ASPHER Associate Member, The School of Public Health (ESPM) at the National Institute of Public Health of Mexico (INSP) recently held a webinar on the terrible impact of COVID-19 on Child Nutrition. A letter summarizing the lessons from the webinar was published as part of their ongoing series of English Language Friday Letters. Read the letter here below or on the ESPM website.
“The COVID-19 pandemic has unleashed not only a crisis in health systems but also an unprecedented economic and social crisis that threatens to exacerbate malnutrition and mortality in children under the age of 5 in countries of low to middle economic levels. It is anticipated that Covid will result in a higher incidence of malnutrition due to decreased income and availability and access to food for pregnant mothers and lactating mothers with children resulting in the interruption of nutrition and health protection services in an already weakened healthcare system.”
That is what Dr. Juan Rivera Dommaro, General Director of the National Institute of Public Health of Mexico (INSP) said during a recent webinar he hosted entitled, “Impact of Covid on child malnutrition.” The webinar was attended by prominent representatives in the field of national and international health who expressed concern about the effects of the pandemic on child nutrition.
“As we all know, child malnutrition increases the risk of illness and death in children and the risk of chronic diseases in those who survive. Several estimations predict that this crisis derived from the pandemic will have great costs in lives and in the health of children under five years old in the short and medium term and, possibly, over the long term, a global excess of chronic diseases” said Dr. Juan Rivera.
After his presentation, Dr. Rivera introduced Dr. Marie Ruel, Director of the Poverty, Health and Nutrition Division of the International Food and Policy Research Institute (IFPRI), who commented on the estimates of the effects that the pandemic has in the state of nutrition: "The Covid crisis affects health, economic and food systems, exacerbates inequalities and affects all systems we trust to improve nutrition." She affirmed that there would be a possibility of (Covid) affecting malnutrition in pregnant mothers and in the reduction of sizes of babies and that the effects will be apparent within two or three years.
The next presenter was Dr. Víctor Aguayo, Deputy Director of the Program Division and Global Head of the UNICEF Nutrition Program. He reviewed some statistics which cited that one of three children “will not grow properly due to some form of malnutrition. Before the pandemic, we had data indicating that 2 out of 3 children under 2 years old do not have access to a diet that ensures the minimum necessary nutrition. With this pandemic, 300 million children worldwide will not receive nutritional supplements”.
“It is necessary to maintain school breakfasts, even during lockdown, to provide maternal and child nutrition as well as to promote social protection programs. We must prevent the pandemic from leaving a legacy of hunger and malnutrition in childhood”.
In Mexico in 2018 prior to the pandemic, 55% of households had some level of food insecurity, 14% of children under five years old had chronic malnutrition with no improvements recorded since 2012. The pandemic will probably increase the prevalence of malnutrition and nutritional deficiencies in children compared to the numbers that the INSP registered in 2018. As such, in 2020, INSP, UNICEF, FAO, PAHO, WHO, published a document endorsed by the Inter-secretarial Group of Health, Food, Environment and Competitiveness (GISAMAC), listing 12 recommendations to avoid a decline in the nutritional status of children under five years of age.
Dr. Anabelle Bonveccio, Director of Research in Nutrition Policies and Programs at the Nutrition and Health Research Center (CINys) at INSP, took the floor and commented on the document entitled: “Prevention of poor nutrition in children and adolescents in Mexico in the face of the Covid-19 pandemic. Recommendations addressed to decision-makers”. She cited from the document, “the signatory organizations estimate that the economic crisis derived from the loss of employment and reduction of income will intensify vulnerability to households, so priority attention is required to avoid problems of malnutrition in minors”.
The COVID-19 pandemic found Mexico with three major structural disadvantages that it seems our country has been dragging on before the pandemic:
- Mexico’s health system was considered - according to OECD, World Bank and IDB evaluations- as one of the weakest in the OECD and remains so among Latin America countries
- Mexico is one of the countries with the highest burden of chronic diseases, which increases the risk of complications and death from Covid.
- More than half of population in Mexico lives in poverty conditions which makes it hard to implement mitigation measures such as lockdown as people need to go out to earn a daily living.
Despite the efforts to provide a health response in Mexico, these three factors make it difficult to contain and mitigate the epidemic and to effectively treat cases. This inequity in Mexico throughout its history and the deficiencies in nutrition and health services also explain the concern about the effects that pandemic can have on the already deteriorated nutritional status of millions of children and on those who, due to the deepening poverty, find themselves in a vulnerable situation.
Concluding the webinar, Dr. Rivera urged the community to create a national plan for the protection of Maternal-Infant nutrition and, in particular, actions for the promotion of adequate infant feeding including both breastfeeding and an adequate complementary diet.
With these actions, INSP underscores its social commitment to the continued efforts to improve the health of the population in Mexico that initiated long before to the Covid-19 pandemic.