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June 12, 2020
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Pandemic’s indirect impact on maternal, child health may outweigh deaths from virus

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WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, warned that the indirect effect the COVID-19 pandemic is having on the health of women and children may outweigh the number of deaths from the disease itself.

“As the pandemic escalates in low- and middle-income countries, WHO is especially concerned about its impact on people who already struggle to access health services often women, children and adolescents,” Tedros said during a virtual press conference about maternal, child and adolescent health during the COVID-19 pandemic.

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According to Tedros, early evidence has shown that children and adolescents in their teens and early 20s are at a greater risk for depression, anxiety, online harassment, physical and sexual violence, and unintended pregnancies. Services typically provided for youths are not readily available during the pandemic, which may lead to problems later.

“Adolescents’ and young people’s access to sexual and reproductive health services is disrupted, which puts them at risk of unintended pregnancies,” Jayathma Wickramanayake, the United Nations Secretary General’s Envoy on Youth, said during the press conference. “Needless to say, young women and girls are particularly vulnerable.”

According to Wickramanayake, 1.2 billion children and youths have been kept out of school during the pandemic, “and this means that they not only miss formal education, but also nonformal education, which they usually receive through community interventions, universities, clubs, peer organizations and networks, and youth groups. Not having access to this information could seriously impact the choices they make about their lives and bodies today [and] also impact their futures.”

Mary-Ann Etiebet, MD, MBA, executive director of Merck for Mothers, noted the essential need for funding for these services to continue during and after the pandemic.

“In the worst-case scenario, a recent publication in The Lancet estimated that COVID-19 — in the next 6 months alone — could result in the deaths of over 1 million children and over 50,000 mothers all due to the indirect impact of COVID-19 and the reductions in utilizations of essential services,” Etiebet said. “We are all living in that worst-case scenario right now.”

Etiebet shared statistics from Nigeria and India, which together account for one-third of global maternal deaths. After a nationwide lockdown was enforced in India in March, institutional birth deliveries decreased by 43%, she said. In May, the Nigerian Federal Ministry of Health reported that antenatal care and childhood immunization visits had decreased by 50%.

Tedros Adhanom Ghebreyesus

WHO and other groups warned last month that at least 80 million children could miss routine immunizations due to the pandemic. Data from the United States showed a sharp decline in vaccination in the early months of the pandemic.

“We cannot afford to look back on the next 10 years as a decade of picking up the pieces and rebuilding trust in the ability of health systems to deliver on essential services for women and children,” Etiebet said. “We need rather to look back on the next 10 years as a decade of accelerating action, because we all need to be together to do this.”

Recently, the Global Vaccine Summit raised $8.8 billion in funding for programs in an effort to vaccinate 300 million children by 2025. More specifically, the summit raised $567 million as part of a new initiative to provide access to SARS-CoV-2 vaccination in low- and middle-income countries, when a vaccine becomes available.

“It’s our collective responsibility to ensure these interventions are available and accessible to all people who need them,” Tedros said.

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