The World Health Organization (WHO) published a first indicative survey on the impact of coronavirus on health systems based on 105 countries’ reports. Data collected from five regions from March to June 2020 shows that 90% experienced disruption to its health services, with low-and middle-income countries reporting the greatest difficulties.
The purpose of the survey was to gain insights and perspectives on both the impact of the COVID-19 pandemic on up to 25 essential health services in countries and how countries are adapting strategies to maintain essential services.
According to the report most countries reported that many routine and elective services have been suspended, while critical care – such as cancer screening and treatment and HIV therapy – has seen high-risk interruptions in low-income countries.
Services hit across the board
The survey ‘Rapid assessment of continuity of essential health services during the COVID-19 pandemic’ shows that based on reports from key informants, countries on average experienced disruptions in 50% of a set of 25 tracer services.
The most frequently disrupted areas reported included routine immunization – outreach services, 70% and facility-based services, 61%, non-communicable diseases diagnosis and treatment, 69%, family planning and contraception, 68%, treatment for mental health disorders, 61%, cancer diagnosis and treatment, 55%.
Countries also reported disruptions in malaria diagnosis and treatment, 46%, tuberculosis case detection and treatment, 42% and antiretroviral treatment, 32%.
Potentially life-saving emergency services were disrupted
Disruptions to 24-hour emergency room services for example were affected in 22% of countries, urgent blood transfusions were disrupted in 23% of countries, emergency surgery was affected in 19% of the countries.
Disruption due to a mix of supply and demand side factors
76% of countries reported reductions in outpatient care attendance due to lower demand and other factors such as lockdowns and financial difficulties.
The most commonly reported factor on the supply side was cancellation of elective services. Other factors reported by countries included staff redeployment to provide COVID-19 relief, unavailability of services due to closings, and interruptions in the supply of medical equipment and health products.
Adapting service delivery strategies
According to the report, many countries have started to implement some of the WHO recommended strategies to mitigate service disruptions, such as triaging to identify priorities, shifting to on-line patient consultations, changes to prescribing practices and supply chain and public health information strategies
The survey also provides an indication of countries’ experiences in adapting strategies to mitigate the impact on service provision. Despite the limitations of such a survey, it highlights the need to improve real-time monitoring of changes in service delivery and utilization as the outbreak is likely to wax and wane over the next months, and to adapt solutions accordingly.