Global society needs time to clarify the exact effect of Covid-19 on maternal mortality , preterm birth rate, stillbirth and other negative pregnancy outcomes in LMICs. It is clear, however, that pregnant women or new mothers have been noticeably hit by Covid-19. This pandemic won't be the last one. It is therefore imperative that governments and the global society consider appropriate strategies in order to mitigate the risks and results of Covid pandemic on vulnerable populations
By Sevil Hakimi
Rm. PhD. Associate Professor of Maternal and Newborn Health. Tabriz University of Medical Science. Tabriz, Iran
hakimis@tbzmed.ac.ir
Beyond the Waives
Indirect Effects of Covid-19 on Mothers in Low and Middle-Income Countries
Covid-19 pandemic continues to make health system overwhelmed. However, the tremendous direct and indirect effects of this virus on most vulnerable population are always neglected. Pregnant women or new mothers in low and middle-income countries (LMICs) are among the populations that have been noticeably hit by Covid-19. Unfortunately, we have no precise information on pandemic-related indirect effect in the mentioned sector. Every conclusion in this area is based on uncertain data.
LMICs are struggling with a couple of problems including human resource and budget shortfall, weak health system, poverty, inequality, etc.
Older age and systemic disease are among the top predictors of Covid-19 fatality rate. However, there are evidences that weakness of the health system can be a remarkable factor in fatality rate prediction. The majority of LMICs have young population, however their health system is not as strong as high-income countries. The effect of health system weakness can be powerful as it erases young population advantage.
While resources are scant, health care delivery is constrained in this period. Hospitals face considerable challenges for providing standard care. Within this condition, mothers are the most deprived population group. They are young and almost always are healthy. So, it is very probable that while their needed care is shifted to other parts of the hospital, they eventually receive care below standard.
It is more than likely that maternal ward is allocated to Covid patients. So, midwives and nurses working in maternal wards are transferred to other parts of hospital for caring of Covid patients. Seeking care and timely transferring for pregnant mothers, damaged during lockdown, comes as no surprise on the grounds of the limited budget, which is allocated to personal protective equipment (PPE), so that other equipment is not provided. Covid related burnout and mental stress among midwives and nurses have an impact on the quality of care provided.
Covid-19 leads to consider the “separation” policies by the policy makers for the protection of health care providers, newborns and mothers as well. Hence, direct skin to skin contact, breastfeeding and presence of parents in the neonatal intensive care unit (NICU) have been completely disrupted or seriously limited in several countries. Separation policies can have devastating effect on maternal mental health, preterm newborns development and exclusive breastfeeding rate.
In the middle of current Covid pandemic it seems that mothers, as part of most vulnerable population, are obtaining less care than they deserve.
In the heart of communities, and following the policy of “stay at home”, domestic violence (DV) has increased against women. There is no clear data about comparison of DV against women between developed and developing countries. Regarding to economic insecurity role in prediction of DV, we can anticipate that the problem is more severe in LMICs.
Gender based violence on expecting or new mothers can lead to catastrophic physical and emotional results including miscarriage, stillbirth, preterm birth and post-partum depression. Child marriage is another social negative outcome of current pandemic, which has burst in a few countries including Indonesia, India, Brazil, Bangladesh and Ethiopia according to national reports.
Conclusion
Global society needs time to clarify the exact effect of Covid-19 on maternal mortality, preterm birth rate, stillbirth and other negative pregnancy outcomes in LMICs. This pandemic won’t be the last one, definitely. It is, therefore, imperative that governments and the global society consider appropriate strategies in order to mitigate the risks and results of Covid pandemic on vulnerable populations.
News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings
A presentation here of Find Vaccine Now platform which is available in 104 countries, making Covid-19 vaccine access and availability information within reach of more than 5 billion of the world’s population by connecting people to available doses, in addition to building their confidence in vaccinesIn several low income countries, following information is not available or is not easily accessible …our goal is to bring the latest, and most accurate Covid-19 vaccine information to our communities from reliable sources. We hope that providing fast, accurate and timely Covid-19 vaccine information to our communities will help match Covid-19 vaccine seekers with Covid-19 vaccine providers, making it easier to vaccinate more people while reducing long vaccine lines…
Access to Covid-19 vaccine information, location, and availability is essential if we are going to increase vaccinations worldwide. In high income countries availability of vaccines and access information is widely available, however, in low – and lower middle-income countries access information is either not available or very difficult to find even when vaccine availability is becoming better.
