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SHORT COMMUNICATION
Year : 2020  |  Volume : 11  |  Issue : 1  |  Page : 44-45

Sustaining the delivery of essential services among the ongoing coronavirus disease 2019 pandemic


1 Member of the Medical Education Unit and Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission27-Mar-2020
Date of Acceptance10-Jun-2020
Date of Web Publication23-Dec-2020

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpaet District - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjmsr.mjmsr_13_20

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  Abstract 


The Corona Virus Disease-2019 (COVID-19) pandemic has produced a massive impact on the health care delivery system and on the daily routine of the general population. Owing to the massive load on the health sector due to the ongoing outbreak, most of the health systems have been stretched beyond their capacity and capability. This is not a good sign considering the fact that if the health system is exhausted, obviously the incidence of vaccine-preventable diseases and other treatable conditions will show a significant rise. In conclusion, amidst the ongoing battle against the COVID-19 pandemic, it is a must that the delivery of essential health services in the community is also sustained. Even though, it is a difficult ask from the health authorities, proper planning and awareness can definitely help us in the delivery of an accelerated response to COVID-19 and also not jeopardize the delivery of essential services.

Keywords: COVID-19 pandemic, Essential services, World Health Organization


How to cite this article:
Shrivastava SR, Shrivastava PS. Sustaining the delivery of essential services among the ongoing coronavirus disease 2019 pandemic. Muller J Med Sci Res 2020;11:44-5

How to cite this URL:
Shrivastava SR, Shrivastava PS. Sustaining the delivery of essential services among the ongoing coronavirus disease 2019 pandemic. Muller J Med Sci Res [serial online] 2020 [cited 2021 Apr 12];11:44-5. Available from: https://www.mjmsr.net/text.asp?2020/11/1/44/304585




  Introduction Top


The CoronaVirus Disease-2019 (COVID-19) pandemic has produced a massive impact on the healthcare delivery system and on the daily routine of the general population, owing to its novel nature, and the immense potential to get transmitted from one person to another.[1] The facts suggest that across the world, a total of 462684 cases has been reported, of which the European region (25,0287 cases) alone accounted for 54% of the cases.[2] The estimates pertaining to the daily incidence of the disease are extremely alarming in nations such as the United States of America (11,656 cases), Spain (7937 cases), Italy (5210), Germany (4954 cases), France (2895 cases), and Iran (2206 cases).[2] Moreover, the infection has resulted in the death of 20834 people, and the number continues to rise with each day. These estimates are indeed alarming and require an unprecedented response from the public health authorities immediately.[1],[2]

Impact on health system

Owing to the massive load on the health sector due to the ongoing outbreak, most of the health systems have been stretched beyond their capacity and capability.[3] This is not a good sign because if the health system is exhausted, obviously the incidence of vaccine-preventable diseases and other treatable conditions will show a significant rise. In fact, even in the earlier outbreak of Ebola Virus Disease in 2014, a simultaneous rise in the incidence of measles, malaria, and other infectious disease and the associate mortality was reported due to the shortcomings of the health system.[3],[4] This is something which the public health authorities should foresee and prevent at all cost, and it can be averted only by ensuring delivery of essential health services even in these difficult times.[3]

Delivery of essential services

In the current scenario, the delivery of essential services will be determined by the existing capacity of the health system, disease caseload, and the nature of disease transmission (namely, no case, sporadic, imported, or local or community-based cases).[3]

In general, the task of delivery of essential services is difficult in low- and middle-income nations or those nations which have a weak health system or nations which are already experiencing humanitarian emergencies such as civil conflicts. It is a big challenge for the health authorities to respond to the needs of COVID-19 and also sustain uninterrupted delivery of essential health care.[1],[3]

Potential solutions

In fact, the health system collapse can be averted by suspending or postponing elective services and designing a mechanism to streamline patient flow without exposing the normal individuals to the suspect cases of COVID-19 through the implementation of basic infection prevention measures (such as hand hygiene, the use of personal protective equipment, respiratory hygiene, disinfection of contaminated services, and triage in waiting areas).[3],[5] A protocol can be developed to guide the health sector for the delivery of essential health services and the strengthening of the referral mechanism. These essential healthcare services should be always tailor-made to an individual nation (and further to local settings) based on the local burden of the problem.[3],[5]

Further, each nation should come out with a list of problems (such as vaccine-preventable diseases and communicable diseases) for which essential health care needs to be delivered and also a list of routine services which can be delayed for the time being. This should be followed by designing a roadmap to further reduce the delivery of essential services in a phase-wise manner to divert the resources toward the containment of COVID-19.[3] It is important to accept that the essential services cannot be delivered in a similar fashion like before COVID-19 outbreak, and thus some forms of reforms in the delivery of services are inevitable (such as home-based polio immunization cannot be done). Delivery of these essential services can happen only once all the existing health facilities are mapped and only some of them are earmarked to deliver them, owing to the shortage of workforce in each center.[3]

Apart from all this, the crucial factor will be the availability of the health workforce, and thus, it is really essential to sort out the challenges of maldistribution or lack of alignment between the needs of people and the competency level of the available health professionals.[3] In these difficult times, the health workforce can be increased by requesting part-time workers to work for a longer duration or asking retired doctors to join services or even employing doctors in the private sector. At the same time, if the caseload increases suddenly or the health care personnel acquire the infection, the program officers should make strategic shifts to ensure that members of the health team are available 24 × 7.[3] Furthermore, the steps should be taken to identify the requirement of resources and liaise with the suppliers well in advance so that the logistics are available all the time.[5] However, the successful delivery of these essential services can be accomplished only when there is transparency in the communication with the public, and steps are taken to actively engage them in the routine delivery of essential services.[1],[5]


  Conclusion Top


In conclusion, among the ongoing battle against the COVID-19 pandemic, it is a must that the delivery of essential health services in the community is also sustained. Even though it is a difficult task from the health authorities, proper planning and awareness can definitely help us in the delivery of an accelerated response to COVID-19 and also not jeopardize the delivery of essential services.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ward MP, Li X, Tian K. Novel coronavirus 2019, an emerging public health emergency. Transbound Emerg Dis 2020;67:469-70.  Back to cited text no. 1
    
2.
World Health Organization. Coronavirus Disease 2019 (COVID-19) Situation Report – 66. World Health Organization; 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200326-sitrep-66-covid-19.pdf?sfvrsn=81b94e61_2. [Last accessed on 2020 Mar 27].  Back to cited text no. 2
    
3.
World Health Organization. COVID-19: Operational Guidance for Maintaining Essential Health Services During an Outbreak – Interim Guidance. Geneva: WHO Press; 2020. p. 1-10.  Back to cited text no. 3
    
4.
Shrivastava SR, Shrivastava PS, Jegadeesh R. Legacy of Ebola outbreak: Potential risk of measles outbreak in Guinea, Sierra Leone and Liberia. J Res Med Sci 2015;20:529-30.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
World Health Organization. 2019 Novel Coronavirus (2019-nCoV): Strategic Preparedness and Response Plan. Geneva: WHO Press; 2020. p. 1-3.  Back to cited text no. 5
    




 

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