Published on Investing in Health

The risks of a secondary health crisis for women and children: 3 things to know

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Mothers receive family planning services provided by nurses at Primary Health Care Maraba, in Karu, Nigeria. Photo © Dominic Chavez / Global Financing Facility Mothers receive family planning services provided by nurses at Primary Health Care Maraba, in Karu, Nigeria. Photo © Dominic Chavez / Global Financing Facility.

1. What’s at stake for women and children?

Millions of lives are at risk as COVID-19 increasingly disrupts access to essential, life-saving health services for women and children in low- and lower-middle-income countries. When already fragile health systems flex to respond to a serious outbreak, funding and efforts to deliver routine services for women and children are often diverted, endangered or deprioritized, with a devastating impact on health and equity.

Years of global progress to end preventable maternal and child deaths are at risk if essential services such as ante-natal care visits, attended births, delivery of child vaccinations and access to family planning aren’t protected.

Estimates published in the Lancet suggest that, under a scenario in which COVID-19 causes similar disruptions as in West Africa during the Ebola outbreak, almost 1.2 million children and 57,000 mothers could die within six months – a 45% increase in child mortality. 

The Global Financing Facility (GFF), a country-driven partnership hosted by the Bank Group, partnered with the Reproductive Health Supplies Coalition to develop a tool to help policy makers understand how COVID-19 and mitigation measures are likely to affect access to family planning. Using this tool, the GFF can estimate that, without mitigation, as many as 26 million women could lose access to contraception in the 36 GFF partner countries, leading to nearly 8 million unintended pregnancies.

2. What’s being reported from around the world?

Low- and lower-middle-income countries are increasingly reporting significant disruptions to essential life-saving health services.  Beginning in late March / early April 2020, the GFF began conducting monthly, rapid qualitative feedback surveys of its local staff based in its partner countries to take stock of the evolving impact of the COVID-19 pandemic on essential health and nutrition services for women, children and adolescents.

From April to June 2020, these rapid pulse surveys point to a steadily increasing disruption in the supply of, and demand for, essential primary health and nutrition services  – such as family planning, ante- and post-natal care, attended births, child vaccinations and other life-saving care.  These have been key drivers in recent global reductions in maternal and child mortality.   

For example, in Liberia, fears of contracting COVID-19 are preventing parents from taking their children to health care facilities. In Ghana, some pregnant and lactating mothers have elected to postpone ante-natal services and routine immunizations for fear of contracting the virus. In Bangladesh, some hospitals are now only seeing COVID-19 patients and referring patients to other hospitals for other services.

3. What needs to happen?

The GFF is calling for the protection of essential, life-saving health services for women and children to be an integral part of COVID-19 response and recovery.  We’re just beginning to see the rise of COVID-19 and its impact on women, children and adolescents in low- and lower-middle-income countries. More and better investments to create more resilient health systems are needed to save lives now, prevent reversals of recent progress in reducing maternal and child mortality, and ensure that everyone, everywhere can access safe, quality and affordable health care.

As COVID-19 cases continue to climb around the world and raise the risk of a secondary health crisis, a weak health system in any country – lacking capacity to stop this pandemic and the next one – in fact poses a health and economic risk to all countries.

More resilient and equitable health systems are critical for ending preventable deaths of women, children and adolescents – the core mission of the GFF.  They’re also the backbone of more effective pandemic preparedness, response and recovery.

The GFF is supporting its partner countries to achieve better health outcomes for women, children and adolescents.  This means prioritizing investments in proven, high-impact health interventions together with targeted efforts to strengthen health systems, improve primary health care and promote sustainable domestic financing.


Monique Vledder

Practice Manager for the Global Health, Nutrition and Population

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