Reproductive, maternal, newborn and child health during and post Covid -19 

A nurse smiles with a baby as mother looks on. Adara Group photo.

Health Perspective WITH James William Mugeni

United States of America—8, June 2020: The vital statistics across the world are usually measured using maternal health and child health. We talk about mothers dying during the child delivery process. Then after delivery we talk about the child survival strategies which we also use as a measure of national health.

When more women survive childbirth, more children grow up with mothers, and more communities prosper. But here is the reality in the nations where medical clinical officer serve; women struggle to access basic health care, let alone the surgical care that might be needed to help them deliver safely. And that hurts everyone—women, their families, and entire communities. This is an injustice Covid-19 is making worse, as it hits the most impoverished communities hardest. It is also an injustice we need to commit to ending.

Clinical officers’ teams around the world should not let the fight against Covid-19 take resources away from maternal care. It is simple: Childbirth does not stop during a crisis, so neither should care. Covid-19 is threatening to make healthcare scarcer and childbirth more dangerous around the world. As Medical clinical officers and our associates let us not be blind to the deficits below.

  • An estimated 303,000 women around the world died due to complications of pregnancy and childbirth in 2015. Almost all these deaths occurred in low- and middle-income countries, and almost two-thirds of those were in Sub-Saharan Africa. These deaths are preventable with appropriate management and care. Globally, in 2018, 81 percent of births took place with the help of a skilled birth attendant, a significant improvement from 69 percent in 2012. Coverage of skilled birth attendants in 2018 was only 59 percent in Sub-Saharan Africa. 
  • The under-5 mortality rate fell to 39 deaths per 1,000 live births in 2017, a 6.7 percent reduction from 42 deaths in 2015, and an overall reduction of 49 percent from 77 deaths per 1,000 live births in 2000. The total number of under-5 deaths dropped to 5.4 million in 2017 from 9.8 million in 2000. Still, most of these deaths were from preventable causes and almost half, or 2.5 million, occurred in the first month of life—the most crucial period for child survival. The global neonatal mortality rate has continued to decline after a long downward trend from 31 deaths per 1,000 live births in 2000 to 18 in 2017, a 41 percent reduction. 
  • Immunization saves millions of lives and is widely recognized as one of the world’s most successful and cost-effective health interventions. Coverage of the required three doses of the vaccine that prevents diphtheria, tetanus and pertussis increased from 72 percent in 2000 to 85 percent in 2015 and has remained unchanged between 2015 and 2017. An estimated 19.9 million children did not receive the vaccines during the first year of life, putting them at serious risk of these potentially fatal diseases. The global coverage of pneumococcal conjugate vaccine, which has the potential to significantly reduce deaths in children under age of 5, has yet to reach 50 percent. Two doses of the measles vaccine are required to prevent the disease and the illnesses, disabilities and deaths caused by complications associated with it. Coverage with the second dose of measles vaccine increased from 59 percent in 2015 to 67 percent in 2017, but that is still insufficient to prevent this highly contagious disease. 

The Covid-19 has got countries not with clean sheets and this is an injustice Covid -19 is making worse as it hits the most impoverished communities hardest. It is an injustice that we must commit ourselves. Most governments have removed resources away from maternal and childcare or the actions in the lockdown are blind to these MCH issues.

UNICEF warns lockdown could kill more than Covid -19 and they have model estimates of 1.2 million child deaths.

The Clinical officer as a frontline worker must not allow this to happen it is time to have solidarity across the world and we rise voices of the undeserved populations.

The author is a Ugandan Medical Clinical Officer/Certified Public Manager based in United States of America

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