Direct and indirect effects of the covid-19 pandemic and response in South Asia

Chapter 4

Implications and Way Forward for South Asia

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WHO has recommended strategies to minimize the disruption to essential SRMNCH services, including use of telemedicine to minimize patient-provider contact

in the midst of the pandemic, strengthening infection prevention and control capacities, and ensuring essential supplies (61). Encouragingly, many countries have indicated the need for technical assistance and support in implementing these strategies to ensure that the impact of COVID-19 on essential SRMNCH services is minimized (61).

In addition, rates of undernutrition, including anemia, stunting and wasting are also likely to increase as disruptions in food supply systems and economic activity lead to increase in poverty and food insecurity. Prospective data from Bangladesh underscores this concern, where households experiencing food insecurity increased by more than 50% during stay-at-home orders implemented in March – May 2020 (62). Similarly, our economic impact model shows, that even the least severe stage of mitigation strategies, which include warnings/advisories, public gatherings ban, social distancing, and schools closures, could increase the share of the population who is food insecure by almost 20%.

As countries, including those in South Asia, continue to ease COVID-19 restrictions, coverage of maternal and child health and nutrition services need to be prioritized. These services include, but are not limited to: 1) prioritization of services to maximize health impact and protect services for the most vulnerable such as pregnant women and young infants or patients with pre-existing conditions 2) ensuring supply chain of essential medicines and commodities with change in protocols as needed to ensure adequate therapy such as provision

of longer term supply 3) protection of supply-chain and delivery mechanisms for continued and increasing

coverage of childhood immunizations, antenatal care and family planning services, with the aim to avoid stock-outs amid a potential surge in demand for emergency contraception and abortion services; 4) Safe re-opening of ambulatory care systems for antenatal, delivery and child health and nutrition with adequate provision of PPE and a secure, safe environment for patients; 5) improving coverage of community-based nutrition services and immunizations for all antigens included under each country’s Expanded Programme on Immunizations, using outreach services such supplementary immunization activities; 6) expanding the capacity of existing fixed

and outreach health services such as community health workers , with an increased focus on MNCH, nutrition, and detection and triage of serious illnesses for rapid referral to facilities; and 7) instituting and improving nutrition support services for the most vulnerable, such as community-based management of moderate and acute malnutrition (CMAM) programs, the need for which is likely to increase across the region in the wake of the COVID-19 pandemic.