The COVID-19 pandemic is straining health systems worldwide. The
rapidly increasing demand on health facilities and health care workers
threatens to leave some health systems overstretched and unable to
Previous outbreaks have demonstrated that when health
systems are overwhelmed, mortality from vaccine-preventable and other
treatable conditions can also increase dramatically. During the
2014-2015 Ebola outbreak, the increased number of deaths caused
by measles, malaria, HIV/AIDS, and tuberculosis attributable to
health system failures exceeded deaths from Ebola
“The best defense against any outbreak is a
strong health system,” stressed WHO Director-General Tedros Adhanom Ghebreyesus.
“COVID-19 is revealing how fragile many of the world’s health systems and
services are, forcing countries to make difficult choices on how to best meet
the needs of their people.”
To help countries navigate through these challenges, the World Health Organization (WHO) has updated operational planning guidelines
in balancing the demands of responding directly to COVID-19 while
maintaining essential health service delivery, and mitigating
the risk of system collapse. This includes a set of targeted
immediate actions that countries should consider at national, regional,
and local level to reorganize and maintain access to high-quality
essential health services for all.
Countries should identify essential services that will be
prioritized in their efforts to maintain continuity of service delivery
and make strategic shifts to ensure that increasingly limited resources
provide maximum benefit for the population. They
also need to comply with the highest standard in precautions,
especially in hygiene practices, and the provision of adequate supplies
including personal protective equipment This requires robust planning
and coordinated actions between governments
and health facilities and their managers.
Some examples of essential services include: routine
vaccination; reproductive health services including care during
pregnancy and childbirth; care of young infants and older adults;
management of mental health conditions as well as noncommunicable
and infectious diseases like HIV, malaria and TB; critical inpatient
therapies; management of emergency health conditions; auxiliary
services like basic diagnostic imaging, laboratory services, and blood
bank services, among others.
Well-organized and prepared health systems can continue to provide equitable access to essential service delivery throughout an emergency, limiting direct mortality and avoiding increased indirect mortality.
The guidelines stress the importance of keeping up-to-date information. This requires frequent transparent communications with the public, and strong community engagements so the public can maintain trust in the system to safely meet their essential needs and to control infection risk in health facilities. This will help ensure that people continue to seek care when appropriate, and adhere to public health advice.
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2. Parpia, A. S., Ndeffo-Mbah, M. L., Wenzel, N. S., & Galvani, A. P. (2016). Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerging infectious diseases, 22(3), 433.