Health

Poor nutrition is a frequent culprit in this crisis, hurting women and children at every stage of their development. Malnutrition contributes to an estimated 45% of child deaths worldwide—in 2019, that was 2.3 million girls and boys under age five. For children who survive, the long-term effects are significant: by age three, 80% of a child’s brain is formed—during this critical period, good health, nutrition and nurturing care are all foundational for children’s development, future learning and abilities to achieve their potential.

So it’s sobering that an estimated 149 million young children in lower- and middle-income countries are still chronically malnourished—known as “stunted”—a condition that restricts both physical growth and brain development, especially in the first 1,000 days of life. A staggering 45 million young children also suffer from wasting malnutrition with low weight for their height; this failure to gain weight often results from insufficient quantity and quality of food or infections that cause weight loss, and those with the most severe cases of wasting are nine times more likely to die. With the combined economic and health system impacts of COVID-19, an additional 6.7 million children are now estimated to suffer from wasting malnutrition, with South Asia and sub-Saharan Africa bearing the bulk of the burden.

Stunting and wasting are not the only threats to girls and boys’ good nutrition. Even before the pandemic, two out of five children suffered from anemia in lower- and middle-income countries, making them vulnerable to infections and inhibiting their ability to learn. Iron deficiency anemia affects almost a third of girls and women of reproductive age, a condition that saps the energy they need to live full and productive lives and hinders their capacity for learning. A recent review of data collected by the World Health Organization (WHO) from 29 countries across five regions suggests that during pregnancy, severe anemia doubles the risk of women dying during and after childbirth.

Every day, more than 800 women die from severe bleeding, infections and high blood pressure related to pregnancy and childbirth, with higher risks of complications among adolescent mothers than other women. A startling 94% of preventable maternal deaths happen in developing countries (sub-Saharan Africa and South Asia accounted for approximately 86% of global maternity deaths in 2017), where more than 200 million women and girls of reproductive age would like to delay or prevent pregnancy, but can’t access contraception because of limited availability or social and cultural barriers. This unmet need is expected to rise in light of pandemic-related lockdowns that led to increases in early and forced marriage, while 44% of lower- and middle-income countries surveyed reported pandemic-related disruptions to family planning and contraception services in 2021.

It’s important to note that mental health challenges currently contribute to 14% of the global burden of disease worldwide—and 81% of this burden is hitting families in low- and middle-income countries where access to mental health and psychosocial support services are limited or non-existent. COVID-19 has led to an alarming rise in anxiety and major depression worldwide–53 million and 76 million additional cases respectively—with twice as many women and girls affected than their male counterparts.

In fragile contexts and countries experiencing conflict, the health and nutrition situation exacerbated by the pandemic is worse. These settings account for:

• More than 70% of cases of epidemic-prone diseases, such as cholera, measles and meningitis;
• 60% of preventable maternal deaths;
• 53% of deaths in children under five; and
• 45% of infant deaths.

By 2030, 80% of the world’s extreme poor will live in fragile contexts, and the majority will be children. Women, children and youth are uniquely and disproportionately affected by conflict and fragility, whether by gender-based violence, lack of adequate nutrition, broken state-societal relations or insurmountable barriers to basic quality health services.

In addition to the urgent action needed to save lives and address immediate nutritional, physical and mental health needs—now more than ever, the world’s health systems must be strengthened to reach communities in ways that are effective and durable, while addressing the factors that drive fragility itself.