The second round of a World Health Organization (WHO) “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, reported WHO.
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.
Countries have been working to mitigate disruptions. Many have now stepped up communications efforts to inform the public about changes to service delivery and provide advice about ways to safely seek healthcare. They are also triaging to identify and better meet the most urgent patient needs. More than half the countries consulted say they have recruited additional staff to boost the health workforce; redirected patients to other care facilities; and switched to alternative methods to delivering care, such as providing more home-based services, multi-month prescriptions for treatments, and increasing the use of telemedicine.
In addition, WHO and its partners have been helping countries to adapt their processes so they can better respond to the challenges being placed on their health systems; strengthen primary health care, and advance universal health coverage.
Countries are still having to make important decisions when responding to COVID-19 that may negatively affect access to care for other health issues. Redeployment of staff to provide COVID-19 relief and temporary closures of health facilities and services continue. Although they may have taken on new staff, 66% of countries continue to report health workforce-related reasons as the most common causes of service disruptions. Supply chains are also still disrupted in nearly one third of countries, affecting the availability of essential medicines, diagnostics, and the PPE needed to safely and effectively provide care.
Communications efforts need to be further scaled up: more than half of countries report service disruptions due to patients not seeking care and because of community mistrust and fears of becoming infected.
Meanwhile, 43% of countries cite financial challenges as major causes for disruptions in service utilization. As a result, millions of people are still missing out on vital health care. In terms of services, the biggest impact reported by nearly half of countries is on provision of day-to-day primary care to prevent and manage some of the most common health problems. 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.
More than one third of countries are still reporting disruptions to immunization services, despite progress in countries reducing disruptions to immunization services in health facilities and “outreach” immunization services by about 20% and 30% respectively compared to 2020. This highlights the need for new and sustained approaches to improving immunization coverage and uptake.
Meanwhile, nearly 40% of countries are also reporting disruptions to one or more malaria services. While progress compared to 2020 – with about 10% fewer countries reporting disruptions to malaria diagnosis and treatment and 25-33% fewer countries reporting disruptions to malaria prevention campaigns (including distribution of long-lasting insecticide impregnated bed nets, indoor spraying and seasonal malaria chemoprevention), the reported level of disruption is still significant and needs to be urgently addressed.
More COVID-19 coverage HERE.
