Pulse survey on continuity of essential health services during the COVID-19 pandemic: Interim report

The report states that a country with a pre-existing essential health services plan was more likely to have identified a core set of services to be continued during the pandemic. About 80 per cent of the 105 respondent countries had a predefined health services plan before the Covid-19 outbreak, and 66 per cent outlined core services during the pandemic.

Only 55 per cent of the respondent countries allocated additional government funding to ensure access to essential health services during the Covid-19 pandemic.

Essential health services in the Eastern Mediterranean region were most severely affected during the Covid-19 pandemic, followed by Africa and South-East Asia.

As high as 75-100 per cent of essential health services were reported to be disrupted in 28 respondent countries. About 50-74 per cent of services were disrupted in 27 countries, 25-49 per cent in 20 countries and less than 25 per cent in 19 countries. Only 11 countries reported no disruptions.

The report defines ‘partial disruption’ as a 5-50 per cent decline in the use of a healthcare service, and a decline of above 50 per cent is termed as a ‘severe-complete disruption.’ In 30 per cent of the countries, all services related to reproductive, maternal, newborn, child and adolescent health, were at least partially disrupted. About 19 per cent of countries reported no interruptions in such services.

Nearly 62 per cent of the respondent countries reported no disruptions in access to emergency services, such as blood transfusions or surgeries, during the Covid-19 pandemic. On the other hand, emergency services were at least partially disrupted in 15 per cent of the countries.

About 18 per cent of the respondent countries reported disruptions in all services relating to communicable diseases (such as HIV, tuberculosis and malaria). Access to services related to non-communicable diseases – cardiovascular diseases, chronic respiratory conditions, diabetes, cancer and others – were hampered in more than half of the countries, with five per cent of countries reporting severe-complete disruptions.

The report states that access to services relating to mental health disorders were disrupted in 61 per cent of the respondent countries, with three per cent of these countries reporting severe-complete disruptions.

As high as 76 per cent of countries reported a decrease in the number of outpatients – those seeking treatment at a hospital without staying overnight. At the same time, 66 per cent of countries recorded a drop in the number of inpatients – those staying at a hospital for one or more nights – due to the cancellation of ‘elective care.’

About 49 per cent of the countries reported health service disruptions due to the redeployment of clinical staff for Covid-19 duties, and 44 per cent reported a decline in services due to insufficient personal protective equipment for healthcare providers.

Over 75 per cent of the countries reported formulating plans to identify healthcare priorities to overcome obstacles in service delivery during the pandemic. About 63 per cent of the countries reported a shift towards telemedicine to replace in-person consultations, and 53 per cent held community outreach programmes to disseminate crucial health service information on changes during Covid-19.

Focus and factoids by Jerry Jose.

PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.