Find Vaccine Now platform started working on making the access to Covid-19 vaccines easier for people in the United States when vaccines became available in December 2020. We soon realized if finding a vaccine appointment was harder in the United States, it will be even harder in other countries. With that in mind we expanded our platform to other countries.
Find Vaccine Now simply connects people to available doses in 104 countries, in addition to building their confidence in vaccines with WHO health messages.
WHO called the Find Vaccine Now platform “A critical step in connecting people to available doses and enabling the last stretch of vaccine delivery.”
Find Vaccine Now helps people with following information:
Vaccine information from trusted sources
Nearest location information
Vaccine availability information
Types of vaccines available
How to make an appointment
Where to make an appointment
Where to call for more information
To show how effective and important their tool is, Find Vaccine Now team compiled a sample list of a dozen countries with a combined population of about one billion people. The list of countries and the size of the global population without access to this critical information is much bigger.
Please try finding a vaccine location in major cities in any of the following countries using tools available to a common user: Ethiopia, Egypt, Nigeria, Vietnam, DR Congo, Tanzania, Spain, Kenya, Morocco, Nigeria, Angola, Ghana, Chad. Unfortunately, it will be very difficult.
News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings
Now that we just turned the corner on another challenging year, we wish to share here all 2021 PEAH published articles by committed top thinkers, stakeholders and academics worldwide aimed at sparking debate on how to settle the conflicting issues that still impair equitable access to health by discriminated population settings
2021: a Year in Review through PEAH Contributors’ Takes
As we just turned the corner on another challenging year, we wish to share here all 2021 PEAH published articles by committed top thinkers, stakeholders and academics worldwide aimed at sparking debate on how to settle the conflicting issues that still impair equitable access to health by discriminated population settings. PEAH deepest gratitude goes to all of them.
Moreover, as part of PEAH scope and aims, the column titled ‘Focus on: Uganda’s Health Issues‘ continued to serve as an observatory of challenging health issues in Uganda from a comprehensive view encompassing the policies, strategies and practices of all involved actors.
In the meantime, our weekly page PEAH News Flash has been serving as a one year-long point of reference for PEAH contents, while turning the spotlight on the latest challenges by trade and governments rules to the equitable access to health in resource-limited settings.
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*Daniele Dionisio is a member of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases. Former director of the Infectious Disease Division at the Pistoia City Hospital (Italy), Dionisio is Head of the research project PEAH – Policies for Equitable Access to Health. He may be reached at:
News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings
The world is in a very dangerous place right now and things can (will?) get out of hand. In terms of the recommendations at the end of the piece, the UN Security Council (UNSC) simply is not working and reform of its membership now has to be considered a key option so that the voice of people most impacted by poverty, inequities and conflicts is heard loud and clear in particular engaging our Youth who have the most to lose but also the most to gain by taking steps 'to save the world from itself.'
As we look forward to 2022 (and beyond), the issues we face have become existential. One may well ask, as climate change turns into a climate emergency, whether our home on planet earth can be preserved from environmental destruction. In short, can we avert a point of no return?
‘Don’t Look Up’
In the final moments of the Netflix movie, Don’t Look Up, Leonardo DiCaprio, a formidable environmentalist in his own right, playing astronomy professor Dr. Randall Mindy, sensing that Armageddon is near, ruefully utters ‘’We really did have everything, didn’t we?” His words of disbelief could well sum up a future worldwide regret for the fate of our ‘blue’ planet unless we learn to change our trajectory from a path of self-destruction to ensuring life enhancement of all species and planet survival.
The film is ostensibly a parody of how politicians, media, and the public ignore the reality of the planetary threats facing us – in this case a huge asteroid hurtling toward earth capable of extinguishing all life. (The last one hit the earth about 65 million years ago, wiping out the dinosaurs).
But the message of Don’t Look Up, considered by some to be the most important movie of 2021, could be more revealing. Parallels with our responses to climate change (neglecting, rejecting) – including the coronavirus – are clearly at the heart of the storyline. Unquestionably, WE have metaphorically become the comet and, scientists tell us, our species has about ten years before reaching ‘a point of no return’ when the destruction of our biosphere (land, sea, air) becomes inevitable.
Resetting the world geopolitical clock
There are of course other crisis scenarios of significant global risks that may be coming to a head in 2022 and that we need to treat very seriously rather than with arrogance or indifference.
