Liberia: COVID-19 Could Trigger Acute Malnutrition Increase, Says UNICEF

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Monrovia – A Liberia country report by the United Nations Children’s Fund(UNICEF) anticipates that the ongoing deadly Covid-19 pandemic would lead to increased cases of acute malnutrition in vulnerable households especially through the pathway of worsened household food security due to closure of markets, reduced agricultural production as well as deterioration in care and feeding practices.

In order to ensure preparedness for anticipated increases in the number of children with Severe Acute Malnutrition (SAM), UNICEF says it is essential that nutrition supplies to be pre-positioned in all 15 counties across Liberia.

The Fund recently provided supplies including 4,815 cartons of Ready to Use Therapeutic foods and 20 cartons of therapeutic milk, it says are critical for the care of children with SAM a condition which if left untreated increases the odds of death among children by up to 10 times.

Supporting Neonatal Care

Furthermore, UNICEF, in support of neonatal care and enable obstetric clinicians to save new-borns whose lives are at stake, has provided the Redemption Hospital in Monrovia with a resuscitation platform.

In total, the FUND says, 1,618 health care providers were trained on detection, referral and appropriate management of COVID-19 cases among children, pregnant and breastfeeding women.

In collaboration with the World Bank and Last Mile Health organization, 518 community workers were trained. “Training modules and terms of reference for Community Health Assistants have been updated to include information on essential health services related to COVID -19. These trainings targeted the five southeast counties (Sinoe, Grand Gedeh, River Gee, Grand Kru, and Maryland), the report noted.

In support of essential health services for maternal neonatal and child health care, 16 health care providers were trained and conducted a rapid assessment of health facilities in the

two most affected COVID 19 counties. In total, according to the report,  27 helath facilities were assessed and the outcome will inform better programming. Essential supplies mainly Integrated Management of Childhood Illness related supplies, such as oral rehydration salt, zinc, amoxicillin and paracetamol for community health activities were distributed to the County Health Teams in the five south east counties (Grand Gedeh, River Gee, Marlyland, Grand Kru and Sinoe) to ensure continuum of care for children and pregnant women under COVID-19 emergency.

Liberia, on April 10, 2020, declared a 60-day state of emergency, putting in place a set of measures to curb the spread of COVID-19, including a curfew, prohibiting movements between counties, banning of public gatherings and suspension of passenger flights. All schools were ordered closed affecting the education of around 1.4 million school children.

Through cooperation with the Ministry of Education, 992,768 children (486,456 girls, 506,312 boys) from pre-school age up to the age of 17 have benefited from the radio-based lessons aired during the reporting period.

Within the framework of the agreement with the World Bank and the Ministry of Health, UNICEF airlifted 14 metric tonnes of vital health supplies to Liberia including oxygen concentrators, pharmaceutical supplies and personal protection equipment.

As of mid-June 2020, UNICEF Liberia has received US$ 1.17 million against its COIVD-19 appeal and reprogrammed 2.14 million to the response. Currently, the office has a funding gap of 81.5 per cent against its appeal of US$ 18 million. Adequate and timely funding is urgently required to continue to provide life- saving support and reach all vulnerable children in the country.

Situation Overview & Humanitarian Needs

The population of Liberia is estimated at 4.9 million, and over half of these live below the poverty line (HIES 2016), distributed in rural 71.6 per cent and urban 31.5 per cent. In 2018, 71.2 per cent of Liberians experienced multi-dimensional poverty affecting 51 per cent of the population, who are younger than 19 and 16 per cent being under five.

Liberia reported its first confirmed case of COVID-19 on 16 March 2020 in Monrovia, the country’s capital. As of 15 June 2020, the country had recorded 5091(174 females, 335 males) confirmed cases of COVID-19 including 51 children under 18 and 50 health workers. A total of 223 cases have recovered and 33 deaths have been reported with a case fatality rate of 6.5 per cent. Montserrado County remains the epicentre with 85 per cent of the confirmed cases. Liberia has started the testing of dead bodies in the communities of which 12 have tested positive for COVID-19.

Local transmission from contacting confirmed cases has accounted for approximately 98 per cent of the cases. Following the declaration of a state of emergency starting on 10 April 2020, a set of measures to curb the spread of the virus have been put in place including a curfew, prohibiting movements between counties, adoption of two critical practices – personal hygiene and social/physical distancing, banning of public gatherings and suspension of passenger flights. All schools were ordered closed affecting the education of around 1.4 million school children.

The limited availability of health services, which has affected the right to health of the population also affects the most vulnerable and marginalized people in society particularly, pregnant women, youth, infants, persons with disabilities, and people with underlying health conditions. Containing the COVID-19 pandemic requires a well-coordinated multisectoral response including a system of care, beyond the health care measures. As such, the Government of Liberia has requested the United Nations to assist in the implementation of the country’s COVID-19 national response plan.

Emergency (EIE) working group and further provided technical and financial support to the finalization of the Education Emergency response plan.

Supporting Delivery of Essential Needs

The COVID-19 response and preparedness has been decentralized to the county level. Out of the country’s 15 counties, nine of them are in response mode, one in the 28- day countdown mode and five in preparedness mode. The World Health Organisation’s (WHO) planning and response scenario model is being used by all 15 counties to prepare their COVID-19 preparedness and response plans while heightening surveillance for COVID-19 related illnesses as part of the county’s priority diseases.

UNICEF has developed a partnership with the Inter-Religious Council of Liberia (IRCL) to utilize its extensive experience and religious strength to mobilize and carry “Faith-Based Action to Combat COVID-19 including raising awareness of 600,000 people in eight counties.

UNICEF, the World Bank and the Ministry of Health signed a trilateral agreement through which UNICEF will support the delivery of essential emergency supplies to the Ministry of Health within the framework of the World Bank-financed COVID-19 Emergency Response Project.

UNICEF focuses on ensuring that affected populations have access to life saving information to enhance their knowledge and skills and foster the adaptation of positive behaviors (handwashing, social distancing and wearing of masks etc).UNICEF has supported the production and printing of more than 50,000 copies of culturally appropriate an Information, Educational and Communications materials and messages (posters, flyers, etc.)

More than 1.16 million people including school-age children were reached with awareness messages on prevention of the COVID-19 and means of protection. UNICEF utilized different platforms to reach the target audience mainly through the community radio stations.

Risk-Perception Survey

In the highly affected counties of Montserrado and Margibi, UNICEF supported a risk perceptions survey to assess the perceptions and myths surrounding immunization and COVID-19. The findings from the survey are being used to inform the revision of immunization messages within the current COVID-19 context and promote immunization service uptake.

Through UNICEF’s support to the Ministry of Youth and Sports, trained youth and adolescent peer educators have engaged with 183 children and adolescents (149 girls, 34 boys) to raise their awareness on how to prevent and protect themselves against the COVID-19. Further 23 adolescents (14 girls and 9 boys) and 64 adults (40 women and 24 men) received awareness raising sessions.

In collaboration with UNFPA, training for case management and Infection Prevention Control was provided to 20 health care workers (14 midwives, two psychologists and four monitors) at the maternity wing of the Martha Tubman Hospital. This training strengthened the capacity of frontline health workers who manage the new maternity wing at the military hospital treatment unit to ensure quality care for COVID 19 infected pregnant women and children. In total three pregnant women and 23 children infected with COVID 19 were admitted and later two woman and 11 children have recovered and discharged.

Strategic priority 2: Continuity of health, education and social services; assessing and responding to the immediate secondary impacts of the COVID-19 response.

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