The World Health Organisation (WHO), yesterday, published a first indicative survey on the impact of coronavirus disease (COVID-19) on health systems based on reports on 105 countries.
Data collected from five regions from March to June 2020 illustrate that almost every country (90 per cent) experienced disruption to its health services, with low-income and middle-income countries reporting the greatest difficulties.
According to the survey, most countries reported that many routine and elective services have been suspended, while critical care – such as cancer screening and treatment, and Human Immuno-deficiency Virus (HIV) therapy – has seen high-risk interruptions in low-income countries.
WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, said: “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.”
According to the WHO survey, based on reports from key informants, countries on average experienced disruptions in 50 per cent of a set of 25 tracer services. The most frequently disrupted areas reported included routine immunisation – outreach services (70 per cent) and facility-based services (61 per cent), non-communicable diseases diagnosis and treatment (69 per cent), family planning and contraception (68 per cent), treatment for mental health disorders (61 per cent), cancer diagnosis and treatment (55 per cent).
Countries also reported disruptions in malaria diagnosis and treatment (46 per cent), tuberculosis case detection and treatment (42 per cent) and antiretroviral treatment (32 per cent). While some areas, 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.
According to the WHO survey, 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 per cent of countries, urgent blood transfusions were disrupted in 23 per cent of countries, emergency surgery was affected in 19 per cent of the countries.
The survey showed that disruption was due to a mix of supply and demand side factors. It was revealed that 76 per cent of countries reported reductions in outpatient care attendance due to lower demand and other factors such as lockdowns and financial difficulties. The most commonly reported factor on the supply side was cancellation of elective services (66 per cent). 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.
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