As we continue to explore this question, and how countries define and implement measures of essentiality during COVID (and at other times), here is a potentially useful recent paper in BMJ Global Health:
CITATION: Practice: Protecting essential health services in low-income and middle-income countries and humanitarian settings while responding to the COVID-19 pandemic
Karl Blanchet et al. BMJ Global Health. https://gh.bmj.com/content/5/10/e003675 October 2020
The authors say: 'While each country will need to define essential services according to their epidemiological profile, health system capacity and available resources, we believe that guidance on the type of essential services required by low-income and lower-middle-income countries is a valuable contribution to inform urgent decision making during health crises... We present a list of 120 essential non-COVID-19 health interventions that were adapted from the model health benefit packages developed by the Disease Control Priorities project.'
- A concrete list of 120 essential non-COVID-19 health interventions has been developed based on the Disease Control Priorities-3 highest priority package (HPP).
- Adjustments of HPP was made based on level of urgency of interventions and contextual factors.
- The adjusted HPP could be used by governments and donors as input for discussions about disinvestments and continued investments during the COVID-19 pandemic.
- We argue that the selected interventions are the most essential to deliver and protect, even if substantial resources need to be diverted to the COVID-19 response.
- Each country will need to define essential services according to their epidemiological profile, health system capacity and available resources
- The priority list of 120 essential services is mainly designed for low-income and middle-income countries and humanitarian settings.
- We propose that governments and agencies that are in the process of defining which essential services should be protected under the COVID-19 crisis use our model list as input for further deliberation with key stakeholders, citizens, funders, local and national decision-makers.
- Governments in low-income and middle-income countries and relief agencies need to make clear decisions to not only mitigate the impact of the COVID-19 pandemic but also deliver essential routine services to their populations. This is a clear message from WHO in their operational guidance for maintaining essential health services during an outbreak.
What approaches have been taken in your country (or healthcare facility) to identify 'essential services'? Which services have been identified as 'non-essential'?
Best wishes, Neil
Coordinator, WHO-HIFA Collaboration: HIFA project on Essential Health Services and COVID-19
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