Drastic cuts in the availability and use of essential public health services across South Asia due to COVID-19 may have contributed to an estimated 228,000 additional child deaths in 2020, according to a new United Nations report published today.

Around 11,000 more maternal deaths are expected.

As per the report 'Direct and Indirect Effects of COVID-19 Pandemic and Response in South Asia', clinics and other health facilities have been closed and many vital health and nutrition programmes halted as the region battles to contain COVID-19 cases, which numbered 11 million by the end of 2020.

The study focuses on South Asia's top six populous countries, including Afghanistan, Bangladesh, Nepal, India, Pakistan and Sri Lanka, and makes s case for interventions and strategies to minimise these indirect consequences.

The report, commissioned by UNICEF and supported by the World Health Organisation and the United Nations Population Fund, cites the examples of more severe service disruptions. They include an 80 per cent drop in the number of young children treated for severe acute malnutrition in Nepal and Bangladesh, and a sharp drop in childhood immunisation in Pakistan and India.

"The reduction of these critical services has had a devastating impact on the health and nutrition of the poorest families," said UNICEF Regional Director for South Asia, George Laryea-Adjei.

"It is absolutely vital that these services are fully restored for children and mothers who are in desperate need of them, and that everything possible is done to ensure that people feel safe to use them."

The report calls for making essential health services for pregnant women, adolescents and young infants topmost priority. Strengthening supply chains for the delivery of vaccines and other essential childhood medicines is also vital. "Maintaining essential health services is an important pillar of WHO's COVID-19 response strategy," said Dr Poonam Khetrapal Singh, Regional Director of the WHO South- East Asia Region. "Countries in the region have been focusing efforts on continuation and restoration of essential services, as disruption will only increase the risk of deaths from preventable causes."

"Given the cultural and social context of South Asia, the suspension of these services is deepening inequalities and is likely to lead to increase in the number of maternal and neonatal deaths," said Bjorn Andersson, Asia-Pacific Regional Director of UNFPA. "It's likely that there will be an additional 3.5 million unintended pregnancies in this region."

Some 420 million children in South Asia remain out of school due to pandemic control measures. The report warns that 4.5 million girls are likely to never return to school, and are at particular risk due to deteriorating access to sexual and reproductive health and information services.

The report calls for cash transfer programmes to the poorest families. It welcomes various national social safety programmes put in place since the onset of the pandemic, but notes that their full impact still needs to be evaluated.

A version of this article appears in the print on March 18, 2021, of The Himalayan Times.