United Nations Children’s Fund (UNICEF) and the World Health Organization, 2020
Children who suffer from wasting and/or bilateral pitting oedema are up to 12 times more likely to die from common illnesses than children who are not wasted. As the COVID-19 pandemic affects many countries with fragile health systems and countries affected by a humanitarian crisis or severe food insecurity, wasted children should be prioritized as a vulnerable group.
To reduce the number of children becoming wasted, all levels of health services must deliver coordinated actions that reduce infection, improve maternal nutrition and birthweight, ensure appropriate breastfeeding and complementary feeding and care practices in the first two years of life, and facilitate the early detection of child wasting. In doing so, every effort should be made to reduce exposure to COVID-19 for children, caregivers and health workers, while ensuring continuity of these critical prevention and treatment services throughout all stages of the response. This will require efforts to adapt nutrition services based on the phase of the pandemic, to ensure the safety of routine services and minimize exposure and the risk of infection. In contexts where health systems experience partial or full closures or where there is a high level of community transmission, temporary adaptations may be required to ensure that children receive the support they need. Preventing the disruption of essential nutrition services remains key to limiting the burden of morbidity and mortality from this preventable and treatable condition.
SCOPE AND PURPOSE
This document serves as a tool for implementing the recommendations reflected in existing WHO and UNICEF guidance on the delivery of services through national health systems for the prevention, early detection and treatment of child wasting in the context of COVID-19. This note reflects broad guidance for all levels of the health system, including community health services that offer prevention, early detection and treatment services for child wasting. WHO and UNICEF recognize that context-specific adaptations to these recommendations will be necessary depending on transmission levels, population mobility restrictions, resources, and other national public health measures to respond to and mitigate the effects of the pandemic across different countries. This note therefore offers specific examples of programmatic changes or adaptations that may be temporarily introduced to ensure the continuity and safety of prevention and treatment services. Child wasting is significantly impacted by household food insecurity, and for many food insecure populations, food-assistance programmes are critical to prevention efforts; however, such services and their delivery in the context of COVID-19 are addressed in other guidance notes.