Globally, 6,000 additional children under five could die every day.

The estimate is based on an analysis by researchers from the Johns Hopkins Bloomberg School of Public Health, newly published in The Lancet Global Health journal.

In a commentary to the Lancet report, UNICEF warns these disruptions could result in potentially devastating increases in maternal and child deaths. 

The analysis offers three scenarios of the potential impact of COVID-19 in 118 low- and middle-income countries, including Nigeria. In the worst-case scenario, the estimate is that an additional nearly 173,000 under-five deaths could occur in just six months, due to reductions in routine health service coverage levels – including routine vaccinations - and an increase in child wasting.

In Nigeria, these potential child deaths would be in addition to the 475,200 children who already die before their fifth birthday every six months – threatening to reverse a decade of progress in ending preventable under-five child mortality in Nigeria.

About 6,800 more Nigerian maternal deaths could also occur in just six months.

“Under a worst-case scenario, the global number of children dying before their fifth birthdays could increase for the first time in decades,” said UNICEF Executive Director Henrietta Fore. “We must not let mothers and children become collateral damage in the fight against the virus.”

Peter Hawkins, UNICEF Nigeria’s Country Representative, said, “We have made steady progress in reducing preventable child and maternal deaths in Nigeria over the last 20 years – and it would be devastating if that progress is lost or reversed – devasting for Nigerian families, communities and for the country as a whole.”

The under-five mortality rate has declined gradually over the last two decades in Nigeria - from 213 deaths per thousand in 1990 to 120 today. This is likely due to improved access and coverage of key lifesaving interventions at primary health care and community levels and improved immunization rates.

But in countries with still overall weak health systems, like Nigeria, COVID-19 is causing disruptions in medical supply chains and straining financial and human resources. Visits to health care centres are declining due to lockdowns, curfews and transport disruptions, and as communities remain fearful of infection.

According to the modeling, and assuming reductions in coverage in the worst-case scenario, the 10 countries that could potentially have the largest number of additional child deaths are: Bangladesh, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Nigeria, Pakistan, Uganda and United Republic of Tanzania.

The 10 countries that are most likely to witness the highest excess child mortality rates under the worst-case scenario are: Djibouti, Eswatini, Lesotho, Liberia, Mali, Malawi, Nigeria, Pakistan, Sierra Leone and Somalia.

“The estimates in this new study show that if, for whatever reason, routine health care is disrupted, the increase in child and maternal deaths will be devastating,” said Peter Hawkins.

“What this study also shows is the critical importance of continuing to provide of life-saving services during these challenging times. We need to continue to deliver children into a safe pair of hands at a well-equipped clinic; we need to continue to ensure newborns receive their essential vaccinations and have their births registered; and we need to continue to ensure children get the essential nutrition they need to survive and thrive beyond their first day and throughout their childhoods.”