Lessons for responding to COVID-19, from Exemplars in Under-five Mortality Reduction: [version 1;peer review: 3 approved with reservations]

ABSTRACT

COVID-19 may not have the same direct effects on children as it does on older adults, but its indirect effects still pose a threat to child health, by disrupting delivery of routine health services like immunizations. This has happened during previous crises, and early indications point towards similar disruptions due to the coronavirus pandemic. To mitigate this, countries need to build resilient health systems capable of maintaining essential maternal and child health interventions, while also responding to COVID. How can this be accomplished? To find some answers, we can learn from countries in the past who improved health outcomes in the face of challenging circumstances. Specific to child health, countries with positive-outlier performance in reducing under-five mortality provide helpful strategies. These lessons include a clear national plan that drives rapid response, leveraging existing data systems to inform decision-making, engaging communities via community health workers, and focusing on equity. Today, countries around the world are facing the challenge of responding to the pandemic while building resilient health systems that continue to deliver invaluable maternal and child health services. Studying lessons from previous success stories can help inform the road ahead.