Covid-19 is making policy makers rethink national priorities and increase investment in the health systems. We have seen reports of counties spending more on their development budget, purchasing beds and Personal Protective Equipment, and both national and county governments hiring additional health workers.
Such investments in health facilities in the long-term will benefit the county health facilities, including Mother and Child Health services once the corona pandemic is over.
Despite the potentially positive impacts in responding to the current crisis however, there are fears that the focus on managing the covid-19 situation in the country may affect further the delivery of maternal and child health services.
HEALTH AND NUTRITION
Health and nutrition service delivery in the Maternal Child Health and Nutrition (MCHN) programme is currently under threat as a lot of focus is shifting toward prevention and treatment of Covid-19.
Malnutrition has for a long time been a public health concern due to the high mortality and morbidity rates among children under five.
However, the prevention and treatment of malnutrition seems to be receiving less attention as the emphasis is now more on preparedness to cope with the expected rise in corona cases.
Ensuring good nutritional status of the community at large with special emphasis on the vulnerable members of society helps achieve healthy lifestyle and averts mortality and morbidity rates among women and children.
Services like immunisation, the safe delivery of babies, nutrition and antropometric measurements may be affected further in a number of ways.
A concern for many Kenyans is the lack of access to reproductive healthcare, including access to family planning services.
Two indicators – maternal deaths and an unmet need for family planning – highlight some of the reasons for this concern.
Although Kenya has made great strides in reducing maternal deaths it is still the case that the country records the unacceptably high figure of 6,300 women dying every year during pregnancy and childbirth. A major contributing factor to maternal deaths is unplanned pregnancy exacerbated by the lack of family planning services.
There are now challenges in conducting anthropometric assessments by nutritionists and health care workers due to fear of contracting covid-19.
Likewise there may be a reduction in seeking MCHN services and postnatal care visits by mothers because of fear of exposing their children to the virus. This may in turn lead to missing out on malnutrition cases and result into late interventions regarding malnourished children.
There is also a danger of mothers missing appointments and a resultant defaulting of malnutrition cases that were being monitored.
The loss of income sources among women as a result of lockdown and curfew which may also result in poor food choices and nutrition of pregnant women.
Further, the failure to attend antenatal and postnatal care visits could also be exacerbated because of the fear of being caught by police and the threat of being taken to a quarantine facility as punishment of flaunting curfew laws.
There could also be difficulties in accessing reproductive and maternal healthcare services as health facilities slowly become overwhelmed with the increase in the number of Covid cases.
In addition, we might see cases of diversion and reorganization of county financial and personnel resources already budgeted for and prioritized to support maternal child health, nutrition services and reproductive health services to manage the corona pandemic should the numbers surge. Thus a strain on the county health finances will be felt which may further affect the delivery of maternal and child health services and reproductive health services, and lead to increased maternal mortality rates across the country.
As the covid-19 pandemic forces governments and policy makers to rethink their health systems and related services such as family planning, given the potential impact in the short and long term, maternal child health and nutrition services must not be compromised and should continue to be a priority.
More research and advocacy is needed into the impact of Covid-19 on maternal and child health across the country and lessons must be learned as to how we can revamp the healthcare system, improving it for the better so that the lives of children and mothers are not lost.
Vivian Magero is a trained nutritionist and public policy and budgeting expert.