Carrying Children Through COVID-19 and Beyond

Supply chains for essential medicines, like oral rehydration solution and zinc for diarrhea, are critical to protecting children from common and deadly infections that could see an increase throughout the pandemic.

Disruptions in supply chains due to Covid-19 could kill thousands of additional children every day. 

​​​​​​Since 1995, continued progress in the realm of child survival is thanks to high-impact, low-cost tools like vaccines and oral rehydration solution. Similar principles apply to COVID-19.

An additional 43,000 children around the world per month could die due to undernutrition during COVID-19 restrictions. 

70% of the African population depends on the informal economy for its livelihood. Direct and indirect costs, such as time away from work, can be financially devastating.

Toilet paper stockouts are now a regular fact of life in the US and other wealthy countries. But what if you didn’t have a toilet, period? Two billion people in the world do not.

WASH and vaccines are a winning combination to protect families from acute and chronic infectious diseases.

Many families are forced to choose between treatment and family finances when battling infectious diseases.

Around the world, health workers and patients run the risk of infections due to lack of sanitation and hygiene in health facilities.

COVID-19 is an opportunity to invest in sustainable WASH systems that can continue to function once funding is gone.

For disease prevention, policymakers must not overlook the provision of water, sanitation, and hygiene in healthcare facilities. 

​​​​​​Handwashing protects against COVID-19, pneumonia, diarrhea, typhoid, and many other infectious diseases.

UNICEF and WHO recently launched Hand Hygiene for All, a call for all people to have access to the supplies they need to clean their hands at critical moments and at key places. On our blog, Aarin Palomares from the Global Handwashing Partnership comments on what this would mean for health systems and our everyday lives.

We can't achieve universal health coverage if we don't address disease outbreaks like cholera, typhoid, and COVID-19 which will continue as long as WASH access is poor.

If hand hygiene is that effective, why isn’t everyone washing their hands? Rouden Esau Mkisi, PATH Senior Program Officer in Malawi, shares his insights.

WASH in healthcare facilities creates a safe environment for both health workers and patients, especially during disease outbreaks.

COVID-19 has been a stark reminder of the importance of strengthening routine immunization and primary healthcare, building national and sub-national capacities in epidemic preparedness, and laying the foundation for future disease and outbreak prevention. Immunization Agenda 2030 charts a way forward.

For every one excess COVID-19 death attributable to infections acquired during routine vaccination clinic visits, there could be up to 549 deaths in children prevented by sustaining routine childhood immunization in Africa. 

A risk-benefit analysis published in The Lancet Global Health projects that the benefits of sustaining childhood immunization visits in Africa vastly outweigh the risks of COVID-19 associated with clinic visits. For every one additional COVID-19 death that might be associated with exposure to the virus during routine clinic visits in Africa, an additional 84 deaths in children under five years of age could be prevented by continuing with routine vaccinations.

Beyond a vaccine against COVID-19, we must continue to deliver on the 100+ prequalified vaccines that exist already against deadly infectious diseases.

​​​​​Countries that have introduced rotavirus vaccines see fewer children hospitalized with deadly diarrhea. Routine immunization is one of the best opportunities to sustain community health through COVID-19 and beyond.

​​​​​As the world races toward a COVID-19 vaccine, access must be top of mind. Lessons from rotavirus vaccine development can help. 

​​​​​​“Children may be at relatively low risk from severe disease and death from COVID-19 but at high risk from other diseases that can be prevented with vaccines,’’ says Dr. Tedros, World Health Organization. Almost half of all infants still lack access to rotavirus vaccine, mostly in Asia.

​​​​Greater access to rotavirus vaccines result in fewer children hospitalized with deadly diarrhea.

Immunization programs offer ideal entry points for hygiene education.

Local, uneven disease burden demonstrates the value of data in fighting disease. 

Three health system “musts” for immediate and long-term efforts: equitable access to medical technologies like vaccines; WASH infrastructure in health facilities; and a sufficient, well-trained, and well-equipped workforce.

