Indirect effects on maternal and child mortality from the COVID-19 pandemic: Evidence from disruptions in healthcare utilization in 18 Low- and Middle- Income countries

Article on one of the most critical of secondary consequences, the decrease in the utilization of health services and the resulting consequences for mortality. In low- and middle-income countries, these disruptions can halt progress towards reducing maternal and child mortality. It was estimated that decreases in essential health service utilization between March 2020 and June 2021 led to 113,873 additional deaths in the 18 countries, representing 3.8% and 1.4% increases in child and maternal mortality, respectively. This corresponds to an average of 2.6 indirect deaths per COVID-19 death officially reported in the same period. This excess mortality results from the decline in utilization of the RMNCH services included in the analysis, but the utilization shortfalls vary substantially between countries, health services, and over time. The largest disruptions, resulting in 27.5% of the excess death, occurred during the second quarter of 2020, regardless of whether countries experienced the highest rate of COVID-19-related deaths during the same months. There is a significant relationship between the magnitude of service disruptions and the stringency of mobility restrictions.