The number of global under-five deaths were at an all-time low of 5.2 million in 2019, but disruptions in child and maternal health services due to COVID-19 put millions of other lives at stake, the World Health Organization (WHO) said Wednesday.

The WHO said that under-five deaths dropped to its lowest point on record in 2019, to 5.2 million, from 12.5 million in 1990.

The new mortality estimates were released by UNICEF, the WHO, the Population Division of the UN Department of Economic and Social Affairs, and the World Bank Group.

However, surveys by UNICEF and WHO reveal that the COVID-19 pandemic has resulted in significant disruptions to health services that threaten to undo decades of hard-won progress.

“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 center of our response,” said Dr. Tedros Adhanom Ghebreyesus, the 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.”

Henrietta Fore, UNICEF executive director, said: “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 re-start disrupted health systems and services, millions of children under five, especially newborns, could die,” Fore said.

Disruptions in health services

Over the past 30 years, health services to combat child death such as pre-term, low birth weight, complications during birth, neonatal sepsis, pneumonia, diarrhea, malaria, and vaccination have played a large role in saving millions of lives.

Now countries worldwide are experiencing disruptions in child and maternal health services.

These include health checkups, vaccinations, prenatal and post-natal care, resource constraints, and a general uneasiness with using health services due to a fear of getting COVID-19.

A recent WHO survey based on 105 countries’ responses revealed that 52% of countries reported disruptions in health services for sick children and 51% in services to manage malnutrition.

Such health interventions are critical for stopping preventable newborn and child deaths.

For example, women who receive care by professional midwives trained according to international standards are 16% less likely to lose their baby and 24% less likely to experience pre-term birth, according to WHO.

A UNICEF survey conducted mid-year across 77 countries found that almost 68% of countries reported some disruption in health checks for children and immunization services.

Also, 63% of countries reported disruptions in antenatal checkups and 59% in post-natal care.

Based on countries’ responses in the UNICEF and WHO surveys, the most commonly cited reasons for health service disruptions included parents avoiding health centers for fear of infection, transport restrictions, suspension or closure of services and facilities.

They also cited fewer healthcare workers due to diversions or fear of infection due to shortages in personal protective equipment such as masks and gloves; and more significant financial difficulties.

Afghanistan, Bolivia, Cameroon, the Central African Republic, Libya, Madagascar, Pakistan, Sudan, and Yemen are among the hardest-hit countries, according to the survey.

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