How has COVID-19 affected the delivery of essential child health services in your health facility or country(4)

26 May, 2021

Here is my Perspective on newborn health during COVID-19

Against all predictions, COVID-19 in Nigeria has been relatively mild compared to what was and is being witnessed in some countries.

The first confirmed case of COVID-19 was an Italian citizen who returned to Lagos after a business trip to Italy in February 2020. While the first confirmed child with COVID-19 in Nigeria was a 6-weeks old infant who also imported the disease from the UK. Subsequently, nearly 166,000 cases in both children and adults had been confirmed from different parts of the country with the epicentre in Lagos

According to statistics being released by the NCDC, Lagos has been the worst-hit state in Nigeria. Our facility was one of the facilities designated as COVID-19 isolation and treatment centre. We were the first centre with an organized protocol for managing and delivering pregnant COVID-19 positive women.

https://www.tandfonline.com/doi/full/10.1080/14767058.2020.1763948

So far we have not recorded any COVID-19 infection in any exposed newborn.

https://www.clinical-medicine.panafrican-med-journal.com/content/article...

We have not documented nor confirmed any case of neonatal COVID-19 infection in our facility. However, we do not routinely test all neonates for COVID-19 unless they or their mothers fail the routine screening test as outlined in our protocol.

From our clinical observations, the COVID-19 may have impacted our newborns not by causing the infection but by changing the health-seeking behaviour. During the peak of the pandemic, institutional deliveries declined, ill babies were not readily brought to hospitals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076627/

Those that managed to present were severely ill or have sustained severe complications before presenting. For example, more cases of babies with acute bilirubin encephalopathy were seen compared with those without ABE. Some of these complications may have resulted from the difficulty to access health care facilities during the lockdown as movement and transportation were restricted. Also, the fear of contracting the disease in hospital, resource diversion, and closure of facilities that comprised access to essential health services may have all contributed to the decline.

The present pandemic has exposed a lot of deficiencies in our health system. Our educational and social systems were not spared. Individuals, communities and government have to have a rethink, go back to the drawing board and critically reappraise our healthcare system and other systems and come up with a workable plan on how to mitigate pandemics and other disasters without compromising healthcare for all.

Beatrice Ezenwa

CHIFA Profile: Beatrice Ezenwa is a neonatology consultant based in Lagos.

Email .beatriceezenwa AT yahoo.com