Across Asian developing countries, Covid-19 is a gigantic nemesis that can paralyze their already frail and inadequately prepared health systems. Overcrowded health facilities combined with shortage of Personal Protective Equipment (PPE) for health workers put immense pressure on the health systems. Unsurprisingly, other services might have to wait, such as pregnancy care check-up, or immunization services for children.
Fortunately, some countries keep essential health services for children available. India’s Ministry of Health and Family Welfare postponed the Village Health Sanitation and Nutrition Day (VHSND) but immunizations are available at facility level. Indonesian Pediatric Society or IDAI recommends parents to continue immunization for 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 and the chronically ill, whereas young people and children usually have mild symptoms or are asymptomatic. However, they might progress into more severe situations such as pneumonia.
If children and their families do not have access to general public health care, this will increase risk for other preventable diseases and/or malnutrition.
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 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 communities need to find ways to support these families to meet their basic needs and ensure Mental Health and PsychoSocial Support (MHPSS) services available for them.
Along with the medical teams, the front-line community health workers (CHWs) or community health volunteers play a crucial role for Covid-19 response. They are mobilized into the community, often without protective equipment, to provide important information about symptoms of Covid-19 and teaching people about hand-washing with soap.
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 the government 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 together with other dangerous diseases, such as tuberculosis, malaria, HIV, dengue, and rabies. CHWs and volunteers have long experience in doing communicable-disease prevention.
Still, Covid-19 is the “game changer” -- forcing governments, NGOs, CSOs, and FBOs to find new ways of working to ensure continuation of health and nutrition programs, even during an outbreak. Some fundamental questions triggers the need for creativity:
- How to do a behaviour change program when everyone has to stay home?
- How to use technology to assist the work of CHWs and volunteers?
- How to provide mental health and psychosocial support (MHPSS) to caregivers and children impacted by Covid-19?
In Asia-Pacific, World Vision seeks to find solutions in collaboration with the governments, UN agencies, other NGOs, and partners. We have been responding in the countries hit by Covid-19, such as China, Bangladesh, 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, 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.
We appeal that any response to a pandemic such as Covid-19 should be as integrated as possible, putting children at the centre, and covering the sectors of health, nutrition, psychosocial, 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.
Esther Indriani is a Public Health specialist with 20 years of experience in health and nutrition programming. Her current position is as Technical Advisor for Health and Nutrition for World Vision International. She holds a Master of Public Health degree (with Honours) from Maastricht University and a Post Graduate Degree on Food Security and Nutrition (with Distinction) from Wageningen University.