The COVID-19 response in developing countries has become the primary focus for health workers all over the developing world. The volume of COVID-19 patients is placing a strain on hospitals and health systems globally. This trend is especially notable in developing countries that already have limited health resources, medical supplies and medical staff.

Other major global health focuses such as other infectious diseases, diarrheal diseases, cholera, Ebola and so many more are not getting the same level of attention. Basic health services such as maternal care, family planning and vaccination programs are being impacted. Health workers are being reassigned to COVID-19 patients and resources are redistributed to prioritize the pandemic. While lessons can be drawn from previous health crises such as the 2014 Ebola outbreak in West Africa, COVID-19 has spread on a global scale and will have a large impact on essential health services.

Immunization Programs

According to GAVI, the Vaccine Alliance, vaccine shortages due to border closures and limited air travel have been reported in at least 21 low- and middle-income countries. Additionally, 14 vaccination campaigns supported by GAVI have been delayed. These programs would have vaccinated 13.5 million people for diseases including polio, measles, cholera, HPV, yellow fever and meningitis. GAVI expects these numbers to increase as more programs are delayed. Outreach vaccination programs, where health workers travel to various communities with vaccines, and routine immunization programs are also negatively affected. Lockdowns and distancing efforts, as well as hygiene guidelines, are contributing to program delays. GAVI is planning to support large immunization programs as soon as the COVID-19 safety measures are no longer in place in order to address these disparities.

PATH Solutions

PATH proposes three steps to ensure the continuation of essential health services during the pandemic. The first action item is to appoint an “Essential Health Services Coordinator” per COVID-19 task force. This coordinator would make sure that COVID-19 distancing guidelines are not preventing individuals from accessing basic services. They would also identify any health service interruption from health management data and collaborate with directors and social groups to act based on community concerns. Second, PATH proposes that COVID-19 public updates should include information about essential health services. This is crucial so that people are aware of what services are available and do not stop requesting medical help for non-COVID-19 related issues. Finally, international agencies such as WHO, UNICEF and Africa CDC should supply developing countries with strategies for the most pressing issues such as protecting health workers, how to provide medical care for the most vulnerable in the population and how to maintain basic health services during the pandemic.

WHO Guidelines for Maintaining Essential Health Services

The World Health Organization has outlined important ways of maintaining essential health services during COVID-19 in developing countries. These guidelines include access to emergency health care 24/7, removing financial barriers that limit access to patients, identifying which services are essential and which can be delayed and taking advantage of telemedicine and digital methods of providing health care. Additionally, the WHO highlights the importance of identifying which individuals are most vulnerable in society, such as marginalized groups and ensuring these individuals have access to health care. The WHO has also outlined several essential health categories to specifically address during the COVID-19 pandemic. These include ethics, health financing, mental health, non-communicable diseases, nutrition and food safety, older people, tuberculosis and sexual and reproductive health and rights. The COVID-19 response in developing countries must ensure the continuation of essential health services.

– Maia Cullen
Photo: PATH