Every Newborn Action: Regional and country responses to the COVID pandemic

In the recently held global event Lives in the Balance COVID-19 Summit, the global and regional newborn health community showcased their efforts in assisting countries to protect, preserve and track the delivery of good quality care to every woman and newborn during the COVID-19 Pandemic.

As the world faces the global pandemic of COVID-19, the lives and wellbeing of women and their babies are in the balance. The indirect, or unintended, consequences of COVID-19 on maternal and newborn health (MNH) are of great concern. As we move into the action decade of Sustainable Development Goals (SDGs) and the next five-year phase of the Every Newborn Action Plan, we stand a real risk of losing all of the past gains due to COVID-19. Even before the emergence of COVID-19, high quality and timely MNH services were unavailable, inaccessible, or unaffordable for millions of women and newborns. Lockdowns, disruption of services and economic recessions threaten to exacerbate limited access to care and negatively impact women’s and child’s health.

The Lives in the Balance COVID-19 Summit for the Health and Well-Being of Women, Children and Adolescents (1-2 July 2020) provided an opportunity to bring together the global community to reflect on the global response to COVID-19, share best practices and collaborate and act to forge a path forward. The Every Newborn community provided a glimpse at their response during the marketplace session. The dynamic session, hosted by Gagan Gupta (UNICEF-HQ), engaged global and regional experts from WHO and UNICEF working on MNH and the COVID-19 response.

From the global perspective, Ornella Lincetto (WHO-HQ) provided an overview of the increased risk of mortality and negative outcomes due to reduced access, availability and utilization of essential maternal and newborn health services. The estimated effects of COVID-19 on essential services shows that the pandemic threatens the progress gained previously for MNH. To respond, WHO has developed a number of tools to help protect maternal and newborn health services and reduce the spread of COVID-19. Collaboration between the global and regional levels also led to the development of the Guidance on Essential Services and the Guidance on Community Services. The bi-weekly webinar series on Survive and Thrive: Transforming care for small and sick newborns has enabled sharing regular updates on COVID-19 in pregnant women and newborns to MNH stakeholders around the world.

Regional efforts have been at the forefront of supporting country responses by sharing the latest information on MNH and COVID-19 and providing platforms for south-south learning exchange. For sub-Saharan Africa, Assumpta Muriithi (WHO AFRO) shared the realities of many countries in the region, including repurposing of many health facilities and health workers to COVID-19 response, reduced access to MNH services, inadequate IPC, and shortage and stock outs due to disruption of the supply chain, misinformation and stigma, reports of gender-based violence and increases in maternal and newborn mortality. Fatima Gohar (UNICEF ESARO) provided an overview of the joint response from WHO, UNICEF, and UNFPA in the region, including the establishment of well-coordinated interagency regional and inter-sectoral working groups for coordinated action and joint advocacy. These groups developed joint regional documents, based on global guidelines and regional context, on the continuity of essential health services and support countries in the adaptation of the global guidelines. They have also hosted bi-weekly webinar series on Continuity of Maternal and Newborn Services in Eastern and Southern Africa reaching over 900 participants. Work is underway for the development of joint sexual, reproductive, maternal, neonatal, child and adolescent health (RMNCAH) monitoring for the disruption of MNH health services. They are also working to equip country offices to address barriers linked to access and quality of care issues. To address the “infodemic,” they continue collaborating with the risk communication and community engagement to address rumors and misinformation.

Rajesh Mehta (WHO-SEARO) explained the enormity of the risk in losing gains related to the SDG targets of ending preventable newborn and child mortality and reducing maternal mortality in South East Asia, home to the highest share of newborn deaths globally. In a joint effort, WHO, UNICEF, and UNFPA released one of the first regional joint operational guideline to continue services for women, children and adolescents during the pandemic, that have been used by the countries in their national plans and are providing support to national governments for continuing essential SRMNCAH services during the COVID-19 pandemic. They have also provided support for establishing registry of positive pregnant women, newborns and children and preparing standard management protocols. The UN agencies have jointly conducted a baseline assessment of services to understand modification applied to  services, the impact on service delivery and the related health system functions. Atnafu Getachew Asfaw (UNICEF-ROSA) described how the regional offices have developed a dashboard with existing indicators to frequently monitor SRMNCAH services  and are supporting countries to adopt within existing health information systems and take corrective actions. They have also been working on modelling the direct and indirect effects of the pandemic and national response to address the pandemic on women’s, newborns’ and children’s health.

For the Middle East and North Africa, Khalid Siddeeg (WHO EMRO) explained how COIVD-19 comes on top of already disrupted health care systems in most of the conflict affected countries in the region where services for newborn care were already weak. Poor governance and coordination have resulted in insufficient use of resources, an uncoordinated response and wasting of precious time. Lack of precise data and information remains a key challenge in humanitarian settings, but the available data shows decline in MNH services. Tomomi Kitamura (UNICEF MENARO) shared the joint response of WHO, UNICEF and UNFPA and other stakeholders to ensure continuity of MNH services by working together with Ministries of Health. She provided two examples of efforts in Iraq and Syria.

Dr. Gupta concluded the session with the following statement: “The message is loud and clear lives of millions of mothers and newborns are really hanging in balance today. Across continents, we all need to play our part to help the governments, communities and those at the frontlines to navigated through these uncharted waters.”

Though mothers and newborns may not be the face of the COVID-19 pandemic, they run the risks of being its biggest victims due to the indirect impacts because of barriers in provision and use of essential services. This session demonstrated the commitment of the global and regional newborn health community to work with countries to ensure continuation of the essential services for women, newborns, children and adolescents during the pandemic to prevent mortality and adverse health outcomes. The Every Newborn group has recently defined the new coverage targets and milestones to 2025 to be launched in coming months. It will be critical to achieve these targets and milestones, in spite of the COVID-19 pandemic, if we want to reach the SDGs and prevent millions of maternal and newborn deaths and stillbirths.

Watch the session here.

Session Host: Dr Gagan Gutpa (UNICEF HQ)

Session Speakers

  1. Ornella Lincetto (WHO HQ)
  2. Rajesh Mehta (WHO SEARO)
  3. Atnafu Getachew Asfaw (UNICEF ROSA)
  4. Fatima Gohar (UNICEF ESARO)
  5. Assumpta Muriithi (WHO AFRO)
  6. Tomomi Kitamura (UNICEF MENARO)
  7. Khalid Siddeeg (WHO EMRO)

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