NEW DELHI: The coronavirus pandemic may have indirectly contributed to around 228,000 additional child deaths in 2020, 11,000 maternal fatalities and 3.5 million unwanted pregnancies in South Asia, the UN said in a report Wednesday.

The study commissioned by UNICEF blamed "drastic cuts in the availability and use of essential public health services" because of the pandemic across India, Pakistan, Nepal, Bangladesh, Afghanistan and Sri Lanka, home to 1.8 billion people.

"The fall-off of these critical services has had a devastating impact on the health and nutrition of the poorest families," said UNICEF regional director George Laryea-Adjei.

"It is absolutely vital that these services are fully restored for children and mothers who are in desperate need of them, and that everything possible is done to ensure that people feel safe to use them," Laryea-Adjei said.

The estimates were based on actual observed changes and modelling exercises using data from before the pandemic in South Asia, where in 2019 alone 1.4 million children under five died, 63 percent of them newborn babies.

Countries in the region, like elsewhere, imposed stringent lockdown measures to halt the spread of coronavirus. Many restrictions have since been eased although many schools remain shut.

The report said that even where health services were not shut down, the number of people visiting them declined.

In Bangladesh and Nepal, for example, the number of young children being treated for severe acute malnutrition (SAM) fell by over 80 per cent, while child vaccinations fell sharply in India and Pakistan.

With some 420 million children in South Asia out of school due to the pandemic, the report also warned that nine million children were likely never to return to school, the report added.

This in turn is expected to lead to an increase in child marriages, resulting in an additional 400,000 adolescent pregnancies, as well as an increase in the number of maternal and neonatal deaths, and in rates of child stunting.