As COVID-19 devastates already fragile health systems, over 440,000 additional children under five could die in the next six months in South Asia, without urgent action
UNICEF launches #Reimagine, a global campaign to prevent the pandemic from becoming a lasting crisis for children
KATHMANDU, 13 May 2020 – An additional 2,400 children could die every day from preventable causes over the next six months in South Asia as the novel coronavirus (COVID-19) pandemic continues to weaken health systems and disrupt routine services across the region, UNICEF said today.
The estimate is based on an analysis by researchers from the Johns Hopkins Bloomberg School of Public Health, newly published in The Lancet Global Health journal. Based on the worst of three scenarios in 118 low- and middle-income countries globally, the analysis estimates that an additional 1.2 million under-five deaths could occur in just six months, due to reductions in routine health service coverage levels and an increase in child wasting. The researchers estimate that in the next six months up to 300,000 children could die in India alone; 95,000 in Pakistan, 28,000 in Bangladesh, 13,000 in Afghanistan, and 4,000 in Nepal.
“We fear that the number of children dying before their fifth birthdays is going to increase for the first time in decades,” said UNICEF Regional Director for South Asia, Jean Gough. “We must protect the mothers, the pregnant women and children in South Asia at all cost. Fighting the pandemic is critical but we cannot lose momentum on the decades of progress we have made in the region to reduce preventable maternal and child deaths.”
“It is crucial that childbirth, child health and nutrition services remain available for families during the time of COVID-19,” said UNICEF Regional Health Adviser for South Asia Paul Rutter. “It would be terrible to see a situation in which many thousands of children die, not because of the virus itself but because routine services are disrupted.”
In countries with already weak health systems, COVID-19 is causing disruptions in medical supply chains and straining financial and human resources. Visits to health care centres are declining due to lockdowns, curfews and transport disruptions, and as communities remain fearful of infection. In a commentary to the Lancet report, UNICEF warns these disruptions could result in potentially devastating increases in maternal and child deaths.
The paper analyzes three scenarios for the impact of reductions in lifesaving interventions due to the crisis on child and maternal deaths globally. It warns that in the least severe scenario, where coverage is reduced around 15 per cent, there would be a 9.8 per cent increase in under-five child deaths, or an estimated 1,400 a day globally, and an 8.3 per cent increase in maternal deaths. In the worst-case scenario, where health interventions are reduced by around 45 per cent, there could be as much as a 44.7 per cent increase in under-five child deaths and 38.6 per cent increase in maternal deaths per month. These interventions range from family planning, antenatal and postnatal care, child delivery, vaccinations and preventive and curative services. The estimates show that if, for whatever reason, routine health care is disrupted and access to food is decreased, the increase in child and maternal deaths will be devastating. The greatest number of additional child deaths will be due to an increase in wasting prevalence among children, which includes the potential impact beyond the health system, and reduction in treatment of neonatal sepsis and pneumonia.
According to the modeling, and assuming reductions in coverage in the worst-case scenario, the 10 countries that could potentially have the largest number of additional child deaths are: Bangladesh, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, Uganda and United Republic of Tanzania. The 10 countries that are most likely to witness the highest excess child mortality rates under the worst-case scenario are: Djibouti, Eswatini, Lesotho, Liberia, Mali, Malawi, Nigeria, Pakistan, Sierra Leone and Somalia. Continued provision of life-saving services is critical in these countries.
In addition to the estimated potential rise in under-five and maternal deaths described in the Lancet Global Health Journal analysis, UNICEF is deeply alarmed by the other knock-on effects of the pandemic on children:
- An estimated 77 per cent of children under the age of 18 worldwide – 1.80 billion out of 2.35 billion – were living in one of the 132 countries with stay-at-home policies, as of early May.
- Nearly 1.3 billion students – over 72 per cent – are out of school as a result of nationwide school closures in 177 countries.
- 40 per cent of the world’s population are not able to wash their hands with soap and water at home.
