A Revolutionary Change in Paediatric Healthcare Leave a comment
By Minnie Bodhanwala
The COVID-19 pandemic has wide-reaching implications for children’s health and well-being including serious implications for child survival. Children have emerged as victims during the pandemic. They were unable to get access to vital child healthcare services like newborn care and immunization, and faced problems such as nutritional deprivation, mental impairment, and compromised learning. Read on to know how the pandemic has brought a significant change in paediatric healthcare.
Covid-19 has led to a devastating effect on all age groups, including children and adolescents. It had an adverse impact on children’s health and psychosocial well-being, along with the difficulty in accessing healthcare services.
This is how lockdown impacted children
The birth rate has dropped in Mumbai during the pandemic as mothers migrated to their hometown/village due to the Covid scare and expensive delivery facilities in the city, planned delay in pregnancy during a pandemic due to uncertainty of outcomes, delayed marriages and motherhood is the thought process of Gen Z. During the lockdown, vital child health and welfare services in terms of nutritional programs, maternal and new-born care, immunization services, and community-based child protection programs were completely shut down. Moreover, the closure of the schools also invited problems such as social.
The impact of Covid may have been more acute for children having disabilities and chronic health conditions and has raised child protection issues for vulnerable children. Moreover, elective and non-elective surgeries were also not carried out at the beginning of the pandemic which led to a lot of serious complications.
Child healthcare services like newborn care and immunization, nutritional deprivation, and mental impairment were highly impacted. Routine immunization is one of the worst affected services and dropped down in many countries. According to the data from the Health Management Information System in India, monthly immunizations dropped by 70% nationwide in April 2020 but then rebounded substantially. National Family Health Survey (NFHS-4) revealed that merely 62% of the children aged between 12 and 23 months were known to have all basic vaccinations, and only 54% received all the basic vaccinations at 12 years of age. These figures are harrowing.
Children living with heart, ear, lung, and kidney problems didn’t get timely intervention for their health issues. Children seem to be the greatest victim of this global crisis.
There were comprehensive guidelines for maternal and child healthcare (MCH) during lockdown that left the children in need of essential healthcare services. There was a surge in childhood diseases like acute respiratory infections like pneumonia, diabetes ketoacidosis, obesity, malignancies, panic attacks, meningitis, diarrhoea, and other water-borne diseases, not to mention the upsurge of vaccine-preventable diseases like Diphtheria, Hepatitis A, Hepatitis B, Influenza (Flu) and so on which can claim many lives in the future. Many children were asymptomatic and were detected with Covid and suffered from long-Covid problems such as Multisystem inflammatory syndrome in children (MIS-C). Children were scared due to the effect of Covid-19, voicing concerns about family members dying. A majority of children had to suffer a lot during the pandemic.
The pandemic took a toll on the child’s mental health. No internet services and lack of technology during E-schooling and classes led to a lot of problems. Screen time increased and children became obese, stressed, eat junk food, and did not exercise. They became anxious, and nervous due to exam cancellations. They could not sleep properly on concentrate on their studies. Many children may develop feelings of sadness, anxiety, fear of death, fear of parents’ death, and fear of being isolated in the hospital due to the increasing Covid cases.
The pandemic is forcing Indian children out of school and into farms and factories to work, causing child labour problems. The pandemic is also leading to a steep rise in poverty, hunger, and malnutrition among children.
The challenges in paediatric healthcare: It is the need of the hour to make sure that every child gets vaccinated on a priority basis for BCG Vaccine, Hepatitis B Vaccine, and Oral polio vaccine (OPV). The pentavalent vaccine protects a child from five life-threatening diseases – Diphtheria, Pertussis, Tetanus, Hepatitis B, and Hib. Pneumococcal conjugate vaccine (PCV13) and Measles, Mumps, Rubella (MMR) Vaccine should also not be missed at all. Primary Paediatric care centres are required at every village level which are supervised for outcomes. We need better growth monitoring and monitoring of programs for malnutrition. It is essential to strengthening the Neonatal care and Pediatric hospital at the Taluka level. Decongest tertiary care centres in metro cities, strengthen secondary care paediatrics at the district level, maintain, electronic medical records all over the country, more research is required in pediatrics, especially low birth weight babies, killer diseases of children (Gastroenteritis, respiratory illness, malaria, TB). Fortunately, post-Covid issues in children are very few and rarely children have had persistent respiratory symptoms. The incidence of juvenile diabetes in the young and tuberculosis has increased post-pandemic. The incidence of Autism and attention-deficit/hyperactivity disorder (ADHD) has increased. Long-covid symptoms seen in adults are also seen in children though rare. Minor sequalae need close monitoring and follow up especially evaluating one’s heart and lungs. Most paediatric hospitals have post-Covid OPDs and are following up on these children. To help children lead a healthy life, it is necessary to retain the physical activity of children as post-pandemic obesity is on rising. Decrease screen time in children, reduce gaps in immunization caused by pandemic, malnutrition and growth monitoring has to be taken on a mission mode, improve rehabilitative services which were disrupted during pandemic especially physiotherapy, speech therapy, occupational therapy. Due to the unavailability of appropriate vaccination against covid for young children, the incidences of covid infections are predominant in school-going children. However, they have been mild. New-borns as a group have been spared any serious affliction or consequences due to the pandemic.
The last word|: There should be no disruption of essential healthcare services, which are critical for child survival in terms of immunization, child health, and nutrition. The government should ensure affordable access to healthcare services with prioritization for vulnerable children and their families, especially those having pre-existing health conditions. Educate children about COVID-19 and preventive behaviour like wearing a mask, hand sanitizing, maintaining social distance, and personal hygiene. Encourage children to go for mental health check-ups to overcome stress, anxiety, and depression. Furthermore, children of the lower socioeconomic class should get the required support to lead healthy lives. Quality healthcare should be delivered to children during emergencies.
Dr Minnie Bodhanwala, CEO Of Wadia Hospital
(DISCLAIMER: The views expressed are sole of the author and ETHealthworld does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly.)
