COVID-19 economic downturn caused excess infant deaths

The economic downturn in low and middle income countries caused by COVID-19 is likely to have caused an additional 267,000 infants’ deaths in 2020, according to an analysis published today.

A modelling study, published in BMJ Open, by World Bank economist researchers, reveals this is 7% higher than expected for the year.

The number of people living in poverty is expected to have grown by 120 million, while the global economy is believed to have contracted almost 5% in the first year of the pandemic.

Although previous projections of the likely impact of the pandemic on indirect deaths have focused on the extent of assumed disruptions to essential health services, this study examined the impact of the aggregate “income shock”, represented by the anticipated fall in Gross Domestic Product (GDP) on the survival of children aged up to 12 months in low- and middle-income countries.

They linked data on GDP per head of the population to 5.2 million births, reported in Demographic and Health Surveys between 1985 and 2018, finding 82% of these births were in low- and lower middle-income countries.

They went on to apply International Monetary Fund economic growth projections for 2019 and 2020 to predict the effect of the economic downturn in 2020 on infant deaths in 128 countries.

Their calculations revealed an additional 267, 208 infants in low- and middle-income countries died in 2020, about a 7% increase in the number of infant deaths expected for that year.

The highest numbers were in eight countries in South Asia, where there were thought to be 113,141 additional deaths.

They accept several limitations to their projected figures, including that their calculations drew on retrospective data, but they write: “Regardless of the exact number of projected deaths, the large number of excess infant deaths estimated in our analysis underscores the vulnerability of this age group to negative aggregate income shocks, such as those induced by the COVID-19 pandemic.

“Several mechanisms are likely driving this increase in mortality among children nought to one year of age: impoverishment at the household level will lead to worse nutrition and care practices for infants and reduced ability to access health services, while the economic crisis might also affect the supply and quality of services offered by the health systems.”

Shapira G, de Walque D, Friedman J. How many infants may have died in low-income and middle-income countries in 2020 due to the economic contraction accompanying the COVID-19 pandemic? Mortality projections based on forecasted declines in economic growth. BMJ Open 24 August 2021

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