COVID-19 caused substantial disruptions to essential health services in most countries

The COVID-19 pandemic caused substantial disruptions in essential health services in 9 out of 10 countries surveyed by WHO.

In the newly released report by the world health body, conducted to assess impacts on 25 essential health services, it found out that "many routine and elective services have been suspended [in most countries], while critical care — such as cancer screening and treatment and HIV therapy — has seen high-risk interruptions in low-income countries".

Major disruptions were noted in routine immunization (70 per cent for outreach and 61 per cent for facility-based services), family planning (68 per cent), antenatal care (56 per cent), [treatment of] mental health disorders (61 per cent), cancer diagnosis and treatment (55 per cent), antiretroviral therapy services for HIV (32 per cent), malaria diagnosis and treatment (46 per cent) and TB detection and treatment (42 per cent). Services such as 24-hour emergency, urgent blood transfusions and emergency surgery were disrupted in 22 per cent, 23 per cent, and 19 per cent of the countries, respectively.

"Reductions in outpatient care attendance owing to lower demand were reported by 76 per cent of countries, with other factors such as lockdown (48 per cent) and financial difficulties (33 per cent) also mentioned. The most commonly reported factor on the supply side was cancellation of elective services (66 per cent)," the report suggested.

Sushmita Roy Chowdhury, consultant pulmonologist at the Apollo Gleneagles Hospitals, Kolkata, India, tells SciDev.Net that non-COVID-19 work took a significant hit in the past six months due to numerous factors such as disruption of normal outpatient clinics, fear of contracting infection, increasing number of COVID-19 patients, and prolonged lockdowns affecting transport services.

The WHO survey findings are really worrisome and show very serious disruption of routine [and] essential health services in most countries."

Madhukar Pai, Canada Research Chair in Translational Epidemiology and Global Health Director, McGill International TB Centre, McGill University, Montreal, Canada

The fact that low- and middle-income countries were more affected is not surprising, he explains, since many low- and middle-income countries already had fragile health systems before the pandemic. "I fear that many [low- and middle-income countries] will be even more dependent on international aid [now], but high-income countries might cut back on aid because of the recession," Pai tells SciDev.Net.

WHO noted that various countries are taking up measures to combat the situation. The initiatives include triaging to find out priorities, using telemedicine services for online patient consultations, advocating adjustments with respect to medicine supply and dispensing and adopting community outreach measures to provide public health information.

"To overcome this problem, general awareness of sanitisation, universal mask use and social distancing should be continued," Roy Chowdhury adds. She suggests that COVID-19 services should be separated from non-COVID-19 services in hospitals and healthcare centres and anxiety amongst patients should be allayed as far as possible.

Oyewale Tomori, renowned virologist and former vice chancellor of Redeemers University, Osun State, Nigeria, tells SciDev.Net, "COVID-19 is an invasive and pervasive disease that has taken over the already poor healthcare delivery system in many [low-income and middle-income] countries.

"We need to better educate our citizens [regarding] the safety of [hospital or healthcare facilities'] environment, and we also need to establish better outreach of delivering healthcare services through minimisation of hospital visits."

According to the WHO, the survey reveals that "even robust health systems can be rapidly overwhelmed and compromised by a COVID-19 outbreak, reinforcing the need for sustained data collection and strategic adaptations to ensure maintenance of essential care provision".