​​​​​​Infectious disease burden, shown here through ETEC and Shigella data, is frequently uneven within countries. High-burden pockets should guide policymaker priorities.

In Africa, 90% of cholera cases occur in hotspots occupied by less than 5% of the population. Deploying prevention and treatment tools where the burden is highest will ultimately yield a greater return on investment.

The Partnership for Maternal and Child Health's seeks to prevent the COVID-19 pandemic from becoming a lasting crisis for women and children, while forging stronger primary healthcare systems as a pathway to Universal Health Coverage and fostering a more equitable world. The Partnership provides resources for governments and advocates.

Over the past year, the Global Financing Facility (GFF) has seen a 25% drop in coverage of essential health services for women and children. That's equivalent to 82 million children not receiving oral rehydration treatment for diarrhea and 17 million children missing vaccinations. A campaign to raise $1.2B in funds before the end of 2021 seeks to keep these secondary impacts of COVID-19 at bay by engaging more directly with countries.

The COVID-19 Policy Tracker is a new tool from PATH that catalogs the policies that governments in low- and middle-income countries are making to maintain essential health services during the COVID-19 pandemic.

The Partnership for Evidence-Based COVID-19 Response (PERC) has the following recommendations for governments managing the indirect effects of COVID-19:

1. Strengthen data collection for swifter, more effective action
2. Continue tailoring public health and safety measure to balance containing the pandemic with minimizing burdens on the population
3. Increase health facility capacity to maintain essential health services and engage communities to restore demand
4. Prioritize evidence-based measures to
increase food security and economic recovery

More children are becoming malnourished due to the deteriorating quality of their diets, interruptions in nutrition and other essential services, and the socioeconomic shocks created by the pandemic. Four UN agencies highlight five urgent actions to prevent wasting and protect children's rights to nutrition during COVID-19. 

Vitamin A supplementation remains an essential health and nutrition intervention for regions with rate rates of Vitamin A 

Three billion people – 40% of the world’s population – do not have a place in their homes to wash their hands with water and soap. The Hand Hygiene for All report, published in June 2020 by UNICEF and the World Health Organization as part of the Hand Hygiene for All Initiative, is a call to action to make universal access to hand hygiene a reality for everyone. 

Before COVID-19, at least 250 million young children were already at risk of not reaching their full potential. That number is likely to increase exponentially due to the physical and mental health consequences of the COVID-19 crisis. 

The Early Childhood Development Action Network (ECDAN) is calling for seven actions.

Experience with previous epidemics has shown that the indirect health and nutrition impacts resulting from overwhelmed health and food systems can be more devastating for children than the specific disease itself. World Vision has recommendations for multiple sectors to proactively mitigate the impacts of COVID-19 on children’s health and nutrition

When a mother's own milk is not available, WHO recommends pasteurized donor human milk as the first alternative. In The Lancet Child & Adolescent Health, the Virtual Collaborative Network of Human Milk Banks and Associations called on global policy leaders and funding agencies to prioritize four high-impact areas:

(1) ensure neonatal nutrition is an essential focus during emergencies;

(2) fund research to optimize human milk bank systems in response to new infectious threats;

(3) invest in innovation across all aspects of milk banking processes to improve the responsiveness, access, and quality of donor milk provision; and

(4) support the integration of learnings and innovations by the global milk bank community during COVID-19 into newborn, nutrition, and emergency response planning for future emergencies.

​​​​​​Help Gavi, the Vaccine Alliance protect the next generation during the pandemic and beyond with vaccines against deadly childhood diseases like pneumonia and diarrhea.

Compiled by PATH, this list of technical and policy guidance supports evidence-based decision-making for maintain essential health services during a pandemic.

​​​​​​Focused on the African continent, this campaign aims to disseminate World Health Organization messages, empower pan-African leaders with accurate information, and engage donors to invest in system-wide capacity building.