Covid lockdown increased infant deaths - report

A midwife attends to an expectant woman. The researchers said in absolute terms, total cases of birth asphyxia increased from 29 per 1,000 births in 2019 to 32 per 1,000 births in 2020 because of difficulty in accessing antenatal care during the lockdown and increased home births. PHOTO | FILE

What you need to know:

  • The researchers said in absolute terms, total cases of birth asphyxia increased from 29 per 1,000 births in 2019 to 32 per 1,000 births in 2020 because of difficulty in accessing antenatal care during the lockdown and increased home births because of the same. Uganda registers an average of 1.2 million births per year.

The 2020 Covid-19 lockdown increased cases of birth asphyxia, the failure to establish breathing at birth, by an average of 3,600 because of difficulty in accessing healthcare, a number higher than the 265 Covid-19 deaths registered in that year.

This information is contained in the report from the Uganda National Institute of Public Health (Uniph), an agency established by the government in 2013 for a coordinated response to public health threats and emergencies.

Birth asphyxia accounts for 47 percent (15,228) of the average of 32,400 newborn deaths registered annually in the country, according to the researchers. 

The complication also leaves 80 percent of survivors with life-long disabilities such as palsy, intellectual disabilities and behavioural problems, the researchers said.

The researchers said in absolute terms, total cases of birth asphyxia increased from 29 per 1,000 births in 2019 to 32 per 1,000 births in 2020 because of difficulty in accessing antenatal care during the lockdown and increased home births because of the same. Uganda registers an average of 1.2 million births per year.

Dr Allan Komakech, the lead researcher, told Daily Monitor yesterday that they analysed the national health data for 2017 to 2020 to arrive at the conclusion. 

A total of 134,801 birth asphyxia cases and 4.6 million total deliveries occurred in the period.

Dr Komakech said the risk factors for birth asphyxia include pregnancy hypertension, young maternal age, prolonged labour, premature birth and poor resuscitation efforts at the hospital, among others.

“About half of the neonatal deaths were due to birth asphyxia. It can be caused by issues with the mother or complications of the baby. If the baby survives [through resuscitation], 80 percent have brain issues. The lack of oxygen supply to the brain has long-term effects on their mental capacity,” he said.

Dr Richard Mughai, the assistant commissioner for reproductive and child health, said any delay in to access care, especially for a woman who is experiencing difficulty in delivering, can result in birth asphyxia.

“Asphyxia means the child is born with breathing difficulties. It is the number one cause of death among newborns. But we have increased interventions to curb the deaths,” he said.

The average national incidence of birth asphyxia in the four years was 29 per 1,000 total deliveries, according to the Uniph report.

 “The highest annual incidence (32 birth asphyxia cases per 1,000 deliveries) over the four years was recorded in 2020 despite the decline in reporting rates from 73 percent to 46 percent in the same period, 2017-2020,” the report reads.

The researchers added: “The spike is likely due to delayed access to mothers to health facilities following the imposition of the Covid-19 lockdown travel restrictions.”

The Unip researchers didn’t analyse the effects of the 2021 lockdown on infant health. 

Dr Komakech said they also observed a significant increase in incidence rates of birth asphyxia in northern and eastern regions, signalling serious challenges in access to services.

The report indicates that northern region had a 7 percent increment in birth asphyxia incidence while the eastern region had a 5 percent increment during 2017-2020.

The central region registered the highest mean annual incidence rate of 30 birth asphyxia cases per 1,000 total deliveries, partly because most births happen there and complicated cases are handled at facilities in the area.

Dr Mugahi said they have increased access to oxygen which is essential in saving the lives of babies who experience asphyxia, and trained health workers to handle the cases.