Women and children lose 20% of health, social services to COVID-19

Women in line at a COVID-19 emergency response activity in Dhaka, Bangladesh. Photo by:  UN Women Asia and the Pacific / CC BY-NC-ND

NEW YORK — Globally, women and children are losing access to 20% of their health and social services as a result of COVID-19, according to new findings by senior global health experts commissioned by the United Nations.

Approximately 13.5 million children have missed life-saving vaccinations over the past four months, and some kids in low-income countries may never receive these routine shots, according to the annual report issued by the U.N. secretary-general’s Independent Accountability Panel for Every Woman, Every Child, Every Adolescent.

Before the pandemic, the rate of maternal mortality was declining at a slower annual rate than what is required to meet the Sustainable Development Goals by 2030. Globally, maternal mortality will see a spike of 24,000 deaths during 2020, as a result of COVID-19, according to the report. Two hundred and ninety-five thousand women were already estimated to die during or shortly after pregnancy in 2020. 

The overall service loss in individual countries for women, children, and adolescents varies from 10% to 60%, according to Elizabeth Mason, co-chair of the panel. And some specific indicators show higher rates of sudden service drop-off. In the United Kingdom, for example, 80% fewer children have been admitted to the hospital during the pandemic, Mason explained.

“The question is, what has happened to those children? Are hospital admissions there normally too many, or are the children who are actually better off in the hospital now sitting at home and suffering the consequences?” Mason said.

The panel released its annual report on the sidelines of the ongoing U.N. High-level Political Forum on Sustainable Development on Monday.

“These new findings show how weak our health systems are at protecting mothers, newborns, young children, and adolescents,” Joy Phumaphi, co-chair of the panel and former WHO assistant director general, said in a media statement. “We are at a point where decades of progress for this group could be easily reversed.”

Reproductive health care access for many women and girls has worsened during the pandemic, and a return to pre-pandemic activity remains uneven. Médecins Sans Frontières is one organization that also reported early in July on the “potentially catastrophic secondary impacts” COVID-19 is having on women and girls’ health worldwide.

The panel was already developing its annual report before the pandemic hit in early 2020. Initial findings already revealed a “bad situation,” according to the panel, who found that universal health coverage remains uneven, and mistrust in governments, private sector, media, and nonprofit organizations was rising globally because of a “growing sense of inequity and unfairness.”

Overall, global progress on reducing preventable maternal, newborn, child, and adolescent deaths was already lagging by around 20%.

“When the pandemic hit, very quickly we started to see indeed there are issues around increased domestic violence, for example, and we had early reports of immunization stopping,” Mason said. “We started to look at it in more detail to see this massive side effect of COVID. Because the focus has been on COVID and, in fact, there are other services that have suffered tremendously in many countries.”

The report’s new findings are the result of available literature reviews, country data, and official World Health Organization estimates. The latest U.N. data does not yet reflect the effects of COVID-19, though, and primary data on the effects of the pandemic are limited, according to the panel.

Available studies indicate that maternal and child mortality is expected to be higher than projected, and may “deteriorate relative to estimated 2015 mortality levels,” the panel reported. 

Surveys show that 73% of health workers in 30 countries have cited shortages of sanitary products, and another 50% reported reduced access to clean water to help manage menstrual hygiene, according to the panel’s research.

“The impact can actually be massive,” Mason told Devex.

Governments lifting restrictions and reopening parts of society is unlikely to offer a quick fix to restoring health care access.

“If you look at the wave of closures and then reopenings, it is not necessarily in line with the wave of the pandemic. The fear of people using the services can continue to be there and the issue of health workers being reallocated to other tasks can still be there. Individual countries need to look at what is happening regarding their services and to encourage people to use the services,” Mason continued.

The panel recommends that governments invest in improving data quality on women and children’s health, institutionalizing accountability processes to monitor, review, and apply lessons to women and children’s health, and enabling public participation in accountability reform.

“Governments have a duty to protect women, children, and adolescents, and they have to do the right thing for them, too. They may be doing the right thing for COVID, but it should be in addition to, not at the expense of women and children’s health,” Mason said.

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