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Overcoming disruption of programmes and health services for pregnant women and children

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Dr Sujeet Ranjan, Executive Director, The Coalition for Food and Nutrition Security & Dr Tripti Kumar, Communication Manager, The Coalition for Food and Nutrition Security talks about the need for building capacities of front-line community health workers to support mothers and families for exclusive breastfeeding

India has to not only deal with the present health crisis but also with the already existing problems of unemployment, low incomes, rural distress, malnutrition, and widespread inequality which is in a state of aggravating further. Addressing the critical problem of accessible, affordable and available healthcare could help overcome the disruption to maternal and child health and many other problems such as high maternal, newborn and child death rates.

The spread of COVID-19 has impacted the health, nutrition and wellbeing of the country’s most vulnerable populations and will have lasting effects on people. The impact on maternal & child health especially among pregnant women and children in an environment where health & nutrition services are reduced or destroyed, caring structures have broken down within society and trauma is prevalent, increases.

We are learning more about how COVID-19 is affecting people every day. As this is a new virus, we are still learning how it affects children. Unfortunately, COVID-19 does not treat us equally. Undernourished mothers and children have weaker immune systems, and may be at greater risk of severe illness due to the virus. People who already suffer as a consequence of inequities are at greater risk.

The impact of the COVID-19 pandemic on essential health services is a source of great concern. Major health gains achieved over the past two decades can be wiped out in a short period of time. The collapse of essential health services – including health promotion, preventive services, diagnosis, treatment and rehabilitative and palliative services – is likely to have serious adverse health effects, especially on the most vulnerable populations, such as children and pregnant mothers.

The first 1000 days of life – between a woman’s pregnancy and her child’s second birthday – is a unique period of opportunity when the foundations for optimum health and development across the lifespan are established. The right nutrition and care during the 1000-day window influences not only whether the child will survive, but also his or her ability to grow, learn and rise out of poverty. As such, it contributes to society’s long-term health, stability and prosperity.

Breastfeeding, in particular, is of critical importance. As a baby’s first vaccine, it is the first and best protection they have against illness, disease and death. Promotion, support and protection of exclusive breastfeeding until six months in the current phase of COVID 19 is high impact public health interventions. This information is being used to target action and ensure the right interventions reach the right people, thus making best use of available resources.

Building capacities of front-line community health workers to support mothers and families for exclusive breastfeeding, improved hygiene practices, early stimulation and completing immunizations. Improving knowledge and demand for services with Digital Road to Health Booklet, that provides tailored information to the mother/caregiver on all aspects of maternal & child health and development can make a difference.

Overcoming disruptions owing to the COVID-19 pandemic includes strengthening of telemedicine to replace in-person consultations, task shifting, community outreach to provide information on service disruptions or changes, and redirection of patients to alternative health care facilities. Other approaches including designation of mobile medical teams, digital health, transportation and financial support for patients, additional training/guidelines to the frontline workers and intensified communication and advocacy activities while strengthening public private partnership would be an add on and could play the major role.

The meaningful involvement of communities and the private sector, including civil society organisations in a strategic manner can bring desired health & nutrition outcomes. Public-private partnerships can serve to increase funding, strengthen monitoring, and/or improve programme implementation, especially at the community level. Good governance and accountability are important factors in successfully improving community health. This includes high-level leadership, strong monitoring systems, clear and time-bound nutrition focused targets, and regular impact evaluations to measure the effectiveness of the interventions in changing nutrition indicators among the key beneficiaries.

Protecting the progress made on maternal & child health will, therefore, require continued leadership, attention, financing and commitment at all levels and across society. There is no time to lose because many women are pregnant today, babies are being born every single day and many more, including adolescents, are in sensitive periods of physical and mental development. COVID-19 is likely to be with us for a long time and we need to plan accordingly.

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