As COVID-19 devastates already fragile health systems, over 6,000 additional children under five could die a day, without urgent action

UNICEF launches #Reimagine, a global campaign to prevent the pandemic from becoming a lasting crisis for children

13 May 2020
As COVID-19 devastates already fragile health systems, over 6,000 additional children under five could die a day, without urgent action
UNICEF Timor-Leste/2019/Monemnasi

NEW YORK, 13 MAY 2020 – An additional 6,000 children could die every day from preventable causes over the next six months as the COVID-19 pandemic continues to weaken health systems and disrupt routine services, 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, 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.

These potential child deaths will be in addition to the 2.5 million children who already die before their 5th birthday every six months in the 118 countries included in the study, threatening to reverse nearly a decade of progress on ending preventable under-five mortality.  
Some 56,700 more maternal deaths could also occur in just six months, in addition to the 144,000 deaths that already take place in the same countries over a six-month period.

“Under a worst-case scenario, the global number of children dying before their fifth birthdays could increase for the first time in decades,” said UNICEF Executive Director Henrietta Fore. “We must not let mothers and children become collateral damage in the fight against the virus. And we must not let decades of progress on reducing preventable child and maternal deaths be lost.”

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. 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, 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 Fore. “It is our shared responsibility today, to reimagine what the world will look like tomorrow.”


Download photos, broll and the paper here.  Review the data for 118 countries here.

The paper will go live in the Lancet Global Health journal on 12 May, 23.30 UK time:  

Learn about the #Reimagine campaign here:

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




COVID-19 ne’ebe estraga ona frajilidade sistema saúde sira, labarik sira tinan lima mai kraik la ho asaun urjente 6.000-tan mate lor-loron, 

UNICEF lansa #Reimajina, kampaña global ida atu prevene pandemia la bele sai krize ida naruk ba labarik sira

Nova Yorke, 13 Maiu 2020 – UNICEF dehan ohin loron labarik sira 6.000 bele mate lor-loron husi kauza sir abele prevene iha fulan neen mai ne’e enkuantu pandenia COVID-19 kontinua hafraku sistema saúde sira no estraga servisu rutina sira, 

Estimasaun ne’e bazeia ba analize ida husi peskizador sira husi Johns Hopkins Bloomber School of Public Health, newly published in the Lancet Global Health journal. Bazeia senariu aat liu tolu iha país ho rendimentu ki’ik no mediu 118, analize sira ne’e halo estimasaun katak labarik sira tinan lima mai kraik millaun 1,2 sei mate iha deit fulan neen, tamba redusaun nivel kobertura servisu saúde rutina no aumenta iha labarik desperdisu. 

Mate potensial hirak husi labarik sira millaun 2,5 tan mak mate ona molok kompleta tinan lima fulan-fulan neen iha país 118 inklui m’os iha estudu ne’e, ameasa sei atraza progresu besik decade ida kona-ba mortalidade tinan lima mai kraik mak bele prevene. 
Mortalidade maternal sira 56.000 bele mós akontese iha fulan neen nia laran, alende mate 144.000 sira mak akontese ona iha país sira hanesan iha periudu fulan neen nia laran.

“Liu husi kazu senariu aat liu – númeru global husi labarik sira mate antes halo tinan lima bele aumente ba tempu decade dahuluk,” dehan Diretora Exekutiva UNICEF Henrietta Fore. “Ita tenke husi inan no oan sira sai kolateral ba estragu ba funu hasoru virus ne’e. No ita tenke la bele husik progresu decade redusaun maternal maternal no infantil liu deit.”

Iha país isr ne’ebe ho sistema saúde fraku, COVID-19 desturba mekanismu suprimentu no hafraku rekursu finanseiru umanu sira. Vizita ba sentru saúde sira fraku tanba blokeadu, restrikasun iha kalan no interupsaun transporte sira, no hanesan komunidade sira tauk loos ba infesaun. Iha komentariu ida hodi lansa realtoriu Lancet, UNICEF alerta katak interupsaun sira ne’e bele rezulta ba aumentu estragu potensial iha maternidade infantil no maternal sira.

