The second round of a World Health Organization (WHO) “pulse survey” reveals that over one year into the COVID-19 pandemic, substantial disruptions persist, with about 90% of countries still reporting one or more disruptions to essential healthcare services, marking no substantial global change since the first survey conducted in the summer of 2020.
Within countries, however, the magnitude and extent of disruptions has generally decreased. In 2020, countries reported that, on average, about half of essential healthcare services were disrupted. In the first 3 months of 2021, they reported progress, with just over one third of services now being disrupted.
More than half the countries consulted in the survey say they have recruited additional staff to boost the health workforce; redirected patients to other care facilities; and switched to alternative methods to delivering care, such as providing more home-based services, multi-month prescriptions for treatments, and increasing the use of telemedicine.
Although they may have taken on new staff, 66% of countries continue to report health workforce-related reasons as the most common causes of service disruptions. Supply chains are also still disrupted in nearly one third of countries, affecting the availability of essential medicines, diagnostics, and the PPE needed to safely and effectively provide care.
Meanwhile, 43% of countries cite financial challenges as major causes for disruptions in service utilization.
Potentially life-saving emergency, critical and surgical care interventions are still disrupted in about 20% of countries, reflecting the most immediate indirect consequences of the pandemic. Two thirds of countries also report disruptions in elective surgeries, with accumulating consequences as the pandemic is prolonged.
Among the most extensively affected health services (i.e., those for which more than 40% of countries are reporting disruptions) are those for mental, neurological and substance use disorders; neglected tropical diseases; tuberculosis; HIV and hepatitis B and C; cancer screening, and services for other noncommunicable diseases including hypertension and diabetes; family planning and contraception; urgent dental care; and malnutrition.
