Challenges posed by the COVID-19 pandemic in the health of women, children, and adolescents in Latin America and the Caribbean

The COVID-19 pandemic has unexpectedly transformed the access and the organization of health services for an indeterminate time, circumventing the efforts made in recent years to improve women, children, and adolescent health indicators in Latin America and the Caribbean.

Arachu Castro, the Samuel Z. Stone Chair of Public Health in Latin America at Tulane University, has authored a report that exposes the need to restore essential health services as soon as possible, to strengthen the primary health care strategy, and to increase public spending on health beyond immediate spending to face the pandemic. The countries that, before the pandemic, had prioritized investment in public health and in strengthening primary care are those that have not suspended care and those that are best prepared to prevent more deaths from causes other than COVID-19.

This report presents estimates of the effects of the reduction of health services coverage on achieving or maintaining the 2030 Agenda for Sustainable Development’s Goal 3 targets – reducing maternal, neonatal, and under-5 mortality and guaranteeing universal access to sexual and reproductive health services.

"Although the entire population is at risk of acquiring the coronavirus, its transmission does not occur equitably: it always disproportionally affects people underserved by public services," said Dr. Castro. "Limiting or closing public health services is causing excess deaths, particularly among those already disadvantaged. Responses to the pandemic that avoid the most excluded population’s needs will cause greater suffering and greater inequity."

In most countries, the segmentation of health services, the concentration of human resources and medical technology in some urban hospitals, the under-financing of primary health care and epidemiological surveillance, and the lack of coordination between the different levels of care weaken the coordination of national response actions. Maintaining essential health services for women, children, and adolescents while mitigating the pandemic’s impact represents an unprecedented challenge.

The pandemic and its response make it challenging to reach or sustain these targets, even though the region was well on track to achieve them. Urgent priorities oriented towards achieving women, children, and adolescent health equity during and after the pandemic require to 1) increase public spending on health and social policies to control the pandemic and to favor social and economic reactivation and reconstruction, 2) restore and rebuild essential health services, and 3) strengthen the primary health care strategy.