lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Early Estimates of the Indirect Effects of the Coronavirus Pandemic on Maternal and Child Mortality in Low- and Middle-Income Countries

31 Pages Posted: 21 Apr 2020

See all articles by Timothy Roberton

Timothy Roberton

Johns Hopkins University - Bloomberg School of Public Health

Emily D. Carter

Johns Hopkins University - Bloomberg School of Public Health

Victoria B. Chou

Johns Hopkins University - Bloomberg School of Public Health

Angela Stegmuller

Johns Hopkins University - Bloomberg School of Public Health

Bianca D. Jackson

Johns Hopkins University - Bloomberg School of Public Health

Yvonne Tam

Johns Hopkins University - Bloomberg School of Public Health

Talata Sawadogo-Lewis

Johns Hopkins University - Bloomberg School of Public Health

Neff Walker

Johns Hopkins University - Bloomberg School of Public Health

More...

Abstract

Background: While the coronavirus pandemic will increase mortality due to COVID-19, the indirect effects of the pandemic will likely increase mortality from other diseases. In this study, we estimate the additional maternal and under-five child deaths resulting from weakened health systems and reduced utilization of routine services during the pandemic.

Methods: We modeled three scenarios in which coverage of basic life-saving interventions is reduced to different extents (10% to 50%) and for different durations (3, 6, and 12 months), using assumptions based on emerging reports of the supply-side and demand-side effects of the pandemic. We used the Lives Saved Tool (LiST) to model maternal and under-five child mortality for each scenario in 118 low- and middleincome countries.

Findings: Reductions in coverage of around 15% for 6 months would result in 253,500 additional child deaths and 12,190 additional maternal deaths, while reductions of around 45% for 6 months would result in 1,157,000 additional child deaths and 56,700 additional maternal deaths. This would represent a 9·8% to 44·7% increase in underfive child deaths per month, and an 8·3% to 38·6% increase in maternal deaths per month, across the 118 countries.

Interpretation: Our estimates are based on tentative assumptions and represent a wide range of outcomes. Nonetheless, they show that if routine health care is disrupted – as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic – the increase in child and maternal deaths will be devastating. We hope these numbers add context as policy makers establish guidelines and allocate resources in the days and months to come.

Funding: This study was supported by the Bill & Melinda Gates Foundation and Global Affairs Canada, who fund the Lives Saved Tool.

Conflict of Interest: The authors declare no conflicts of interest.

Keywords: Modeling, Maternal and Child Health, Coronavirus, Mortality, Lives Saved Tool, LiST

Suggested Citation

Roberton, Timothy and Carter, Emily D. and Chou, Victoria B. and Stegmuller, Angela and Jackson, Bianca D. and Tam, Yvonne and Sawadogo-Lewis, Talata and Walker, Neff, Early Estimates of the Indirect Effects of the Coronavirus Pandemic on Maternal and Child Mortality in Low- and Middle-Income Countries (April 15, 2020). Global Health, Volume 8, Issue 7, E901-E908, July 01, 2020, https://doi.org/10.1016/S2214-109X(20)30229-1, Available at SSRN: https://ssrn.com/abstract=3576549 or http://dx.doi.org/10.2139/ssrn.3576549

Timothy Roberton (Contact Author)

Johns Hopkins University - Bloomberg School of Public Health ( email )

615 North Wolfe Street
Baltimore, MD 21205
United States
443-844-9749 (Phone)

Emily D. Carter

Johns Hopkins University - Bloomberg School of Public Health

615 North Wolfe Street
Baltimore, MD 21205
United States

Victoria B. Chou

Johns Hopkins University - Bloomberg School of Public Health

615 North Wolfe Street
Baltimore, MD 21205
United States

Angela Stegmuller

Johns Hopkins University - Bloomberg School of Public Health

615 North Wolfe Street
Baltimore, MD 21205
United States

Bianca D. Jackson

Johns Hopkins University - Bloomberg School of Public Health

615 North Wolfe Street
Baltimore, MD 21205
United States

Yvonne Tam

Johns Hopkins University - Bloomberg School of Public Health

615 North Wolfe Street
Baltimore, MD 21205
United States

Talata Sawadogo-Lewis

Johns Hopkins University - Bloomberg School of Public Health

615 North Wolfe Street
Baltimore, MD 21205
United States

Neff Walker

Johns Hopkins University - Bloomberg School of Public Health

615 North Wolfe Street
Baltimore, MD 21205
United States