Enabling Delivery of Essential Health Services during the COVID 19 Outbreak: Guidance note

The COVID 19 outbreak has placed unprecedented demands on our health system, Our health facilities and workforce are currently inundated by a plethora of activities related to controlling the pandemic. In doing so, there is a risk that essential health services which communities expect from the health system, would be compromised. It is likely that health seeking may be deferred because of social/physical distancing requirements or community reluctance owing to perceptions that health facilities may be infected. Focusing on COVID 19 related activities, and continuing to provide essential services, is important not only to maintain people’s trust in the health system to deliver essential health services but also to minimize an increase in morbidity and mortality from other health conditions. Analyses from the 2014-2015 Ebola outbreak suggests that the increased number of deaths caused by measles, malaria, HIV/AIDS and tuberculosis attributable to health system failures exceeded deaths from Ebola. Particular attention needs to be paid to the delivery of essential health care for specific population sub-groups, while ensuring the safety of health workers. Essential services for all areas include maternal, new born and child health, prevention and management of communicable diseases, treatment for chronic diseases to avoid complications, and addressing emergencies. Non-Covid services such as health promotion activities, IEC campaigns, meetings of the Village Health Sanitation and Nutrition Committees/Mahila Arogya Samitis, community based screening for chronic conditions, other screening programmes, etc. could be deferred and undertaken after lockdown/restrictions are lifted. These services could be considered as desirable.