Since the outbreak of the coronavirus,90% of countries have experienced disruptions in their health services. This is according to a recent survey conducted by the WHO to examine the impact of COVID-19 on health systems. The survey was conducted from March to June in five regions on a sample of 105 countries.
“Data collected from five regions over the period from March to June 2020 illustrate that almost every country (90%) experienced disruption to its health services, with low- and middle-income countries reporting the greatest difficulties”-WHO.
WHO indicated that most countries have suspended routine and elective services, while critical care such as cancer screening and treatment as well as HIV therapy have seen high-risk interruptions in low-income countries.
The Director-General of the WHO, Dr Tedros Adhanom Ghebreyesus indicated that the pandemic has taught the world a lesson on the importance of investing in health systems that prepare them for emergency situations such as the outbreak of the pandemic.
“The survey shines a light on the cracks in our health systems, but it also serves to inform new strategies to improve healthcare provision during the pandemic and beyond.
“COVID-19 should be a lesson to all countries that health is not an ‘either-or’ equation. We must better prepare for emergencies but also keep investing in health systems that fully respond to people’s needs throughout the life course”, said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
Based on reports from key informants, countries on average experienced disruptions in 50% of a set of 25 tracer services. The most frequently disrupted areas reported included routine immunization outreach services (70%) and facility-based services (61%), non-communicable diseases diagnosis and treatment (69%), family planning and contraception (68%), treatment for mental health disorders (61%), cancer diagnosis and treatment (55%).
Furthermore, the survey found that countries also reported disruptions in malaria diagnosis and treatment (46%), tuberculosis case detection and treatment (42%) and antiretroviral treatment (32%).
While some areas of health care, such as dental care and rehabilitation, may have been deliberately suspended in line with government protocols, the disruption of many of the other services is expected to have harmful effects on population health in the short- medium- and long-term.
Potentially life-saving emergency services were disrupted in almost a quarter of responding countries. Disruptions to 24-hour emergency room services for example were affected in 22% of countries, urgent blood transfusions were disrupted in 23% of countries, emergency surgery was affected in 19% of the countries.
There was also disruption due to a mix of supply and demand side factors. For instance, 76% of countries reported reductions in outpatient care attendance due to lower demand and other factors such as lock-downs and financial difficulties. The most commonly reported factor on the supply side was cancellation of elective services (66%). Other factors reported by countries included staff redeployment to provide COVID-19 relief, unavailability of services due to closings, and interruptions in the supply of medical equipment and health products.