Health Services for the Most Vulnerable Have Been Severely Impacted

Part one: Global Trends

Maiwut, South Sudan

Hospital porters carry a patient from the intensive care unit at an ICRC-supported centre in Maiwut. ICRC/Albert Gonzalez Farran

Almost half of all deaths in low-income countries are caused by communicable diseases, and maternal, perinatal and nutritional conditions. Respiratory infections, diarrhoea, malaria, tuberculosis (TB) and HIV/AIDS are the top 10 causes of death.¹ At the current pace, many health-related Sustainable Development Goals (SDGs) will not be met in 2030, including premature mortality from non-communicable diseases, the incidence of TB and malaria, and new HIV infections.²

COVID-19 severely impacts the operational readiness of health systems worldwide, dealing a considerable blow to operating budgets and the ability to maintain the minimum stock levels of essential commodities for HIV, TB and malaria.³ In 502 health facilities across Africa and Asia, HIV testing fell 41 per cent, TB referrals declined by 59 per cent and malaria diagnoses fell by 31 per cent in 2020 compared with 2019.⁴ This disruption means that people are not as widely tested, diagnosed or treated for HIV, TB and malaria, increasing the chance of HIV and TB transmission within communities.⁵

Maiduguri, Nigeria

After losing her family to the insurgency, this woman fled Kukawa to the Teacher’s Village IDP camp. During the COVID-19 lockdown, she had a stillbirth because the clinic was closed. She is pregnant again; UNICEF is supporting her to ensure she delivers safely. Humanitarian partners in Maiduguri work to end preventable maternal, newborn and child deaths and stillbirths by scaling up quality essential maternal and newborn care services, sustaining immunization programmes, and supporting preventive, promotive and curative services for pneumonia, diarrhoea, malaria and other child-health conditions.

OCHA/Damilola Onafuwa

Declining health systems are particularly dangerous for mothers and children. If they have reduced access to essential health services, mortality among children under 5 years of age could rise.⁶ Antenatal-care visits have already fallen by 43 per cent.⁷ 2020 saw a decrease of 23 per cent in consultations for under-5 services in Africa and a large drop of 74 per cent in Asia.⁸

In 2021, about 23 million children worldwide missed out on basic childhood vaccines. Children living in remote or deprived areas are the most affected, highlighting the widening gaps in vaccine access.⁹

Conflict severely hampers the provision of health care. In 2020, Yemen experienced six outbreaks of infectious diseases, including cholera, dengue, diphtheria and malaria. Only 51 per cent of health-care facilities across the country are reported to be fully functional, due to the conflict. The fragile health system has extremely limited capacity to implement effective COVID-19 preparedness and response measures.¹⁰

Mental health services require greater support, particularly in conflict settings, where adults are almost three times more likely to have mental health conditions. Children who are refugees or IDPs or who live in conflict settings also have high levels of mental health issues.¹¹