South Africa

Children have suffered in lockdown for sake of adults’ health, say child experts

Stats show disruption of services, growing hunger and more burns and falls

Children wash their hands at an early childhood development centre run by the Tshepang Educare Trust in rural Free State. New statistics show how the response to the pandemic has had a negative impact on child health.

Children wash their hands at an early childhood development centre run by the Tshepang Educare Trust in rural Free State. New statistics show how the response to the pandemic has had a negative impact on child health.
Image: Tanya Farber

Children’s health has suffered during the Covid-19 pandemic to protect the health of adults, the Children’s Institute said on Tuesday.

The institute, based at the University of Cape Town (UCT), said primary health care visits by under-fives in the Western Cape dropped by 23% during the pandemic, leading to major gaps in testing and treatment of HIV, TB and malnutrition.

It is hoped advocacy briefs published by the institute on Tuesday will inform those whose work involves decisions that affect children.

“Elective surgeries for children were cancelled, and many children with disabilities were unable to access care,” said Lori Lake, an education specialist at the institute.

“The data shows hospital admissions for diarrhoea and pneumonia decreased, but in-hospital mortality increased, raising concerns about life-threatening delays in seeking care.”

The concerning picture that has emerged from the Western Cape is probably far worse in other provinces with fewer resources.

On violence and injury, Lake said from 2019 to 2020 there was a 15% decrease in children admitted to the Red Cross War Memorial Children’s Hospital with unintentional injuries.

This was driven by a general decrease of 56% in road traffic injuries during hard lockdown and the ban on alcohol sales.

However, over that time, injuries like burns and falls increased. 

Speaking from the Eastern Cape during a webinar, public sector paediatrician Dr Nomlindo Makubalo said: “We are seeing an increase in diarrhoea from rotavirus as so many children missed their immunisations.

“When we ask parents, they say the clinic was closed or money was so tight over this time that they could not travel to the clinic.”

She said many complicated TB cases in children were not adequately treated as services had been diverted to the Covid-19 crisis, and much defaulting on antiretroviral (ARV) treatment had occurred for the same reason.

This was all against a backdrop of rising child hunger.

Prof Michael Hendricks of the department of paediatrics and child health at UCT said: “Rising unemployment and food prices increased pressure on poor households, with 47% of households running out of money to buy food during hard lockdown.”

He said despite families’ efforts to shield youngsters, child hunger has remained high with one in seven households reporting a child went hungry in April 2021. 

At the same time, the disruption of routine health services made it harder to identify and support children at risk of malnutrition, he said.

According to the advocacy briefs, “concerted efforts by child health practitioners and community health workers helped ensure some of these services were fully restored — with measles immunisation recovering to 95% (a 5% increase on coverage in 2019).  However, it will require time, ongoing advocacy and proactive decision-making to address the significant and potentially life-threatening backlogs in elective surgeries.” 

Prof Maylene Shung-King, a public health specialist at UCT, said: “The assertions by key experts for the advocacy briefs showed how the country overlooked the disastrous collateral damage on many aspects of children’s lives in response to the pandemic. Their needs were sidelined and the advocacy briefs highlight those”.

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