new operational instructions for the COVID-19 context

The guide describes a set of basic principles and gives some practical recommendations for states. That includes:

• Ensuring timely access to emergency services 24 hours a day, 7 days a week
• Adapt management and coordination mechanisms to support timely action
• Ensuring measures to control and control infection to ensure the safe provision of services.
• Priority priority to essential services – identifying what can be delayed and what cannot; an assessment of what can be moved to areas less affected by COVID-19; identifying the special needs of the marginalized population, including indigenous people, sex workers, migrants and refugees.
• Reassignment of health workers from COVID-19 low or zero transmission areas, or from overcapacity sites, to increase the workforce in severely affected areas to maintain basic services.
• Maintaining the availability of essential medicines, equipment and supplies by mapping lists of basic services by source and weekly reporting from major distribution points, such as hospitals and district stores, on critical products that are at risk of shortage or other problems.
• Remove financial barriers to accessing and financing public health by suspending payments or benefits to users at the point of care for basic health services for all patients, regardless of their insurance or citizenship.
• Disseminate information in local languages ​​to prepare the public for changes in service delivery platforms using data sources trusted by the public and ensuring that these sources are updated on changes in basic service delivery and available resources, such as hotlines.
• Redirecting the delivery of some routine services to digital platforms (telemedicine) and establishing a mechanism for the implementation of electronic prescriptions (e-prescriptions) among public and private pharmacies and suppliers

The guidelines provide concrete advice on how to meet some common health needs. Examples include mechanisms to reduce the number of people visiting health centers through bulk prescriptions of medications and dietary supplements and home delivery from the place of descent.

Other approaches include monitoring and assisting people with pre-existing conditions to ensure they seek care that cannot be safely delayed, such as emergency care for heart attack, sepsis, or pregnancy complications; ancillary services, such as basic diagnostic imaging, laboratory services, and blood bank services.

The instructions provide specific recommendations for adapting the route of administration of the vaccine to reduce the risk of transmission of COVID-19, while preventing the outbreak of other deadly diseases.

It also highlights ways to protect people who are particularly vulnerable to the direct and indirect consequences of a pandemic. They include interventions to protect the elderly from infection and mitigate the effects of social isolation; or alternatives to the provision of school services, such as dietary supplements, and activities to protect children from violence and preserve their health at home when schools are closed. It also offers guidance on improving and strengthening mental health services in a pandemic context.

This new guideline will help decision-makers and managers at the national and sub-national levels to ensure the continuity of basic health services in the context of COVID-19.

These are hitherto unsuccessfully coordinated efforts within the WHO through four departments, 14 departments and dozens of program units at WHO headquarters, all linked to regional counterparts around the world.