EHS-COVID (272) WHO press relase: COVID-19 continues to disrupt essential health services in 90% of countries

24 April, 2021

Dear HIFA colleagues (with thanks to Shams Syed, WHO)

Below are extracts from a WHO press release published yesterday, and comments from me. Read in full: https://www.who.int/news/item/23-04-2021-covid-19-continues-to-disrupt-e...

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WHO press release: COVID-19 continues to disrupt essential health services in 90% of countries

Some signs of recovery emerging but major efforts required to restore and strengthen health services

23 April 2021 News release Geneva

The second round of a World Health Organization “pulse survey“ reveals that over one year into the COVID-19 pandemic, substantial disruptions persist, with about 90% of countries still reporting one or more disruptions to essential health services, marking no substantial global change since the first survey conducted in the summer of 2020.

Within countries, however, the magnitude and extent of disruptions has generally decreased. In 2020, countries reported that, on average, about half of essential health services were disrupted. In the first 3 months of 2021, however, they reported progress, with just over one third of services now being disrupted...

Long-term care for chronic conditions, rehabilitation, and palliative end-of-life care, is also still badly disrupted - severely affecting older people and people living with disabilities.

Potentially life-saving emergency, critical and surgical care interventions are still disrupted in about 20% of countries, reflecting the most immediate indirect consequences of the pandemic. Two thirds of countries also report disruptions in elective surgeries, with accumulating consequences as the pandemic is prolonged.

Among the most extensively affected health services (i.e. those for which more than 40% of countries are reporting disruptions) are those for mental, neurological and substance use disorders; neglected tropical diseases; tuberculosis; HIV and hepatitis B and C; cancer screening, and services for other noncommunicable diseases including hypertension and diabetes; family planning and contraception; urgent dental care; and malnutrition...

This survey looks at 63 core health services across delivery platforms and health areas. It was sent to 216 countries and territories across the six WHO regions. 135 responses were received (63% response rate) from senior ministry of health officials predominantly between January and March 2021. The responses referred to the situation in the country during the 3 months prior to survey submission (in this case predominantly covering periods between October 2020-February 2021).

The purpose of the survey was to gain insights and perspectives on the impact of the COVID-19 pandemic on essential health services and how countries are adapting strategies to maintain essential services.

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Comments (NPW):

1. The full report is available here: https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS-continuity-sur... I note with interest that the vast majority of African countries participated, whereas many other regions were underrepresented (for example, it seems that India, Nigeria and the USA did not respond). This raises the broader questions: Why are some countries more responsive to (some) global surveys than others? What might be done to encourage/facilitate greater response to such surveys in the future?

2. The report appears to be a global overview and appears not to include detail on national/in-country experience or comparisons.

3. HIFA's current project with WHO - Maintaining essential health services during COVID-19 (and beyond) - is hugely important to provide detail on national/in-country experience. What is the situation right now with regards to COVID and essential health services in your country? What approaches have you found to be useful (or not useful) to maintain health services?

4. The EHS-COVID working group met yesterday on Zoom and we are preparing a new 2nd Thematic Discussion to start here on HIFA on 10th April. This will build on our 1st Thematic Discussion at the end of last year. Details to follow soon. https://www.hifa.org/projects/essential-health-services-and-covid-19

Neil Pakenham-Walsh, HIFA Coordinator, neil@hifa.org www.hifa.org