- Nearly 370 million children across 143 countries who normally rely on school meals for a reliable source of daily nutrition must now look to other sources as schools are shuttered.
- As of 14 April, over 117 million children in 37 countries may miss out on their measles vaccination as the pandemic causes immunization campaigns to stop to reduce the risk of spreading the virus.
This week, UNICEF is launching #Reimagine, a global campaign to prevent the COVID-19 pandemic from becoming a lasting crisis for children, especially the most vulnerable children – such as those affected by poverty, exclusion or family violence. Through the campaign, UNICEF is issuing an urgent appeal to governments, the public, donors and the private sector to join UNICEF as we seek to respond, recover and reimagine a world currently besieged by the coronavirus:
- Respond. We must act now to stop the disease from spreading, help the sick, and protect first responders on the frontlines risking their own lives to save others.
- Recover. Even when the pandemic slows, each country will have to continue to work to mitigate the knock-on effects on children and address the damage inflicted. Communities will also have to work together, and across borders to rebuild and prevent a return of the disease.
- Reimagine. If we have learned anything from COVID-19, it’s that our systems and policies must protect people, all the time, not just in the event of a crisis. As the world recovers from the pandemic, now is the time to lay the groundwork for building back better.
To kickstart the campaign, two of UNICEF’s valued partners - Pandora and ING - have both agreed to pledge a generous donation to show their part in answering the call to this appeal and to spur more donations from the public in the coming weeks.
“The COVID-19 crisis is a child rights crisis. We need an immediate-, medium- and long-term response that not only addresses the challenges created by the pandemic and its secondary impacts on children, but also outlines a clear version for building back a better world when the crisis finally recedes. For that, we need everyone’s ideas, resources, creativity and heart.” said UNICEF Executive Director Henrietta Fore. “It is our shared responsibility today, to reimagine what the world will look like tomorrow.”
Notes to Editors:
The paper will go live in the Lancet Global Health journal on 12 May, 23.30 UK time: http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30229-1/fulltext
Learn about the #Reimagine campaign here: www.unicef.org/reimagine
The authors of the Lancet Global Health study used the Lives Saved Tool (LiST) to model maternal and under-five child mortality for three scenarios in 118 low- and middle-income countries. They modelled three scenarios in which the coverage of essential maternal and child health interventions is reduced by 9·8–51·9 per cent and the prevalence of wasting is increased by 10–50 per cent. They estimated additional deaths for a single month and extrapolated for 3 months, 6 months, and 12 months
These interventions range from family planning, antenatal and postnatal care, child delivery, vaccinations and preventive and curative services. The modeled scenarios are hypothetical and do not reflect actual policies or distinguish between mitigation strategies—only that disruptions will occur.
About UNICEF’s Covid-19 Programme and Advocacy Response
The response is built around a six-point Agenda for Action that supports Governments and calls on decision-makers to:
- Keep children healthy and well nourished
- Reach vulnerable children with water, sanitation and hygiene
- Keep children learning
- Support families to cover their needs and care for their children
- Protect children from violence, exploitation and abuse
Protect refugee and migrant children, and those affected by conflict
UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children, visit www.unicef.org. For more information about COVID-19, visit www.unicef.org/coronavirus. Follow UNICEF on Twitter and Facebook
The UNICEF South Asia region include Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka.
UNICEF’s Regional Office for South Asia (ROSA) works with all eight UNICEF Country Offices in South Asia to help to save children’s lives, defend their rights, and help them fulfill their potential. Follow UNICEF ROSA on Twitter and Facebook.
For more information regarding the study, please contact:
Sabrina Sidhu, UNICEF New York, +1 917 4761537, email@example.com
For all other inquiries, please contact:
Anne Sophie Bonefeld, Regional Chief of Communication, UNICEF Regional Office for South Asia (ROSA), +977 9801030076, firstname.lastname@example.org
UNICEF promotes the rights and wellbeing of every child, in everything we do. Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere.
For more information about UNICEF and its work for children, visit www.unicef.org.