COVID-19疫情威胁全球儿童生命健康，可逆转数十年防控进展

联合国儿童基金会、世界卫生组织等国际机构联合警告，COVID-19疫情引发的卫生服务中断正在威胁全球防治可预防儿童死亡的长期成果1。2019年全球五岁以下儿童死亡数为520万例，创历史新低，相比1990年的1250万例实现大幅下降1。然而这一来之不易的进展正面临严峻挑战。

根据联合国儿童基金会对77个国家的调查，68%的国家报告儿童健康检查和免疫服务至少存在部分中断，63%的国家报告产前检查服务中断，59%的国家报告产后护理服务中断1。世界卫生组织基于105个国家的问卷反馈发现，52%的国家报告患病儿童卫生服务中断，51%的国家报告营养不良管理服务中断1。这些服务的中断带来严重后果。约翰斯·霍普金斯大学5月的初步建模显示，由于疫情导致的服务中断，每天可能有近6000名儿童额外死亡1。

专业医护服务的重要性在此次危机中更加凸显。获得经过国际标准培训的专业助产士护理的妇女，其流产风险低16%，早产风险低24%1。统计数据表明，2019年新生儿每13秒死亡一例，47%的五岁以下死亡发生在新生儿期，相比1990年的40%有所增加1。卫生系统薄弱的国家风险最大，包括阿富汗、玻利维亚、喀麦隆、中非共和国、利比亚、马达加斯加、巴基斯坦、苏丹和也门等在内的多个国家受影响最为严重1。

United Nations agencies have raised alarm that the COVID-19 pandemic risks reversing hard-won gains in child survival. The disruption of maternal and child health services caused by the crisis threatens progress achieved over three decades in preventing child deaths, according to warnings from UNICEF, the World Health Organization, and other organizations 1.

In 2019, the global number of deaths among children under five reached a historic low of 5.2 million, a dramatic decline from 12.5 million in 1990 1. However, the pandemic-induced service interruptions could trigger a stark reversal. According to preliminary modeling by Johns Hopkins University in May, the disruption to health services caused by COVID-19 may result in nearly 6,000 additional child deaths daily 1. The impact threatens to be most severe in countries with already fragile health systems 1.

A UNICEF survey covering 77 countries during the summer found widespread service disruptions: 68 percent of countries reported at least partial interruptions in child health checks and immunization services, 63 percent reported disruptions in prenatal care, and 59 percent reported disruptions in postnatal care 1. Complementary data from WHO, based on responses from 105 countries, showed that 52 percent reported interruptions in health services for sick children, while 51 percent reported disruptions in malnutrition management services 1. The data underscores the pandemic's reach across multiple dimensions of child health care.

The vulnerability of newborns is particularly acute. In 2019, a newborn died every 13 seconds globally, with newborn deaths accounting for 47 percent of all deaths in children under five—an increase from 40 percent in 1990 1. Countries including Afghanistan, Bolivia, Cameroon, the Central African Republic, Libya, Madagascar, Pakistan, Sudan, and Yemen face the heaviest burden 1. Research has demonstrated that access to professionally trained midwifery care reduces maternal miscarriage risk by 16 percent and premature birth risk by 24 percent 1, making the current service gaps particularly consequential.