How many young children die worldwide, and did the COVID-19 pandemic disrupt the health services that keep babies and toddlers alive? This news release comes from UNICEF, the World Health Organization (WHO), the UN Population Division and the World Bank Group. It combines new child mortality estimates for 2019 with two surveys of countries: a UNICEF survey of 77 countries and a WHO survey of 105 countries.
It is not a study of individual families, and it does not cover Singapore or name it.
5.2 million: the lowest child death toll on record
Global deaths of children under five fell to 5.2 million in 2019, down from 12.5 million in 1990. The agencies credit services that prevent or treat the main causes of child death. These include vaccination and care for premature or low-birthweight babies. They also include care for birth complications, neonatal sepsis (a serious infection in newborns), pneumonia, diarrhoea and malaria.
Newborns remain the most vulnerable. In 2019 a newborn baby died every 13 seconds. Deaths in the newborn period made up 47 per cent of all under-five deaths, up from 40 per cent in 1990.
Check-ups, vaccinations and pregnancy care were disrupted in many countries
In the UNICEF survey, almost 68 per cent of countries reported at least some disruption to child health checks and immunisation. In the same survey, 63 per cent reported disruption to antenatal check-ups and 59 per cent to post-natal care. In the WHO survey, 52 per cent of countries reported disruptions to services for sick children, and 51 per cent to services for managing malnutrition.
The most common reasons countries gave were:
- parents avoiding health centres for fear of infection
- transport restrictions
- suspended or closed services
- fewer health workers
- greater financial difficulties
Afghanistan, Bolivia, Cameroon, the Central African Republic, Libya, Madagascar, Pakistan, Sudan and Yemen were among the hardest hit. In Cameroon, the survey reported an estimated 75 per cent disruption in services for essential newborn care, antenatal check-ups, obstetric care and post-natal care.
Some limits matter here. The surveys count countries, not children, and "at least some disruption" does not say how severe it was. The release does not report actual deaths caused by the disruptions. A Johns Hopkins University model from May estimated almost 6,000 additional children could die per day. That is a projection, not a count.
Fear of the clinic was part of the problem
The release says working with parents to ease their fears is important. It also says women who receive care from professional midwives trained to international standards are 16 per cent less likely to lose their baby and 24 per cent less likely to have a pre-term birth, according to WHO.
The hardest-hit countries were mostly places with high child mortality, and the release gives no figures for Singapore. What it does show is that routine child and maternal health services are linked to the long-term fall in child deaths.
- Keep your child's scheduled health checks and vaccinations. Parents avoiding health centres for fear of infection was a leading reason services were disrupted.
- If you are pregnant, attend antenatal and post-natal check-ups. WHO reports trained midwife care is linked to 16 per cent fewer baby losses and 24 per cent fewer pre-term births.