Highest rise in child mortality, maternal deaths likely in India: Unicef report on Covid-19 impact
India is likely to register the greatest increase in the number of deaths among children below five years among six South Asian countries in 2020 and also the highest number of maternal deaths amid the coronavirus pandemic, which disrupted the country's health services, according to a Unicef report.
The 'Direct and Indirect Effects of COVID-19 Pandemic and Response in South Asia’, a report commissioned by Unicef Regional Office for South Asia (ROSA) is based on the six most populous countries of the South Asian region - Afghanistan, Bangladesh, Nepal, India, Pakistan and Sri Lanka. It studied the impact of Covid-19 on mortality, hospitalisations, and ICU admissions due to the disease and the impact of nation-wide lockdown on maternal and child mortality, educational attainment of children, and the region’s economy. The report indicated grim results for all the countries with major impact of Covid-19 on maternal and child mortality, education and economy.
Due to observed and expected reduction in coverage of modern contraceptive methods, the report said more than 3.5 million additional unintended pregnancies are expected in South Asia with the highest number or over 3 million likely in India. The largest increase in the number of stillbirths as a result of reduced SRMNCH services are also expected in India (10 per cent) followed by Pakistan. SRMNCH services include family planning, antenatal care, facility births, vaccines, full immunisation, zinc supplements, antibiotics for pneumonia, acute malnutrition treatment etc.
Bangladesh, India and Sri Lanka are expected to have fewer maternal deaths in the first and second quarter of 2021 in comparison to 2019, however additional unintended pregnancies are still projected to be higher. Additionally, the number of deaths due to maternal causes among young females is estimated to increase in the region with the highest rise in India followed by Pakistan. "India is expected to be hit hardest with an additional 3,412 adolescent deaths followed by Pakistan (1,629) and Bangladesh (836)," the report said. The rise in deaths has been cited to malaria and typhoid.
The report said children in rural areas and poorer households are less likely to access remote learning. As a result of prolonged school closures, almost 9 million primary and secondary school children are expected to permanently drop out, with the highest number or 7 million expected in India. Adding to this, the report also suggested that the highest cost of lower education attainment by this cohort will be borne by India, followed by Bangladesh and Sri Lanka.
As a result of the increase in the number of girls dropping out of schools due to the pandemic, the region is anticipated to see a rise in early marriage and adolescents pregnancies.
The coronavirus pandemic has had a significant economic impact on the region from staggering GDP to increased unemployment. The report suggests that even in the least severe stage the increase in food security among the population ranges from 17.4 per cent in Afghanistan to 18.9 per cent in Sri Lanka. The report said given the trajectory Covid-19 will extend in the foreseeable future and maybe till 2020. As part of the way forward, the report suggested strategies as smart lockdown, which have been proven to be more effective than blanket stay-at-home orders, safe schools, securing food supply, resumption of maternal care services etc.
On the impact of Covid-19, the report said it is estimated to have cost the South Asian region more than $2.4 billion including the cost of testing and healthcare utilisation for deaths. "If the current status quo in terms of testing, and infection control and prevention, is maintained, the region is expected to spend an additional $8.1 billion on Covid-19 diagnostic tests, and between $520 million and $2.4 billion on healthcare utilisation by September 2021, depending on the level of mitigation response instituted," the study said, adding that India is expected to bear the largest share of this cost.
The highest number of deaths, hospitalisations and ICU admissions are expected to occur in India with the numbers expected to rise highest in February 2021.
The report also noted that since the observed number of cases and deaths are rising most rapidly in the country as compared to other South Asian neighbours, the impact of modelling the increased coverage and effectiveness of mitigation strategies is also highest in the country.