Iha dokumentu analiza senariu tolu ba impaktu husi redusaun intervensaun salva vida sira tanba krizi kona-ba mortalidade infantil no maternal sira. Nia alerta katak iha senariu grave ki’ik, ne’ebe nia kobertura tu’un ba maizumenus pursentu 15, sei iha aumentu pursentu 9,8 husi mate labarik tinan lima mai kraik sira ka ho estimasaun kada loron mortalidade maternal 1.400, ka aumenta pursentu 8,3. 

Iha kazu senariu a’at-liu, ne’ebe intervensaun saúde sira reduzidu iha labarik mate tinan lima mai kraik no pursentu 38,6 aumenta ba mortalidade maternal ful-fulan. Intervensaun sira ne’e liu husi planeamentu familiar, pre-natal no kuidadu pós-natal, partu, vasinasaun preventiva no servisu kurativu sira. Estimasaun hatudu karik ba razaun saida deit, interupsaun kuidadu saúde rutina no asesu ba aihan aumenta, aumentu ba mortalidade infantil no maternal sei a’at-liu tan. Númeru boot liu ba maternidade labarik sira sei ne’e tanba iha aumentu husi desperdisu ba labarik sira, ne’ebe inklui liu-tan impkatu sistema potensial saúde, no redusaun ba tratamentu husi sepse no pneumonia.  

Tuir modelajen ne’e no hanoin katak redusaun ba kobertura iha kazu senariu a’at-liu, país 10 ne’ebe bele potensialmente hetan númeru boot adisional ba maternidade infantil mak: Bangladesh, Brazil, Republika Demokratika Congo, Ethiopia, India, Indonesia, Nigeria, Pakistaun, Uganda no Republika Unidu Tanzania. País 10 ne’ebe bele liu sai evidensia ba taxa boot husi mortalidade iha kazu senariu a’at-liu mak: Djibouti, Eswatini, Lesotho, Liberia, Mali, Malawi, Nigeria, Pakistaun, Sierra Lione no Somalia. Prestasaun kontiua halao ba servisu salva moris mak kritiku iha país sira ne’e.

Alende aumentu potensial husi númeru estimasaun iha mortalidade tinan lima mai kraik no maternal deskreve iha analize Lancet Global Journal, UNICEF aleta liu-tan ho efeitu inderetu sira seluk husi pandemia ba labarik sira:
• Iha estimasaun husi labarik idade tinan 18 mai kraik pursentu 77 – billaun 1.80 husi billaun 2,35 – moris hela husi país 132 ne’ebe aplika politika hela deit iha uma, iha inisiu fulan Maiu. 
• Estudante besik billaun 1,3 – liu pursentu 72 – la eskola tanba rezultadu husi eskola taka hotu iha país 177.
• Populasaun pursentu 40 iha mundu la bele fase sira-nia liman ho sabaun no bee iha uma.
• Labarik sira kuaze millaun 370 iha país 143 ne’ebe normalmente depende ba merenda eskolar ba nutrisaun lor-loron tenke buka fali rekursu seluk tanba eskola sira taka hotu.
• Iha fulan Abril, labarik sira liu millaun 117 iha país 37 sei lakon sira nia vasina sarampo sira tanba pandemia ne’e kauza kampaña imunizasaun tenke para hodi reduz risku propagasaun virus. 

Iha Semana ne’e, UNICEF lansa hela #Reimagina, kampaña global hodi prevene pandemia COVID-19 husi sai krizi ikus ba labarik sira, espesialmente labarik sira mak vulneravel liu – hanesan sira afetadu husi moris ki’ak, exkluidu ka violensia husi familia. Liu kampaña ne’e, UNICEF hatoo apelu urjente ida ba governu sira, publiku, doador no setor privadu atu involve hamutuk ho UNICEF atu ita buka hatan ba rekupera no reimajina mundu ida atualmente nakonu hela koronovirus: 

Resposta. Ita tenke halo asaun agora atu hapara moras transmite, ajuda ema moras, no proteje responder dahuluk sira kona-ba sira iha oin ne’ebe ariska sira-nia moris atu salva sira seluk.

Rekupera. Maske pandemia ne’e neineik, pís ida-idak sei tenke kontinua atu servisu hodi mitiga efeitu indiretu sir aba labarik sira no rezolve estragu sira mak mosu. 
Komunidade sira sei mós tenke servisu hamutuk, no atravesa fronteira sira hodi harii hikas no prevene moras ne’e atu fila fali. 

Reimajina. Karik aprende ona buat ruma husi COVID-19, ne’e mak ita-nia sistema no politika sira tenke proteje ema, iha tempu hotu, laos deit iha tempu krize sira. Karik mundu rekuperadu ona husi pendemia, agora mak tempu atu lansa baze hodi hadi’ak fali.

Atu hahú kampaña, UNICEF nia parseiru valuavel rua – Pandora no ING – konkorda ona atu atu halo doasaun jeneroza hodi hatudu sira-nia parte hodi hatan ba apelu no estimula doasaun sira seluk husi publiku iha semana sira tuir mai ne’e.

“Krizi COVID-19 mak krizi ba direitu labarik. Ita presiza resposta imediata, mediu no prazu naruk mak laos rezolve deit dezafiu sira kria husi pandemia no nia impaktu sekundaria ba labarik sira, maibe mós hutudu versaun klaru hodi harii fali mundu ida diak liu wainhira krizi ne’e liu ona. Ba ne’e, ita presiza ema hotu nia ideia sira, rekursu, kreatividade no fuan,” dehan Fore. “Ne’e mak ita-nia responsabilidade kompartillada ohin loron, aru reimajina saida mak mundu sei oinsa aban-bainrua.”


Artigu ne’e publika ona iha revista Lancet Global Health iha 12 Maiu, 23.30 oras UK:   

Hatene kona-ba kampaña  #Reimagine iha ne’e:

Autor husi estudu Lancet Global Health uza Lives Saved Tool (LiST) hodi modeliza mortalidade maternal no tinan lima mai kraik ba senariu tolu iha país 118 ho rendimentu ki’ik no mediau sira. Sira modeliza senariu tolu ne’e wainhira kobertura intervensaun saúde infantil no maternal esensial reduz ona husi pursentu 98 ba 51,9 no nia prevalensia desperdisiu aumenta husi pursentu 10 ba 50. Sira halo estimasaun adisional mortalidade bai da-nia laran no extrapoladu husi fulan 3, fulan 6 no fulan 12.

Intervensaun sira varia husi planeamentu familiar, kuidadu ante-natal no pos-natal, tuur-ahi, vasinasaun no servisu preventiva no kurativa sira. Modelajen senariu sira mak ipotetikal no la refleta politika atual sira ka destingi entre estratejia mitigasaun sira – wainhira desrupsuan mosu.

Kona-ba UNICEF-nia Programa COVID-10 no Advokasia Resposta

Resposta ne’e hari’i husi tornu pontu neen Ajenda ba Asaun mak apoia Governu sira no apela ba ema mak foti desizaun sira atu: 
• Mantein labarik sira saudavel no nutrisaun di’ak
• Besik ba labarik vulneravel sira ho bee, saneamentu no ijiene
• Mantein labarik estuda
• Apoia familia sira atu kobre sira-nia nesesidade sira no kuida sira-nia oan sira
• Proteje labarik sira husi violensia, esplorasaun no abuzu
• Proteje refujiadu no migrante labarik sira no sira ne’ebe afetadu husi konflitu 

Media contacts

Rukshan Ratnam
Communication Specialist (English)
UNICEF Timor-Leste
Tel: +67077231103
Tel: +670 331 1300, Extension: 1820
Antonio Gomes
Communication Officer (Tetum)
UNICEF Timor-Leste
Tel: +670 7723 2441
Tel: +670 331 1300, Extension: 1821


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