Children are collateral damage in the flight against the COVID-19 pandemic: some 4 million of them in South Asia under the age of five are at the risk of suffering life-threatening malnutrition as a result of the socio-economic impact of the COVID-19 pandemic.
An analysis in The Lancet recently estimates that 6.7 million children globally could suffer from wasting (low weight for age) and over half (58%) would be from South Asia alone. Prevalence of wasting may increase by 14% in low- and middle-income countries this year. Such an increase in child malnutrition combined with disruptions in vitamin A supplementation and breastfeeding, would mean over 10,000 additional child deaths per month worldwide.
“It’s been seven months since the first COVID-19 cases were reported and it is increasingly clear that the repercussions of the pandemic are causing more harm to children than the disease itself,” says UNICEF Executive Director Henrietta Fore. “Household poverty and food insecurity rates have increased. Essential nutrition services and supply chains have been disrupted. Food prices have soared. As a result, the quality of children’s diets has gone down and malnutrition rates will go up.”
Wasting makes children too thin and weak, and puts them at greater risk of early childhood death, poor growth, development and learning. In 2019, 47 million children worldwide were already wasted — over half of them in South Asia. The number of children suffering from wasting could reach 54 million over the course of the year, bringing global wasting to levels not seen in this millennium.
According to Nepal’s own 2016 Demographic and Health Survey (DHS), wasting among Nepali children under 5 still hovers at 10% — a mere 1% decrease from 8 years ago. The UN’s Sustainable Development Goals (SDGs) require Nepal to reduce wasting to less than 5% by 2030, a target that looks even more daunting in the face of COVID-19 impacts.
But the estimated increase in child wasting is only the tip of the iceberg. Poor diet and the disruption of nutrition services due to the COVID-19 lockdown means other forms of malnutrition in children and women are also on the rise, including stunting, anemia, and problems associated with obesity.
To make matters worse, anaemia among Nepali women has always been very high. Instead of declining, it will now actually increase from 35% to 41% between 2011 and 2016. Anaemia in children below 5 rose dangerously in that period: from 46% to 53%.
UNICEF reports from the early months of the pandemic suggested a 30% overall reduction in the coverage of essential – and often life-saving – nutrition services. In South Asia, these disruptions have been more severe. During the initial weeks of lockdown, the treatment of severe wasting ground to a halt in India and Nepal.
Fear of infection and lack of protective equipment for health workers led to an estimated 40% and 75% decline in admissions to treat severe wasting in children in Afghanistan and Bangladesh respectively.
Most countries in the region had to postpone vitamin A supplementation and other regular immunisation programs against common childhood infectious diseases, while means millions of children under five years are missing life saving shots during a time of the greatest need. Nepal saw an outbreak of measles in Dhading and Gorkha districts during the prolonged lockdown.
“We are also deeply concerned about the potential impact on breastfeeding practices. It is essential that mothers are encouraged and supported to continue breastfeeding, even if they have COVID-19 infection”, said Jean Gough, UNICEF Regional Director for South Asia. “Breastmilk provides the best nutrition for babies as well as protection from a range of life-threatening infections.”
Breastfeeding trends in the region has been decreasing over the years. In Nepal, exclusive breastfeeding in the first 6 months has declined significantly at 65% against SDG target of greater than 90%.
Humanitarian agencies immediately need $2.4 billion to protect maternal and child nutrition in the most vulnerable countries from now until the end of the year. The heads of the United Nation agencies have appealed to governments, aid agencies and the private sector to safeguard access to nutrition and to invest on maternal and child health.
Says Jean Gough: “We are encouraged by the efforts being taken across South Asia to resume nutrition services. It is essential that we combine efforts across health and social protection to prevent more children from becoming wasted, and to identify and treat those that do.”