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Are children forgotten in the response to the pandemic?
To date, 195 countries have partially or fully closed schools, which reduces their capacity to learn and increases risk of child abuse and other safety issues.
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Fifth-grader Mesa (left) helps her younger sister Shafa (center) study for school at their parents' food stall in Pinang Ranti, East Jakarta, on April 3, while their 4-year-old brother Eland looks on. The spread of COVID-19 has forced millions of Indonesians to work and study from home. (JP/P.J.Leo)
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or developing countries in Asia, COVID-19 is a gigantic nemesis that can paralyze their already frail and inadequately prepared health systems. Overcrowded health facilities combined with a shortage of personal protective equipment (PPE) for health workers are putting immense pressure on health systems. Unsurprisingly, other services might have to wait, such as pregnancy check-ups or immunization services for children.
Fortunately, some countries are keeping essential health services for children available. India’s Ministry of Health and Family Welfare postponed the Village Health Sanitation and Nutrition Day (VHSND) but immunization is available at facility level. The Indonesian Pediatric Society (IDAI) recommends that parents continue with the immunization of their children, and health services should offer these services with appropriate infection control, as it is critical for their health and survival.
Where are the children in this COVID-19 situation?
COVID-19 severely affects mainly the elderly, the chronically ill, whereas young people and children usually have mild symptoms or are asymptomatic. However, their cases might progress into more severe ones, such as pneumonia.
If children and their families do not have access to general public health care, this will increase the risk for other preventable diseases and/or malnutrition.
On top of health impacts, quarantine also affects children and their families. To date, 195 countries have partially or fully closed schools, which reduces their capacity to learn and increases risk of child abuse and other safety issues.
By studying previous disease outbreaks, we learn that children’s lives might be threatened by COVID-19 even more. World Vision’s report “COVID-19 Aftershocks” warns that the secondary impacts of the pandemic could threaten the lives of up to 30 million children. A combination of pre-existing weak health systems, populations with high need, and COVID-19 may lead to catastrophic mortality for children.
With closure of businesses, everyone’s livelihood is impacted, but the poorest and vulnerable children will suffer the most. Even before COVID-19, they lacked social protection, rights at work and decent working conditions. Now, their lives are just getting worse.
Caregivers who experience increased stress and lack resources will not be able to care for and protect their children. What will happen to those children, whose caregivers succumb to the virus, or whose families’ livelihoods are disrupted? Governments and the communities need to find ways to support these families to meet their basic needs and ensure that mental health and psychosocial support is available for them.
Along with the medical teams, the frontline community health workers (CHWs) or community health volunteers play a crucial role in the COVID-19 response. They are mobilized in the community, often without protective equipment, to provide important information about symptoms of COVID-19 and teaching people about handwashing. The CHW’s regular work in maternal child health and nutrition programs, such as growth monitoring and promotion, home visitation and counselling of mothers and infants has to stop until governments and NGOs find ways to continue these services while ensuring everyone’s safety.
COVID-19 is a new threat, but for years, people in Asia have been living with other dangerous diseases, such as tuberculosis, malaria, HIV, dengue fever and rabies. CHWs and volunteers have long experience in communicable-disease prevention. Still, COVID-19 is the “game changer” – forcing governments, NGOs, civil society organizations and faith-based organizations to find new ways of working to ensure continuation of health and nutrition programs even during an outbreak.
In Asia-Pacific, World Vision has been responding in the countries hit by COVID-19, such as China, Bangladesh, the Philippines, India, Indonesia and Thailand. Firstly, by promoting hygiene practices and physical distancing, which is important to prevent COVID-19. We also continue with important prevention and treatment of malnutrition among children and other childhood illnesses.
We are calling on governments to find ways of expanding access to essential health services, especially for children, the most vulnerable and those at risk. community health workers and volunteers equipped with COVID-19-specific response training and wearing appropriate protective gear are crucial for this work.
Additionally, governments need to ensure that COVID-19 diagnosis and treatment are free of cost. Civil societies, the private sector, academia and research institutions need to collaborate with governments in scaling-up digital platforms for disease surveillance, while diagnosis and case monitoring are affordable and available in remote locations.
Any response to a pandemic like COVID-19 should be as integrated as possible, putting children at the center and covering the aspects of health, nutrition, psychosocial needs, child protection, education and livelihood. It is not just the role of governments to think of the poor; it is everyone’s responsibility.
Children will be the future of each country, so governments and communities need to develop strategies and policies to protect and enable children to grow in a safe and supported environment.
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Public health specialist and technical advisor for health and nutrition, World Vision International
