alipui.
Commitments to universal health coverage, primary health care, international health regulations and sustainable development, were urgently needed before the pandemic. Now with COVID-19, they are even more important.
“The lives’ of every mother, newborn, child and adolescent matter,” said Giorgi Pkhakadze, a professor of Epidemiology and Public Health. “Quality healthcare is not a luxury, but a life-saving resource.”