Child health vulnerabilities during the COVID-19 pandemic in Brazil and Portugal.

Ivone Evangelista Cabral,Maria De Lurdes Lopes De Freitas Lomba Lomba,Yan Do Rosario Nunes,Lia Leão Ciuffo,Márcia Pestana-Santos

doi:10.1590/1518-8345.4805.3422

Abstract

Objective:to analyze the vulnerabilities of children in the access to primary health care during the COVID-19 pandemic in Brazil and Portugal.Method:documentary study based on Brazilian and Portuguese governmental guidelines issued between March and August 2020 regarding access of children to primary health care. Thematic analysis was based on the precepts of health vulnerability.Results:13 documents were issued in both countries addressing access to vaccination and childcare. Due to the SARS-CoV-2, restrictions were imposed on the circulation of people in social environments, health services, and social protection, decreasing the demand for health services. Both countries continued programs to promote the health of breastfeeding infants. In-person childcare consultations were suspended for low-risk children in both countries. Portugal maintained routine vaccination while Brazil interrupted vaccination in the first 15 days of the pandemic. The countries adopted remote care strategies - telemonitoring, teleconsultation, and mobile applications - to maintain the bond between children and health services.Conclusion:longitudinality was affected due to restricted access of children to health promotion actions, determining greater programmatic vulnerability. Individual vulnerabilities are related to exposure to preventable and primary health care-sensitive diseases.

Highlights

IntroductionVulnerability refers to a context of social relations that limits the ability of people to act when institutional support that would ensure social security is no longer available
The United Nations Children’s Fund (UNICEF) released its action agenda in defense of children who are most vulnerable to COVID-19 (Coronavirus disease 2019), caused by the coronavirus (SARS-CoV2), in the context of global health, highlighting the need for urgent actions to avoid a health crisis that results in violating children’s rights in the broadest sense[1].Vulnerability refers to a context of social relations that limits the ability of people to act when institutional support that would ensure social security is no longer available
The 13 documents selected presented guidelines concerning the care provided to children during the COVID-19 pandemic: seven of which were from Brazil and six from Portugal

Summary

Introduction

Vulnerability refers to a context of social relations that limits the ability of people to act when institutional support that would ensure social security is no longer available These are situations that deny people the possibility to effectively exercise their citizenship rights and, individuals experience insecurity in the present that may frustrate future projects[2]. Prevalence of the disease in different countries is below 5% in the child population (from one day to 15 years old), with an even lower number of cases during lactation[3,4] It is unknown why morbidity caused by COVID-19 is less severe in this group though, considering that the virus is transmitted person-to-person when having direct contact with an infected individual or with his/her respiratory droplets. Even though morbidity and mortality rates are low, one has to be attentive to a greater vulnerability to other diseases not associated with SARS-CoV-2, which may indirectly increase morbidity and mortality in this population

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