Child Mortality Progress Threatened by Pandemic Disruptions
Global under-five deaths fell to an all-time low of 5.2 million in 2019, down sharply from 12.5 million in 1990. New mortality estimates released by UNICEF, the World Health Organization, the Population Division of the United Nations Department of Economic and Social Affairs, and the World Bank Group documented this milestone.
Disrupted Antenatal Care Leaves Newborns Vulnerable to Preventable Complications
- Disrupted Antenatal Care: Pregnant women and newborns are missing essential health checks because clinics are overwhelmed and communities fear infection.
- Preventable Complications: Preterm births, neonatal sepsis, pneumonia, diarrhea, and malaria require continuous clinical management that current pandemic resource constraints interrupt.
- Vulnerable Neonates: Newborns represent a disproportionate share of under-five mortality, with 47 percent of these deaths occurring during the neonatal period in 2019 compared to 40 percent in 1990.
Global Health Agencies Warn of Reversing Decades of Gains
Surveys conducted by UNICEF and the World Health Organization (WHO) reveal that the COVID-19 pandemic threatens to undo decades of hard-won progress in reducing preventable child deaths. Henrietta Fore, UNICEF Executive Director, stated that when health systems are overrun and women avoid hospitals out of fear, they become secondary casualties of the virus.
Over the past thirty years, clinical interventions targeting preterm births, low birthweight, birth complications, neonatal sepsis, pneumonia, diarrhea, and malaria saved millions of lives. However, countries worldwide now experience severe interruptions in routine vaccinations, health checkups, and prenatal and postnatal care. A UNICEF survey of 77 countries conducted over the summer found that nearly 68 percent reported disruptions in child health checks and immunization services. Furthermore, 63 percent reported disruptions in antenatal checkups, and 59 percent noted disruptions in postnatal care.
A separate WHO survey of 105 countries showed that 52 percent faced disruptions in health services for sick children, while 51 percent experienced interruptions in malnutrition management. Professional midwives trained to international standards reduce the relative risk of losing a baby by 16 percent and pre-term birth by 24 percent, according to WHO data.
| Health Service Area | Percentage of Surveyed Countries Reporting Disruptions | Reporting Agency |
|---|---|---|
| Child Health Checks & Immunizations | 68% | UNICEF (77 countries surveyed) |
| Antenatal Checkups | 63% | UNICEF (77 countries surveyed) |
| Postnatal Care | 59% | UNICEF (77 countries surveyed) |
| Sick Child Health Services | 52% | WHO (105 countries surveyed) |
| Malnutrition Management | 51% | WHO (105 countries surveyed) |
High-Risk Regions Facing Severe Service Reductions
Afghanistan, Bolivia, Cameroon, the Central African Republic, Libya, Madagascar, Pakistan, Sudan, and Yemen rank among the hardest-hit nations. Seven of these nine countries sustained high child mortality rates exceeding 50 deaths per 1,000 live births among children under five in 2019. In Afghanistan, where 1 in 17 children died before reaching age five in 2019, the Ministry of Health recorded a significant drop in facility visits as families de-prioritized prenatal and postnatal care.
Newborns face the highest baseline mortality risk. In 2019, a newborn baby died every 13 seconds. In Cameroon, where 1 out of every 38 newborns died in 2019, the UNICEF survey reported an estimated 75 percent disruption in essential newborn care, antenatal checkups, obstetric care, and postnatal services. Initial modeling published in May by Johns Hopkins University indicated that nearly 6,000 additional children could die daily due to pandemic-related disruptions.
Parents Must Seek Medical Care for Urgent Obstetric Emergencies
Parents and pregnant individuals must not avoid professional medical facilities for urgent obstetric emergencies, acute neonatal distress, or severe pediatric infections out of fear of viral transmission.
Sustaining Healthcare Infrastructure During Public Health Emergencies
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized the necessity of keeping investments directed toward resilient health systems. Primary drivers of service disruptions include parental fear of infection, transportation restrictions, facility closures, and healthcare worker reassignments compounded by shortages in personal protective equipment such as masks and gloves. Muhammad Ali Pate, Global Director for Health, Nutrition and Population at the World Bank, emphasized the urgency of protecting life-saving clinical interventions. John Wilmoth, Director of the Population Division of the United Nations Department of Economic and Social Affairs, noted that the data highlights persistent inequities in child survival prospects worldwide.
