EHS-COVID (52) Q1: How has COVID-19 affected the delivery of essential health services in your health facility or country?

16 November, 2020

Dear HIFA colleagues,

I have been reviewing the WHO Guidance: Maintaining essential health services: operational guidance for the COVID-19 context interim guidance (June 2020) in relation to the first question of our discussion (Q1. How has COVID-19 affected the delivery of essential health services in your health facility or country?)

The Guidance says relatively little about the impact of COVID-19 on health services (the focus is understandably on how to maintain services, and the document is now some months old). It does however start with an overview that highlights general concerns:

'Health systems around the world are being challenged by increasing demand for care of people with COVID-19, compounded by fear, stigma, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. When health systems are overwhelmed and people fail to access needed care, both direct mortality from an outbreak and indirect mortality from preventable and treatable conditions increase dramatically. Maintaining population trust in the capacity of the health system to safely meet essential needs and to control infection risk in health facilities is key to ensuring appropriate care-seeking behaviour and adherence to public health advice...

'As demands on systems have surged and health workers themselves have increasingly been affected by COVID-19 infection and the indirect consequences of the pandemic, strategic adaptations have become urgent to ensure that limited public and private sector resources provide the maximum benefit for populations.

'Countries are making difficult decisions to balance the demands of responding directly to the COVID-19 pandemic with the need to maintain the delivery of other essential health services. Establishing safe and effective patient flow (including screening for COVID-19, triage and targeted referral) remains critical at all levels. Many routine and elective services have been suspended, and existing delivery approaches are being adapted to the evolving pandemic context as the risk–benefit analysis for any given activity changes...'

We need a fuller, more detailed understanding of the impact of COVID-19 in different countries and on different aspects of health care. It is important also to hear testimony from HIFA members working in individual hospitals and healthcare facilities, and in public health positions. There is much that can be learned by cross country sharing of experience.

Please share your experience and observations to:

With thanks, Neil

Coordinator, WHO-HIFA Collaboration: HIFA project on Essential Health Services and COVID-19

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: