An additional 51,000 children under the age of five might die in the Middle East and North Africa by end of 2020 due to COVID-19’s disruption in primary health care

AMMAN, 15 June 2020 – “The COVID-19 pandemic is putting health systems under unprecedented stress in the region. Primary health care services have either decreased or been interrupted in several countries.

“While we do not have many cases of COVID-19 among children in the region, it is evident that the pandemic is affecting children’s health firsthand. An additional 51,000 children under the age of five might die in the region by the end of 2020 if the current disruption of essential health and nutrition services is protracted and malnutrition among children increases.

“If this happens, it would be an increase of nearly 40 per cent in comparison to pre-COVID figures, reversing progress made in child survival in the region by nearly two decades.

“A combination of factors will contribute to this bleak prediction.  Overstretched, many front-line health workers have diverted their efforts to respond to the outbreak amid a shortage of personal protective equipment and other essential supplies. Lockdowns, movement restrictions and economic barriers could further prevent communities’ access to health care. Many fear of contracting the virus while at health facilities. Children and mothers are therefore likely to miss out on preventive interventions including immunization, treatment of neonatal infections and childhood diseases, care during pregnancy and childbirth and services to prevent an increase in wasting. 
 
“But we can avoid this scenario, allowing tens of thousands of children to celebrate their fifth birthday surrounded by their families and friends.
 
“We call for the following steps and confirm that UNICEF and WHO are committed to support  health care systems around the region to implement these actions:

• The full and safe resumption of vaccination campaigns and nutrition services, following strict precautionary measures for infection prevention, using personal protective equipment, avoiding overcrowding and adhering to physical spacing in health care facilities.
• Prioritize and facilitate access to primary health care services for every child especially the most vulnerable through the availability of health personnel and supplies.
• Equip the community outreach teams across the region with the minimum requirements for infection prevention and control (IPC) including the implementation of standard precautions and personal protective equipment.
• Invest in effective public communication and community engagement initiatives to increase trust in public health systems and promote appropriate care-seeking behaviors among families.

 
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Notes to editors

- Ten countries are covered in the study including Algeria, Djibouti, Egypt, Iraq, Jordan, Morocco, Syria, Sudan, Tunisia and Yemen. The population of children under the age of five in these ten countries is nearly 41 million, this nearly 75 per cent of the total number of children under the age of five in the MENA region.

- The baseline for under-five child mortality in six months is nearly 133,000 deaths. The additional under 5 mortality is 51,000 which brings the total to nearly 184,000 death.

- The numbers in this joint press briefing are based on the study “Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries”.  The Bloomberg School of Public Health, Johns Hopkins University (JHU) conducted the above study and published it in the Lancet Global Health in May 2020. The study provides indications on the potential magnitude of the impact on child and maternal deaths in developing countries, if essential health services are disrupted and malnutrition increases as a result of COVID-19.

- For the region, a decline in case management of neonatal infections and childhood diseases account for one third of the potential additional deaths, while an increase in wasting prevalence is the cause for one out of five additional deaths. The other top contributing factors are related to the disruption of essential care at birth and immunization. This potential impact is due to a combination of reduction in the supply and in the demand of health services, the latter due to physical and financial barriers to access health care and fear of contracting the virus at health facilities.