Maintain essential health services during COVID-19, says WHO

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The World Health Organization (WHO) on Thursday urged member countries in the South-East Asian region to maintain essential health services and accelerate resumption of disrupted health care services hit by the coronavirus pandemic, as an integral part of the COVID-19 response.

A rapid assessment of 25 essential services carried out by WHO in May showed significant disruptions to essential health services across the world, including WHO South-East Asia Region. Routine immunisation and supplementary measles and rubella campaigns were disrupted in eight of the region's 11 countries.

According to the apex organisation, both out-patient and in-patient services for non-communicable diseases such as diabetes, high blood pressure, heart disease, cancer and others have been greatly affected. The most affected service has been mental health, which is critical in these difficult times.

"Across the region, family planning, antenatal care and institutional childbirth services have been reduced significantly, impacting our capacity to accelerate reductions in maternal and neonatal mortality," said Dr Poonam Khetrapal Singh, Regional Director WHO South-East Asia Region said.

Health system pressures, reduced service utilisation, damaged supply chains and the potential for reductions in health spending could inhibit progress towards universal health coverage and weaken the battle against antimicrobial resistance (AMR). If case detection for TB drops by 50 per cent over a period of three months, the region could return to 2012 levels.

"The pandemic has put immense strain on health systems across the South-East Asia Region. We must fasttrack efforts and do all we can to avoid that happening, while continuing efforts to break COVID-19 transmission chains," said Dr Singh, in a virtual meeting with health ministers from the region.

She said that previous disease outbreaks have shown that disruption to essential services caused by an outbreak can be more deadly than the outbreak itself.

Since the outbreak of COVID-19, repurposing of health workers, cancellation of elective care, closure of outpatient services, insufficient personal protective equipment, and changes in treatment policy have significantly impacted delivery of essential services. Additionally, changes in health-seeking behaviour, constrained physical access and financial hardship have also limited service uptake.

Countries in the region have been developing and implementing innovative ways to overcome these challenges - leveraging the potential of telemedicine; developing novel supply chains and medicine dispensary options; and better engaging the private sector and communities.

"We must strengthen our evidence and knowledge base on how essential services can be maintained. We must continue to innovate and accelerate our efforts to sustain our gains while sharing our experiences and learnings and adapting policies to suit local contexts and transmission scenarios," Dr Singh said.

Boosting health system resilience with a focus on primary health care is key to maintaining and strengthening essential health services amid our new normal, the Regional Director said, adding that the emergence and spread of COVID-19 has reiterated the critical importance of building strong primary health care systems that are able to withstand acute events while continuing to provide the services required to meet most people's needs.

Communities must continue to remain at the centre of the response, she said. Attention should be given to understanding the social impact of the pandemic and how it affects the health-seeking behaviour of disadvantaged and vulnerable groups and their access to services.

"Strengthening and maintaining essential health services has been one of the region's core priorities. The health and well-being of the region's near 2 billion people is at stake, and with it the sustainable development of more than a quarter of the world's population," Dr Singh added.

The Regional Director and health ministers are expected to review and further discuss essential health services at their virtual ministerial roundtable meeting next month during the seventy-third Regional Committee Session of WHO South-East Asia Region.

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