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World Health Organization (who) published today a first indicative survey on the impact of COVID-19 on health systems based on reports from 105 countries. Data collected from five regions during the period from March to June 2020 illustrate that almost all countries (90%) experienced interruptions in their health services, with low- and middle-income countries reporting the greatest difficulties. Most countries reported that many routine and elective services have been discontinued, while critical care, such as cancer screening and treatment and HIV therapy, has experienced high-risk interruptions in low-income countries.
“The survey sheds light on the gaps in our healthcare systems, but it also serves to inform new strategies to improve healthcare delivery during the pandemic and beyond,” said Dr. Tedros Adhanom Ghebreyesus. who Managing Director. “COVID-19 It should be a lesson to all countries that health is not an “one or the other” equation. We must better prepare for emergencies, but also continue to invest in health systems that fully respond to the needs of people throughout their lives. “
Services impacted in all areas: According to key informant reports, countries experienced, on average, interruptions in 50% of a set of 25 follow-up services. The areas most frequently reported included routine immunization: outreach services (70%) and facility-based services (61%), diagnosis and treatment of noncommunicable diseases (69%), family planning and contraception (68%), treatment for mental illness. health disorders (61%), cancer diagnosis and treatment (55%).
Countries also reported interruptions 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 accordance with government protocols, the disruption of many of the other services is expected to have deleterious effects on the health of the population through. Short, medium and long term. -finished.
Life-saving emergency services were disrupted in nearly a quarter of the responding countries. For example, 24-hour emergency room service interruptions were affected in 22% of countries, urgent blood transfusions were interrupted in 23% of countries, and emergency surgery was affected in 19% of the countries.
Disruption due to a combination of supply and demand side factors. 76% of the countries reported reductions in outpatient care due to lower demand and other factors such as lockdowns and financial difficulties. The most commonly reported factor on the supply side was the cancellation of elective services (66%). Other factors reported by countries included redeployment of staff to provide COVID-19 relief, unavailability of services due to closures and interruptions in the supply of medical equipment and sanitary products.
Adapt service delivery strategies. Many countries have started to implement some of the who Recommended strategies to mitigate service interruptions, such as ranking to identify priorities, the shift to online patient visits, changes in prescribing practices, and public health information and supply chain strategies. However, only 14% of countries reported the elimination of user fees, which who recommends compensating for possible financial difficulties for patients.
The pulse survey also provides an indication of countries’ experiences in adapting strategies to mitigate impact on service delivery. Despite the limitations of this survey, it highlights the need to improve real-time monitoring of changes in the provision and use of services, since the outbreak is likely to increase and decrease in the coming months, and to adapt solutions in consecuense.
To that end, who will continue to work with countries and provide support tools to address the consequences of COVID-19. Given the urgent demand for assistance from countries during the response to the pandemic, who is developing the COVID19: Health Services Learning Center, a web-based platform that will share experiences and learn from countries’ innovative practices that can inform the collective global response. who It is also designing additional surveys at the subnational level and at health facilities to measure the long-term impact of outages and to help countries weigh the benefits and risks of applying different mitigation strategies.
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