Maternal Nutrition and Health

in the context of the COVID-19

pandemic

Dr Willibald Zeck

Global Maternal & Newborn Health Thematic

Fund (MHTF) Coordinator

Sexual and Reproductive Health Branch,

Technical Division, UNFPA

UNFPA is committed to achieving three transformative results by 2030:

• Zero preventable maternal deaths

• Zero unmet need for family planning

• Zero gender-based violence and harmful practices

Adolescents are critical to achieving all three results

Our principle: SRHR - integrated Mother & Newborn Health programming along the continuum of care

Key Concepts – comprehensive life course approach to SRHR

Detecting, preventing and

managing reproductive

cancers

Comprehensive sexuality

education

Prevention and treatment of

HIV/STIs

Counselling and services for infertility

Safe abortion services and treatment of unsafe abortion

Counselling and services for

modern contraceptives

Detecting and preventing sexual and

gender-based violence

Antenatal, childbirth

and postnatal

care

Counselling and services

for sexual health and wellbeing

▪ Nutrition is closely

linked to aspects of

maternal & sexual and

reproductive health

▪ Food, nutrition, health,

and socio-economic

outcomes are

intimately inter-linked,

esp. during the

COVID–19 response

5

• Direct and indirect effects of the COVID-19 pandemic →increase of mortality rates likely

• Most severe scenario (Lancet 2020): 56 700 additional maternal deaths over 6 months across 118 countries

• Increase in wasting prevalence: additional child deaths • Reduced coverage of antibiotics for pneumonia and

neonatal sepsis and of oral rehydration solution for diarrhoea: additional child deaths

Expected increase of mortality rates due to the COVID 19 pandemic (The Lancet 2020)

Roberton et al. Lancet 2020

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• Socio-economic impacts influence nutrition practices and services for women

• Negative consequences for mothers’ nutrition, health and immunity and their newborns

• Women are vulnerable during period of pregnancy and breastfeeding

• In food - insecure households → gender and social inequalities

• 31 million additional cases of GBV can be expected to occur if lockdowns continue for at least 6 months (UNFPA 2020)

Maternal nutrition and the COVID - 19 pandemic

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• Limited access to nutritious foods and increase food prices• Includes fortified foods, rich in micronutrients

• Fear of COVID - 19 infection may also prevent women from seeking nutrition services and health care

• Limited essential nutrition services for women• Overstretched healthcare and food/ nutrition systems and

mobility restrictions• Social exclusion, limited decision-making power• Mental health and GBV concerns

Specific risks for mothers and their newborns during the

COVID 19 pandemic

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• Intake of micronutrients for pregnant and lactating women • Iron and calcium deficiencies contribute substantially to maternal

deaths• Maternal iron deficiency is associated low weight babies

• Fetal growth restriction is associated with maternal short stature

• Micronutrients can e.g. reduce stillbirth rates substantially • COVID - 19 increases the risk of adverse pregnancy outcomes during

a time when routine antenatal and postnatal services (and dissemination of micronutrients) may be disrupted

Micronutrient supplementation during COVID - 19 pandemic

Smith et al Lancet Global Health 2017 and Lancet 2020

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• Service delivery for women should be guided by local adaptations of international recommendations

• Essential nutrition commodities should be available for women for service delivery

• Food systems should protect the diets of women

• Social protection programmesshould be expanded to cover the needs of women

6 recommendations for programming in the context of

COVID-19

WFP – UNICEF – Global Nutrition Cluster - GTAM 2020

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• Communications strategies focusing on healthy eating and food hygiene among women

• Nutrition information management, surveillance and monitoring should include indicators for women

6 recommendations for programming in the context of

COVID-19

WFP – UNICEF – Global Nutrition Cluster - GTAM 2020

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• Increasing exclusive breastfeeding to near-universal levels could save more than 800 000 lives/year

• Exclusive breastfeeding continues to be recommended during the COVID-19 pandemic

• Maternal overweight and obesity are associated with maternal morbidity, preterm birth, and increased infant mortality

Breastfeeding and COVID-19

WFP – UNICEF – Global Nutrition Cluster - GTAM 2020

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• Onset of the pandemic: no difference between the clinical manifestations of COVID -19 pregnant and non-pregnant women

• BMJ August 2020 : Meta-analysis 77 studies • Conclusion: Pregnant and recently pregnant women are less

likely to manifest COVID-19 related symptoms of fever and myalgia than non-pregnant women of reproductive age, but potentially more likely to require intensive care treatment or ventilation for COVID-19

Maternal Health and COVID-19

Allotey et al. BMJ 2020

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• Health and social systems across the globe are struggling to cope• Situation is especially challenging in humanitarian fragile

and low-income country contexts• 47 million women in 114 countries may not be able to

access modern contraceptives • 7 million unintended pregnancies are expected to occur if

lockdowns carry on for 6 months• Shortages of vital supplies for sexual and reproductive

health and maternal and newborn health

Maternal Health, SRHR and COVID-19

UNFPA 2020

Supporting HCWs/ midwives is key to maternal and newborn survival

-19

Nutrition counseling and services

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• HCWs/ Midwives are at the front line of the

COVID-19 outbreak response

• They are exposed to hazards that put them at

risk of infection.

• They need to be supported and be able to be a

“Safe Pair of Hands” in the communities they

serve

• Important to consider wellbeing and emotional

resilience

All women and girls must have access to a

continuum of health services, including

antenatal, perinatal and postnatal care,

according to national guidelines and standards.

Supporting HCWs/ midwives is key to maternal and newborn survival

https://www.unfpa.org/resources/sexual-and-

reproductive-health-and-rights-maternal-and-

newborn-health-covid-19-0

UNFPA resources

THANK YOU