Background: COVID-19 pandemic has caused serious interruption to essential maternal and child health services in Ethiopia. However, mortality impact of the interruptions in these health services has not been well examined. This study aimed to estimate the indirect impact of the COVID-19 pandemic on maternal and child mortality in Ethiopia.

Methods: We used the Lives Saved Tool (LiST) to estimate the impact of COVID-19. By varying the coverage of essential Maternal and Child Health (MCH) services from the baseline, we build four scenarios that represent possible service interruptions possibilities. Scenario-1, Scenario-2, and scenario-3 represent average reduction of coverage of MCH services by 25%, 35%, 50% respectively for a year. We also modelled increase in wasting prevalence by 15%, 25%, and 50% respectively for the corresponding scenarios. Scenario-4 represents coverage decrement by 35% and increase in wasting prevalence by 25% for half a year. The Ethiopian Demographic and Health Survey 2016 (EDHS 2016), the Ethiopia Mini Demographic and Health Survey 2019 (EMDHS 2019), and additional multivariate analysis were used to estimate the baseline coverage.

Results: Based on scenario-1, additional 10,252 child deaths, 379 maternal deaths, and 1,673 stillbirths would occur per year. Based on scenario-2, over a year, additional 26,307 child deaths, 2,197 maternal deaths and 7,876 stillbirths would occur.  Based on scenario-3, additional 41,945 under-5 deaths, 4,038 maternal deaths, and 13,294 stillbirths would result in a year. Wasting was the most predominant factor contributing about 16% to 30% of the additional under-5 deaths.

Conclusion: A significant number of additional maternal and child deaths would occur in Ethiopia if the essential maternal and child health service interruption persists, as seen in the first few months of the pandemic. This is more than the mortality so far caused by the pandemic itself.

Keywords: COVID-19, Coverage, Essential Health services, Ethiopia. Lives saved tool Maternal and Child Health, Wasting