Health impacts of lockdowns, economic losses in poor nations require targeted action and vigilance to save lives and protect against a worsening crisis 

September 18, 2020 – Essential health services for women and children in many lower-income countries are being disrupted by COVID-19, according to new findings released by the Global Financing Facility for Women, Children and Adolescents (GFF), using the most extensive quantifiable data available to date. The analysis goes beyond previous projections and draws on data reported by 63,000 health facilities.  

Substantial disruptions have been seen in outpatient visits and vaccinations for young children in most countries. Disruptions in care for pregnant women and new mothers, and safe deliveries by skilled health workers were also seen in several countries.

“These disruptions confirm our early warnings that secondary health impacts caused by COVID-19 are putting at risk many years of hard-fought gains in women’s and children’s health and nutrition. The international community must respond quickly and decisively to save lives and protect the delivery of these essential services as part of a robust recovery from the pandemic,” said Muhammad Pate, Global Director, Health, Nutrition, and Population, World Bank and Director of the GFF.

New analysis of country data through June 2020 shows:

  • Childhood vaccination was the most disrupted service among the countries studied, with a significant drop in the number of children fully vaccinated in Liberia (35% drop), Nigeria (13%) and Afghanistan (11%).  With vaccine programs protecting millions of children from a wide range of common childhood killers – and significantly reducing childhood mortality – these disruptions are deeply concerning.
  • The number of outpatient consultations fell in all countries where this was monitored. The largest reduction was observed in Liberia, with a 35% drop in consultations for children under five years of age.
  • Many women were at greater risk of complications or death from pregnancy. The number of women who attended all four recommended medical visits during pregnancy dropped in Liberia (18%), and the initiation of women seeking medical care during pregnancy fell in Nigeria (16%).
  • Early survey results from Nigeria show that 26% of respondents who needed health services said they could not access the services they needed. Of those, a majority – 55% - said they couldn’t access because they could not afford to pay, while a quarter of respondents said this was due to lockdowns and movement restrictions imposed to control the pandemic.
  • Disruptions vary across indicators and countries. For example, in Nigeria, there was a more than 10% decrease in April and in May a 15% decrease in family planning services, and a 6%  decrease in women delivering babies at health facilities.  However, there are mixed results across indicators in most countries. For example, in Afghanistan, while there were no significant changes in postnatal consultations as a result of the crisis, there was a 14% drop in outpatient consultations.

To dig deeper on what is driving the variations across countries and services, the GFF is collaborating with the World Bank and partner countries to extract and analyze data from household surveys on the socio-economic impacts of COVID-19.  In addition, phone surveys of health facilities are underway with GFF support, which will enable more real-time information and monitoring of changes in service delivery to enable countries to take appropriate actions.

The findings indicate that COVID-19 is having a significant impact on the delivery of essential services. This poses a major risk of lasting, negative secondary health impacts on an entire cohort of children and women – and could also impact the roll out of effective tools to combat COVID-19 as they become available.

The GFF is supporting its 36 low and lower-middle-income partner countries to use this data to drive policy decisions and targeted strategies during their response to the pandemic to protect and promote the delivery of essential health and nutrition services for vulnerable  women, children and adolescents. 

For example:

  • In partnership with the World Bank and the International Finance Corporation (IFC), the GFF is providing additional grant financing and technical assistance for its partner countries to prioritize and plan for continuation services, strengthen frontline service delivery, address constraints in supply of personal protective equipment and other essential health commodities as well as in demand for sexual and reproductive health and other lifesaving services.
  • The GFF has mobilized a learning exchange program for countries to share lessons in real-time and learn from each other. Through this program some countries have introduced measures to continue to provide services while maintaining social distancing, others enhanced the use of mobile technology to facilitate telemedicine, and others reflected on how to better use and integrate Community Health Workers to strengthen continuity of services.

To learn more: GFF response to COVID-19

CONTACT: In Washington, DC: Sheryl Silverman: ssilverman@worldbankgroup.org, +1 202.473.3297

About the Global Financing Facility 

The Global Financing Facility (GFF) is a multi-stakeholder global partnership housed at the World Bank that is committed to ensuring all women, children and adolescents can survive and thrive. The GFF Trust Fund is currently supported by the Governments of Burkina Faso, Canada, Côte d'Ivoire, Denmark, Germany, Japan, the Netherlands, Norway, Qatar, and the United Kingdom; the Bill & Melinda Gates Foundation; the Susan T. Buffett Foundation; the European Commission; Laerdal Global Health; MSD for Mothers, and the Rockefeller Foundation. The GFF supports36 low and lower-middle income countries with catalytic financing and  technical assistance to develop and implement prioritized national health plans and to maximize the use of domestic financing and external support in synergistic ways to scale up access to affordable, quality care and achieve better, more sustainable health results.