[Reprinted: Lancet Global Health, 5-12-2020]
As cases of COVID-19 surge worldwide and threaten to overwhelm life-saving health services, the survival of mothers and children is at great risk. In The Lancet Global Health, Timothy Roberton and colleagues present startling new evidence on the potential rise in maternal and child mortality in low-income and middle-income countries if essential health services are disrupted as a result of COVID-19. Building on lessons learned from previous outbreaks of Ebola virus disease and severe acute respiratory syndrome (SARS), the authors estimate a devastating increase in the numbers of maternal and child deaths resulting from reductions in routine health service coverage.
These findings reinforce the multi-part approach that UNICEF has adopted from the start of the outbreak.
First, we are working to prevent COVID-19 transmission and treat those who fall sick. Second, we are working to address the effects of the policy responses aimed at containing the spread, including maintaining routine health services for all children and mothers, ensuring continuity of learning, keeping mothers and children safe and protected from violence, and scaling up social protections to keep children and their families afloat. Third, we are working to strengthen the systems that underpin all of these services.
The evidence is already showing the negative effects of COVID-19, and the unprecedented measures to contain it, on maternal and child health. Children are at risk not only of infection, but also of losing or being separated from family members and caregivers. Mothers and children are affected by the disruption of essential preventative and curative support and supplies resulting from suspensions in services and transportation systems, as well as by financial constraints.
Fifth, services to prevent and address gender-based violence—including counselling and support—must be designed and delivered. These services should be designated as essential, and moved online. The current crisis makes women and children even more vulnerable to violence.
As we think through new and innovative ways to support children and their families, it is encouraging to see that many local initiatives have already begun.
These initiatives push us all to consider the new opportunities that this crisis creates for communities to recover better, build stronger systems, and orient these services to reach all people, rich and poor alike. This kind of long-term thinking can help us to prevent further loss of life from COVID-19 and to reduce the effects of the global recession, while making progress towards the healthier, more equal, resilient, and sustainable future envisioned in the UN Sustainable Development Goals.