COVID-19: Social services for mothers, newborns, young children and adolescents badly hit

Mothers, newborns, young children and adolescents are losing 20 per cent of their health and social services due to the COVID-19 pandemic says a Panel of senior global health experts.

“Health systems in both rich and poor nations are massively struggling and the services for mothers, newborns, young children and adolescents are crumbling,” says Elizabeth Mason, M.D, co-chair of the UN Secretary-General’s Independent Accountability Panel (IAP) for Every Woman, Every Child, Every Adolescent reviewing the impact of COVID-19 on these groups.

“Especially worrisome decline 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,” Dr. Mason adds.

The Panel provides an overview of estimated­ impacts from COVID-19 pandemic on mothers, newborns, young children and adolescents since its start in January.

“These new findings show how weak our health systems are at protecting mothers, newborns, young child and adolescents,” says Joy Phumaphi, co-chair of the Panel and former WHO Assistant Director-General. “We are at a point where decades of progress for this group could be easily reversed.”

The COVID-19 pandemic has interrupted steady progress and has led to increased poverty and unemployment. Early data finds women experience not only loss of various categories of support and social safety nets, but also an inability to access increased support, compared to men.

“COVID-19 is making a bad situation worse,” says Ms. Phumaphi, reflecting the conclusion of the Panel’s report.

“The lives’ of every mother, newborn, child and adolescent matter,” says Giorgi Pkhakadze, a professor of Epidemiology and Public Health. “Quality healthcare is not a luxury, but a life-saving resource.”

Since 2000, maternal and children under 5 deaths have been cut ­by 40 per cent, because of focused leadership and investment, even in the poorest nations. Also, in the last decade, more than $50 billion has been raised through the Every Woman Every Child movement to meet the health and medical needs of this vulnerable group. Even the poorest countries have shown progress, especially in reducing under 5 mortality.

Each indicator for the 193 countries is colour-coded to depict a country’s current status relative to global/country targets: dark green for surpassed, light green for advanced, yellow for intermediate, and red for catching-up countries.

“The colour-coding makes it easy to pick out the countries where mothers, newborns, young children and adolescents are thriving and countries where they need help,” says Dr. Nicholas Alipui, M.D., a visiting scholar at Yale University and former UNICEF Director of Programmes.

Countries with all dark green surpassed in all seven categories are Finland, Iceland, Slovenia, Luxembourg, Japan, Norway, Estonia Sweden, Italy, Spain, Czechia, Austria, Belgium, Ireland, Germany, Australia, Israel, Portugal, Netherlands, France, Switzerland, Denmark, United Kingdom, Hungary, Poland, Greece, Croatia, Canada, Slovakia, Malta, Bahrain, Belarus, Cuba, Republic of North Macedonia.

Countries that are all dark green, surpassed global targets – except for a light green, advanced ranking for adolescent deaths are: Latvia, Lithuania, New Zealand, United States, Uruguay, Seychelles, Bulgaria, Russian Federation, Romania, Costa Rica, Georgia, Kazakhstan

Countries who are mainly red, catching up are Mauritania, Cameroon, Angola, Lesotho, Côte d’Ivoire, Nigeria, Guinea Bissau, the Democratic Republic of the Congo, South Sudan, Sierra Leone, Central African Republic, Chad, Somalia.

The gap between rich and poor countries is huge. For example: Under 5 mortality rate (per 1,000 live births): Finland –1.7, Iceland and San Marino –2, Slovenia 2.1, Cyprus and Luxembourg –2.4, and Japan –2.5. That compares to the Central African Republic –116.5, Chad –119, Nigeria -119.9, and Somalia –121.5.

On maternal mortality ratio (per 100,000 live births): Norway, Italy, Poland and Belarus – 2, Finland, Czechia, Greece and United Arab Emirates –3. That compares to Nigeria – 917, Sierra Leone –1,120, Chad –1,140 and South Sudan –1,150.

Ethnic minority communities even in the wealthiest countries have large disparities of both morbidity and mortality. A number of factors create disparities: racism, low wages, limited opportunities, and poor education. This exacerbates poor health, lack of access to health, water and sanitation.

Women, children and adolescents in countries with access to similar economic resources sometimes experience different health outcomes. For example, the United States spends more than twice as much on health than either Japan or France, yet children in the US are more likely to die before their 5th birthday and women are more than twice as likely to die in childbirth.

Another example: Nigeria spends around 74 USD per capita on health, compared to 34 USD in Tanzania. However, Nigeria has more than double the child mortality rate compared to Tanzania, 120 and 53 deaths per 1,000 live births, respectively. This reflects significant inequalities and other disparities.

“Critical gaps in quality health service delivery and financial protection require urgent remedy and action,” says Dr. Alipui. “These gaps are found between countries and within countries.”

Losing Ground

Besides the loss of services due to the pandemic, IAP has found that globally implementation is 20 per cent behind on the UN’s 2030 goals to reduce preventable deaths for mothers, newborns, young children and adolescents.

The IAP’s 2020 report, published this week, calls for leaders to fulfil their commitments and lays out the action needed to get back on track. 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.

About 2 USD trillion a year lost due to inefficiencies, corruption and waste

Besides the 20 per cent deficit, the Panel found that 2 trillion USD a year is lost to health expenditures, due to inefficiencies, corruption and waste.

“How money is spent is every bit as important as how much is spent to improve health and socioeconomic benefits,” points out Ms. Phumaphi. “The key is full accountability which connects commitment to progress.”

“A key element to sustainable progress is strong citizen voices which advocate for full accountability at all levels, community, state and national,” says Dr. Alipui.

“Mass protests clamouring for racial justice in both health and policing in the United States and around the globe have laid bare how central accountability is to achieving justice and a fairer world,” explains Alicia Ely Yamin, LLD and a senior fellow in global health and rights at Harvard Law School.

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