Author: Lamin njie & Lolly Boye
Topic: Suspension of non-essential service and observance of physical distancing during Reproductive and Child Health (RCH) Services.
RCH is a package which entails different service components offered to children under five (5) and women of child bearing age. These free services are rendered in order to reduce infant and child morbidity and mortality and maternal mortality in the Gambia. Considering the current situation of Covid-19 pandemic, it is necessary to reduce non-essential components and reorient strategies used during delivery of RCH service to prevent the spread of covid-19. Weighing, immunization, antenatal care and family planning are all services rendered during RCH.
From amongst the services offered, weighing is considered non-essential. In essence, it does not nullify the importance of this particular service; instate use it as a strategy to stop the transmission of covid-19. Viewing the nature at which this service is offered, it is apparent that a positive covid-19 patient can transmit the disease to others considering the factors involve.
- Overcrowding is a necessary factor for the spread of covid-19: notably it is unavoidable during weighing for women not to crowd due to limited space at RCH sites. Women, children and antenatal mothers crowd during normal hours at service receiving points. Many at times, women express their social values of hugging and touching each other during chatting. These are obvious factors that will increase the spread of covid-19 if not avoided.
- The use of single weighing scale: weighing during RCH is conducted by using single scale throughout the season. Women exchange this scale for every child to be weighed, and this can lead to cross-infection if one child is infected with a contagious disease. This also prolong the contact hour between service provider and the caregiver to the child due to the use of single scale and the crowd in question.
Immunization is another component of the services offered during RCH; this is an essential service that is offered routinely to children under five (5) and pregnant women to prevent them from those, vaccine preventable diseases. Despite that covid-19 have less than one (1) as a reproductive number, some of the vaccines preventable diseases have less reproductive numbers than covid-19 which means they can spread faster than covid-19. The likes of measles, whooping cough, and Tuberculosis from amongst the list are all capable of striking at a higher rate with high case fatality if immunization is not strengthened. In strategizing immunizations activities, the WHO guideline are necessary to be instituted in order to break down the chain of transmission of covid-19.
- Screening at the Health Centre gate: this is one of the strategies to be used to identify those caregivers whose children are to be immunized for that particular season, and are allowed entry while passing through the handwashing station and temperature checking. And those whose vaccination date are not due will be given their next appointment date with regards to their due date for vaccination. This will in turn reduce the number of people coming into the facility, and reduce contact hours of the caregivers and the service providers.
- During immunization, the service provider also makes sure that physical distancing is been put unto consideration. In this regard, caregivers are attended to as they come in without accumulating them for mass immunization, and the rest on the queue are strategically position in accordant with the WHO guides for physical distancing. Where necessary, the caregivers to the child should where noise mask and the service provider should also be on full personal protective equipment.