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.
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 health care. strengthen primary health care, and advance universal health coverage.
“It is encouraging to see that countries are beginning to build back their essential health services, but much remains to be done,” says Dr Tedros Adhanom Ghebreyesus, Director General, WHO. It will be especially important to monitor the situation in countries that were struggling to provide health services before the pandemic.“
Persisting causes of disruptions
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. 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.
Two thirds of countries also report disruptions in elective surgeries, with accumulating consequences as the pandemic is prolonged. Those for which more than 40% of countries are reporting disruptions) are those for mental, neurological and substance use disorders;
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.
WHO has pledged to continue supporting countries so they can respond to increased strains on health systems and rapidly evolving priorities and needs throughout the course of the pandemic, and to ensure that COVID-19 control strategies are in balance strategies to tackle other health priorities and secure continued access to comprehensive care for everyone, including the most vulnerable.
Internally, through the “Boost initiative” and the UHC Partnership, which covers 115 countries, WHO has strengthened its capacity to provide additional support to countries so they can maintain essential health services during the pandemic, and advance progress towards universal health coverage.