China, an example of ‘the emergence of a first-rank economic and military power that respects neither democracy nor the rule of law that underpins it,’ tops the list. Seeking to establish a new world order based on totalitarianism, it is becoming apparent that ‘Beijing intends not only to abide by its own rules but expects others to follow –them.’ Other potential flashpoints in 2022 include Russia’s troop build-up around Ukraine, Iran’s escalation of its nuclear programme, and North Korea’s disruptive cyberattacks and military threats.
Considered collectively, it is clear that the lead time to reset the world geopolitical Doomsday Clock (a metaphor created by the Bulletin of the Atomic Scientists in 1947) is even shorter than that for climate change – 100 seconds to midnight – as ‘autocrats everywhere have been using their lockdowns to plot mischief,’ which may, by design or accident, also lead to global catastrophe.
Calling out ‘rogue leaders’ and pulling together for planet sustainability
To safeguard our civilisation, global decision-makers who care about the future of the planet alongside the public at large are now tasked to call out (rein in) ‘rogue leaders’ (or political aspirants) who have the power to destabilise, indeed destroy, c. 4.54 billion years of Planet Earth evolution. The stakes for not doing so are very high indeed.
Individuals (and groups) in question include those who :
place their own self-interests, ambition and power ahead of planet survival;
believe ‘image’ is more important than ‘character’;
engage deliberately in disinformation rather than Truth;
lack understanding, trust and compassion;
instigate division and chaos over inspiring unity;
deny the root causes of global instability (e.g., climate change, inequality);
maintain that ‘might is right’;
support a culture of ‘them and us’;
engage in physical and cultural assaults on individuals and democratic institutions;
flout the rule of law;
espouse totalitarian principles over democratic rights and freedoms.
Unquestionably, the United Nations has a key lead role to play here but may be constrained politically and strategically.
One of its main weaknesses lies in the composition of the United Nations Security Council (UNSC) with its core remit to ensure global peace and security. The main problem is that the same five permanent members with veto power – China, France, Russia, United Kingdom, United States – appointed in 1946 at the end of WWII now represent only about two billion people out of c. 7.8 billion. Close to 1.3 billion in Africa and 1.4 billion in India alone are not permanently represented although some of the poorest and the most disadvantaged live in these regions and will be most affected by climate change.
The UNSC’s ‘win-lose’ conflict resolution approach informed (biased) by political ideologies and hegemony lead the Council to veto or simply neglect key global political issues including humanitarian disasters (e.g., Afghanistan, Myanmar, Covid-19 deaths, migration) and are morally indefensible in light of continuing and needless human suffering.
Covid-19 reminds us that the only way we and particularly Heads of State can achieve planet sustainability is ‘to pull together’ and ‘to stop behaving as if we live in a limitless world.’ It also challenges us to consider what kind of future we want and how to achieve it.
to rise above the political and social ideologies WE have created over millennia resulting in divisions and conflicts with millions of innocent lives sacrificed;
to shape core values to ensure the sustainability of the planet and all life;
to replace the outdated (‘Age of the Strongman’) amoral plans for global conquest (i.e., advancing national and personal self-interests at the expense of others) with ones that optimise planet sustainability and the health & wellbeing of all life.
History has clearly shown us over millennia that free societies tend to flourish while those that dictate or enslave fail or have short lifespans – socially, economically, politically.
Adopting a new worldview
A recurring theme of my previous Impakter articles is that our greatest challenge as a species is to adopt a new mindset / mental models that shift our thinking, policies, and strategies from human-centrism (it’s all about us) to eco-centrism: it’s about all species and the environment and the sustainability of the planet.
This pressing paradigm shift – defining a renewed moral purpose? – in our worldview is encapsulated in the concept called One Health (& Wellbeing-OHW) that recognises the critical interdependence of humans, animals, plants in a shared environment. The underlying point is that the planet will thrive without us but will surely perish if we continue to erode ‘the fabric of the ecosystems which sustain life on earth.’
The One Health approach ‘shifts from reactive sectoralised’ interventions ‘to multi-sector preventive actions at social, ecological, economic and biological levels of society.’ Applying OHW in societal settings involves identifying the root causes of complex issues (e.g., climate change) and finding ways to mitigate these especially in light of potential disastrous consequences.
There is no Plan B for climate change. We either get it right in the forthcoming decades or we disappear. Simple as that!
The same holds true for other global threats – nuclear war, deadly pandemics, food security and others if pushed to extremes. The United Nations remains our best hope for a sustainable future but changes would need to be made to ensure that all nations have an equal voice and are able to speak freely about their challenges unencumbered by political interference or economic manipulations.
Recommendations flowing from this commentary include the need to:
(1) restructure the composition of the UNSC to ensure that the veto power of future permanent members (some conditional) does not lead to political paralysis, that all regions are fairly and equitably represented in terms of numbers and needs, as determined by annual reviews of risks and SDG progress, and that members are held publicly accountable in terms of enabling global peace, security and sustainability.
(2) adopt the One Health & Wellbeing concept/approach and establish a UN One Health and Wellbeing Sustainability Council with a strong Youth voice (e.g., representatives from the Sustainable Development Sustainable Solutions Network-Youth) to review and operationalise global propositions for global sustainability (socio-economic, geopolitical, environmental – aligned with the OH concept and the SDGs (summarised below) :
(3) promote the OHW concept and the UN SDGs at academic, government, and at all societal levels across all global regions through a process of change and education – formal and non-formal – addressing challenges we face in particular how we can better relate to the planet and to each other.
Our choice in 2022: Accept societal transformation or face extinction
The world faces hard choices in the days ahead. After 13.5 billion years of evolution from the Big Bang to the present, in 2022 we are at a turning point. Our choice is stark: acceptance of the societal transformations required to sustain the planet or face possible extinction as a species.
Considered ‘a modern-day heir to Charles Darwin,’ after a lengthy career, evolutionary biologist, conservationist, world-leading naturalist and author of more than 30 books, Edward O. Wilson (1931-2021) ‘felt optimistic that humanity had ‘the potential to solve its crises.’ On the other hand, he cautioned in 2019 that ‘our species was dysfunctional’: we carry Paleolithic emotions, we still depend on medieval institutions and have acquired god-like power – ‘a very dangerous and unstable combination.’
Cover Photo: Last scene from Don’t Look Up as the comet plunges toward Earth (screenshot) – film streaming on Netflix.
PEAH is pleased to post a presentation here focusing on the activities carried out and the challenges faced by the Foundation for Disabilities Hope (FDH) as a Non-Governmental Organization dealing with issues of advocacy for the rights and equality of groups of people with disabilities, youth and children in Tanzania
Foundation for Disabilities Hope (FDH) is a Non-Governmental Organization dealing with issues of Advocacy for the rights and equality of groups of people with disabilities, youth and children. This institution was officially registered in 2019 and obtained National Registration under Act No. 00NGO/R/004. The main office of the foundation is located at the CCM regional office building Dodoma, Tanzania.
2. ACTIVITIES
We have the mandate to serve people with disabilities all over Tanzania mainland and Zanzibar, until now we have managed to execute the following activities:
a) Tourism Activity
This is huge activity as we had done on small scale earlier this year but we have planned to do it bigger next year May, 2022 and we welcome all other tourists from all over the world. We initiated a campaign call “TOUR WITH A PERSON WITH DISABILITY AND STAY SAFE BY GETTING VACCINATED”.
We have great support from the Government and other stakeholders and we also invite persons with and without disabilities from all over the world to come join us and enjoy the beautiful view of Tanzania.
b) Creating Partnership with ADRA Tanzania in Supporting People with Albinism with Hats and sun skin Lotions
This activity is set out to cover large number of people with albinism as we also plan to equip them with soft and hard skills which will help them in earning their income.
c) Media Tour
On 03rd December, 2021 the disabilities day as a Foundation for Disabilities we used this day to create awareness about the needs and challenges of persons with disabilities through various TV and radio stations.
d) Agriculture Activity
Since FDH is planning to reach as many marginalized people as possible, the organization launched a farm project which will help people with disabilities to have an alternative way of earning through agriculture, as for now we already have a land, maize and sunflower seeds to start with.
e) Wheelchair Provision to Beneficiaries
3. CHALLENGES
With all the achievements depicted above the organization faces some challenges in which some of these are organizational, some departmental and some are personal. The following are challenges in which organization is devoted to solve for smooth operations:
Shortage of fund
The organization faces shortage of fund and because of that all employees are working on volunteering basis. But we appreciate the efforts made from our partner as we keep on assisting those in needs.
News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings
News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings
