Abstract
ABSTRACT Essential health, education and other service disruptions arising from the COVID-19 pandemic risk reversing some of the hard-won gains in improving child survival over the past 40 years. Although children have milder symptoms of COVID-19 disease than adults, pandemic control measures in many countries have disrupted health, education and other services for children, often leaving them without access to birth and postnatal care, vaccinations and early childhood preventive and treatment services. These disruptions mean that the SARS-CoV-2 virus, along with climate change and shifting epidemiological and demographic patterns, are challenging the survival gains that we have seen over the past 40 years. We revisit the initiatives and actions of the past that catalyzed survival improvements in an effort to learn how to maintain these gains even in the face of today’s global challenges.
Highlights
More children are surviving past the age of 5 years than ever before because essential services, including immunization against childhood diseases, nutrition support and sick child visits, were prioritized by global health initiatives seeking to eliminate preven table deaths in children under 5 years
During the Covid-19 pandemic, these essential health services and the systems, financing and workforce that sup port them have been disrupted globally because of facility closures, transportation limitations, family fear of attending clinics and reorganization of health services to focus on COVID-19 patient care
World Health Organization (WHO) pulse surveys of key informants in countries in 2020 and again in early 2021 show that 93% of 187 countries suffered at least some service disruptions at the start of the pandemic, falling slightly to 89% of 135 countries by early 2021 [2]
Summary
More children are surviving past the age of 5 years than ever before because essential services, including immunization against childhood diseases, nutrition support and sick child visits, were prioritized by global health initiatives seeking to eliminate preven table deaths in children under 5 years. The cumulative effects of risk and protective fac tors across different time periods in a child’s life are better understood and call for strategic shifts in policies and health-care services so that they respond to the diverse and changing needs of children and adolescents, wherever they may live [16] These shifts included expanding the focus from survival of chil dren under 5 to health, nutrition, psychosocial and supportive environments in the first two decades of life, refocusing action on child survival to target ageand region-specific high mortality burdens emphasiz ing quality care, high coverage of timely interventions and building children’s resilience through responsive care giving, early learning and promoting optimal health, growth and development. All authors contributed to the development of the original concept, structure and editing of the paper
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