Providing Maternal Health Services during the COVID-19 Pandemic in Nepal

By the beginning of 2020, Nepal had reached a tipping point with over 60% of births occurring in a health facility—a three times increase from just 18% in 2006.

National lockdown happened very early in Nepal, on March 21, 2020, well before any community spread of COVID-19. The lockdown took the form of severe restrictions on transport and closure of outpatient departments of many hospitals.

In this article, the authors compare intrapartum care before and during the lockdown period in Nepal. The number of institutional births decreased by 52·4% during the first 2 months of lockdown, and women in relatively disadvantaged ethnic groups were found to be affected more than those in more advantaged groups, indicating a widening equity gap due to COVID-19. They also found that quality of care in the hospitals was compromised compared with before lockdown.

Source: Providing Maternal Health Services during the COVID-19 Pandemic in Nepal

    Vaccine Confidence: A Global Analysis Exploring Volatility, Polarization, and Trust

    This study reports that there is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunization coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019.

    The study’s findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence.

    Source: Vaccine Confidence: A Global Analysis Exploring Volatility, Polarization, and Trust

      COVID-19 Care in India: The Course to Self-Reliance

      The public health response to COVID-19 in India has been highly centralized, resulting in a homogenous strategy applied across a sixth of the world’s population.

      India was placed in a nationwide lockdown on March 24, 2020, with restrictions being relaxed in three phases since June. In May 2020, the prime minister called upon the Indian people to be self-reliant. The authors discuss opportunities to modify several aspects of the medical response to echo this sentiment.

      They conclude that what is still needed is a plethora of low-tech solutions (especially facial coverings), adherence to science, and societal participation in caring for vulnerable people.

      Source: COVID-19 Care in India: The Course to Self-Reliance

        Comprehensive Sexuality Education to Address Gender-based Violence

        The COVID-19 pandemic has unmasked underlying inequities. Measures such as lockdown and physical distancing have confined many people to isolated, unsafe places that may increase risk of gender-based violence (GBV).

        f lockdowns or restricted movement continue for just a year, it is estimated there will be 61 million more cases of GBV than what would have already been expected In response to this increase, UN Women launched the Shadow Pandemic public awareness campaign in May, 2020.2 Meanwhile, the UN Secretary-General has called for countries to include GBV prevention as a component of COVID-19 recovery plans.

        UN Women emphasises vital national responses to address violence against women and girls (VAWG) throughout the COVID-19 pandemic, and these responses could serve as useful entry points for comprehensive sexuality education (CSE) provision in the Arab region. VAWG regional responses include provision of shelters, telephone hotlines, and online counselling; strong messaging from law enforcement that violence against women and girls (VAWG) cases are high priority; and psychological support for women and girls, GBV survivors, and front-line health workers affected by both the COVID-19 and shadow pandemics.

        Source: Comprehensive Sexuality Education to Address Gender-based Violence

          Stigma During the COVID-19 Pandemic

          Stigma associated with COVID-19 poses a serious threat to the lives of healthcare workers, patients, and survivors of the disease.

          In May 2020, a community of advocates comprising of 13 medical and humanitarian organisations including, among others, the International Committee of the Red Cross, the International Federation of the Red Cross and Red Crescent Societies, the the International Hospital Federation, and World Medical Association issued a declaration that condemned more than 200 incidents of COVID-19 related attacks on healthcare workers and health facilities during the ongoing pandemic.

          Source: Stigma During the COVID-19 Pandemic

            Physical Distancing, Face Masks, and Eye Protection for Prevention of COVID-19

            Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread personto-person through close contact.

            The authors of this article aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. They did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-toperson virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses.

            The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance.

            Source: Physical Distancing, Face Masks, and Eye Protection for Prevention of COVID-19

              Talking to Children about Illness and Death of a Loved One during the COVID-19 Pandemic

              In the midst of the devastating death toll and hospitalizations from COVID-19, the psychological effect of the pandemic on children has been sadly overlooked.

              The overwhelming media coverage and barrage of public health messages sustain a high level of physical and emotional threat within our communities, which is intensely observed by children. Age-appropriate explanations are paramount to ensure children have a coherent narrative and emotional support for their experiences. This article offers some guidelines on talking to children about these issues.

              Source: Talking to Children about Illness and Death of a Loved One during the COVID-19 Pandemic

                Building Trust while Influencing Online COVID-19 Content in the Social Media World

                Because of COVID-19’s strict physical distancing measures, people are heavily reliant on maintaining connectivity using global digital social networks, such as Facebook or Twitter, to facilitate human interaction and information sharing about the virus.

                In this article, the authors discuss some ways in which social media has undermined effective responses to COVID-19. They consider how various groups could respond to these challenges—especially government leaders, social media companies, and healthcare providers. Ultimately, these actors each have roles to play in preventing social media from being weaponised to sow distrust and further endanger public health, while also ensuring that social media can fulfill its essential civic function of facilitating good faith political expression and discourse.

                Source: Building Trust while Influencing Online COVID-19 Content in the Social Media World

                  Early Estimates of the Indirect Effects of the COVID-19 Pandemic on Maternal and Child Mortality in Low-income and Middle-income Countries: A Modelling Study

                  While the COVID-19 pandemic will increase mortality due to the virus, it is also likely to increase mortality indirectly. In this study, the authors estimate the additional maternal and under-5 child deaths resulting from the potential disruption of health systems and decreased access to food.

                  The results of the study show that if routine health care is disrupted and access to food is decreased (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. The authors hope these numbers add context as policy makers establish guidelines and allocate resources in the days and months to come.

                  Source: Early Estimates of the Indirect Effects of the COVID-19 Pandemic on Maternal and Child Mortality in Low-income and Middle-income Countries: A Modelling Study

                    Zaracostas, John. 2020. How to Fight an Infodemic. The Lancet, February 29, 2020.

                    WHO is leading the effort to slow the spread of the 2019 coronavirus disease (COVID-19) outbreak. But a global epidemic of misinformation—spreading rapidly through social media platforms and other outlets—poses a serious problem for public health.

                    Source: How to Fight an Infodemic