More than 10,000 births in Nepal were observed, and during the study period the number of women giving birth at the nine hospitals fell by half.
Photograph: Srijana Sharma
In a Lancet Global Health article, researchers from Uppsala University show how Nepalese restrictions prompted by the COVID-19 pandemic have resulted in a large increase in early childhood mortality. Comparison of data from nine hospitals before and after the lockdown that was imposed on 21 March this year make it clear that the proportion of babies that died in the first week after birth rose threefold.
Worldwide, the risks are highest in the first few days of life, and more than two million babies die before reaching the age of one month. This happens despite existing knowledge of how these babies can be saved, and the fact that expensive, advanced care is not required. Instead, what are needed are simple measures, such as helping the newborn to take their first breaths, preventing them from getting cold and starting breastfeeding early. It is also a matter of childbirth taking place in hygienic conditions and being assisted by midwives with knowledge and experience.
More than 10,000 births in Nepal were observed, and during the study period the number of women giving birth at the nine hospitals fell by half. This suggests that the true death rates were even higher, given that many women were unable to get expert care for any complications that arose. The reasons for the lower proportion of hospital births may include limited mobility and access to transport services, but also to an increased fear of seeking care.
In reducing child mortality, Nepal is a country that has made major progress, but it is now threatened by the restrictions imposed. This shows the importance of applying a holistic perspective and being aware of the adverse effects of the restrictions brought in to stop the spread of COVID-19. Similar effects may be expected in countries around the world that are in the same situation, and this jeopardises the global efforts to improve women's and children's health.
"These are worrying results, which have reversed Nepal's previous 20-year positive trend in maternal and child health. Lowering the barriers to women's access to expert obstetric care, reducing inequalities in use of health services and supporting midwives' provision of high-quality care are of the utmost importance," says Ashish KC, the study's lead researcher.
Publication
Ashish KC, et al. Effect of the COVID-19 pandemic response on intrapartum care, stillbirth, and neonatal mortality outcomes in Nepal: a prospective observational study. (2020) Lancet Global Health. DOI: 10.1016/S2214-109X(20)30345-4
