ISLAMABAD: The number of global under-five deaths dropped to the lowest point on record in 2019 — down to 5.2 million from 12.5m in 1990, according to new mortality estimates released by the United Nations Children’s Emergency Fund (Unicef) on Wednesday.

Surveys by Unicef and the World Health Organisation (WHO) reveal that the Covid-19 pandemic has resulted in major disruptions to health services that threaten to undo decades of hard-won progress.

Pakistan has been placed among the most affected countries with health service disruptions including parents avoiding health centres for fear of infection; transport restrictions; suspension or closure of services and facilities; fewer healthcare workers due to diversions or fear of infection due to shortages of personal protective equipment such as masks and gloves; and greater financial difficulties.

Afghanistan, Bolivia, Cameroon, the Central African Republics, Libya, Madagascar, Sudan and Yemen are also among the hardest-hit countries.

Pakistan placed among most affected countries

“The global community has come too far towards eliminating preventable child deaths to allow the Covid-19 pandemic to stop us in our tracks,” said Henrietta Fore, Unicef Executive Director. “When children are denied access to health services because the system is overrun, and when women are afraid to give birth at the hospital for fear of infection, they, too, may become casualties of Covid-19. Without urgent investments to restart disrupted health systems and services, millions of children under five, especially newborns, could die,” he said.

According to a statement issued by WHO on Wednesday, over the past 30 years, health services to prevent or treat causes of child death such as preterm, low birth weight, complications during birth, neonatal sepsis, pneumonia, diarrhea and malaria, as well as vaccination, have played a large role in saving millions of lives.

Now countries worldwide are experiencing disruptions in child and maternal health services, such as health checkups, vaccinations and prenatal and post-natal care, due to resource constraints and a general uneasiness with using health services due to a fear of getting Covid-19.

A Unicef survey conducted over the summer across 77 countries found that almost 68 per cent of countries reported at least some disruption in health checks for children and immunisation services. In addition, 63pc of countries reported disruptions in antenatal checkups and 59pc in post-natal care.

A recent WHO survey based on responses from 105 countries revealed that 52pc of countries reported disruptions in health services for sick children and 51pc in services for management of malnutrition.

Health interventions such as these are critical for stopping preventable newborn and child deaths. For example, women who receive care by professional midwives trained according to international standards are 16pc less likely to lose their baby and 24pc less likely to experience pre-term birth, according to WHO.

“The fact that today more children live to see their first birthday than any time in history is a true mark of what can be achieved when the world puts health and well-being at the centre of our response,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Now, we must not let the Covid-19 pandemic turn back remarkable progress for our children and future generations. Rather, it’s time to use what we know works to save lives, and keep investing in stronger, resilient health systems.”

Even before Covid-19, newborns were at highest risk of death. In 2019, a newborn baby died every 13 seconds. Moreover, 47pc of all under-five deaths occurred in the neonatal period, up from 40pc in 1990. With severe disruptions in essential health services, newborn babies could be at much higher risk of dying. For example, in Cameroon, where one out of every 38 newborns died in 2019, the Unicef survey reported 75pc disruptions in services for essential newborn care, antenatal check-ups, obstetric care and post-natal care.

Published in Dawn, September 10th, 2020