Childhood analysis

Countries need more data to get a full picture of the impact of COVID-19 on child mortality when they are not on track to meet the SDGs

Portrait of a mother and her granddaughter in the Cupelon de Cima district in the city of Bissau, Guinea Bissau. Photo: TLF Images / Shutterstock

This blog is based on new mortality estimates and one report published today by the United Nations Inter-Agency Child Mortality Estimation Group (UN IGME).

Empirical data available from 2020 does not indicate a reversal in child, adolescent and youth mortality as the COVID-19 pandemic spreads as more data is needed for a more complete picture

Since the first deaths from COVID-19 were reported in early 2020, there has been immense concern about the lethality and vulnerability to the disease by age. Even as evidence began to emerge in 2020 showing the very modest direct impact of COVID-19 on child, adolescent and youth mortality, many governments, aid organizations, and medical and scientific institutions have expressed concern. the possible increase in indirect deaths among children, adolescents, and young people due to the significant disruption of health services, many of which are critical to saving the lives of children and women in low- and middle-income countries .

Early scenario-based models warned that a sustained reduction in coverage of basic life-saving interventions could dramatically increase under-five deaths, essentially reversing a decades-long decline in global under-five mortality. five years. A modeling study based on the well-documented relationship between infant mortality and production or economic wealth suggested that the damaging financial consequences of the pandemic could mean more children would die. Based on the results of these modeling exercises, the 2020 edition of the UN IGME report underscored the critical importance of sustaining life-saving interventions and services for children and women during the pandemic to ensure that hard-won gains in the fight against child mortality are not lost.

Data shows limited direct impact of COVID-19 on child, adolescent and youth mortality

We now have new empirical data on mortality, which are observed numbers of deaths continuously monitored by civil registration systems or health information systems in more than 80 countries or areas. These data allow a substantial assessment of the mortality situation of children (aged 0-9), adolescents (aged 10-19) and youth (aged 20-24) in 2020, the year the most recent reported in this cycle of UN IGME Estimates.

So far, these new available data do not yet show the feared reversal of gains in infant mortality as the pandemic spreads. While this empirical data is available mainly in high-income countries and empirical data from low- and middle-income countries is very limited, the evidence from some low- and middle-income countries like Brazil, India, Kenya , Mexico, Mozambique and South Africa also show little impact on child, adolescent and youth mortality in 2020.

Where appropriate, the UN IGME adjusts death rates from HIV / AIDS, conflict and natural disasters to account for possible downward biases resulting from the omission of deaths. UN IGME has assessed whether adjustments for COVID-19 should be made for 2020 rates. As a result of the analysis (please see the excess mortality analysis in the report) and the recommendations of his Technical Advisory Group, the UN IGME did not adjust the 2020 rate for COVID-19-related mortality. Therefore, the new set of estimates are based on empirical data up to 2020, when available, or on an extrapolation to 2020 by continuing recent trends from the most recent empirical data available.

More data needed to get a full picture for 2020 and 2021

Nonetheless, as more quality data becomes available for 2020, further surveillance can provide a more complete picture of child, adolescent and youth mortality as well as relevant contributing factors. For example, fewer injuries, a drop in infectious disease cases, and reductions in exposure to air pollution due to lockdowns or masking may have contributed to the continuing decline in child mortality observed.

At the same time, the impact of missed childhood vaccinations and other essential health services during the pandemic can only be observed in the following years. Further analysis of inequalities on the impact of hard-to-reach populations could also reveal vulnerabilities and impact on the poorest and most left behind.

Even without the COVID-19 mortality adjustments, globally more than 5 million children in 2020 died before they were 5, mostly from preventable or treatable causes.

Significant regional disparities in infant mortality

These deaths are not distributed evenly around the world – children in sub-Saharan Africa and South Asia continue to face the world’s highest risk of death and bear the brunt of the burden of death. infantile.

Huge geographic disparities remain in 2020, where sub-Saharan Africa and South Asia bear 82% of the global burden of under-5 deaths.

Need to intensify efforts to reduce child mortality in order to achieve the SDGs

the Sustainable Development Goals (SDGs) Call for an end to preventable deaths of newborns and children under 5, all countries aiming to have a neonatal mortality rate of 12 deaths or less per 1,000 live births and a death rate of under 5 years of 25 deaths or less per 1,000 live births by 2030.

If these goals are to be achieved, the global community must redouble its efforts to ensure the survival of the most vulnerable children, wherever they may be. The current trends are alarming: more than 50 countries will not meet the goal of under-five mortality by 2030 and more than 60 countries will miss the goal of neonatal mortality without immediate action.

Access to effective, high-quality care and the continued expansion of coverage for life-saving interventions will bring countries closer to achieving these goals. If every country met or exceeded the SDG target, 8 million deaths of children under five could be prevented between 2021 and 2030.

Surveillance needs to be sustained and extended to accurately track progress towards global goals, inform policies to ensure greater survival and respond to sudden shocks like the pandemic. Timely, high-quality and disaggregated data is essential to achieve this goal.

The new UN IGME estimates which are based on the best available empirical data on infant mortality differ from some modeled projections which predicted an increase in deaths in 2020 resulting from service disruptions or economic downturns. However, these data have limits in their representativeness, and the pandemic and the resulting mortality profile could change considerably from what has been observed so far. Data collection should continue, where available, to monitor the situation of child, adolescent and youth mortality in 2021 and beyond. UN IGME will review the new data, if available, in the next estimation cycle and revise the estimates accordingly.

These mortality estimates were produced by UN IGME. The UN IGME includes Unicef, the World Health Organization, the World Bank Group, and the United Nations Population Division as full members. The group was formed in 2004 to share mortality data, harmonize estimates across the United Nations system, improve methodologies for estimating infant mortality, and report on progress towards the MDGs. The group continues to produce reliable and transparent mortality estimates to monitor countries’ progress towards SDG target 3.2. All data, estimates and details on the methods are available on the website Infant Mortality Estimates website. The new estimates will also be available in the Development indicators around the world and HealthStats data base.

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