Many thanks for joining our virtual session on Maintaining Essential Services at the Primary Care Level during the pandemic on Tuesday, June 16^th.

Attached please find the slides from our session for your reference. We were pleased to learn from the country examples of Kenya and Malaysia as shared by Dr. Agatha Olago and Dr. Nazrila Hairizan bt. Nasir, and be able to reflect further in small groups. We hope the virtual session was just the beginning of that discussion, and we look forward to continuing the conversation via a group discussion on My JLN through next Friday, June 26^th. Please find below an initial message from Dr. Kamaliah to the group. We’ll look forward to your reflections in the discussion.

In addition to continued dialogue, our group space on My JLN is also home to the recording of yesterday’s session.

Welcome to our Online Discussion

As we all experience this once-in-a-lifetime pandemic of this scale, as primary healthcare planners and providers, at the back of our mind we are wary that the traditional public health measures instituted to respond to COVID-19 may have an unintentional effect of reducing access to and utilization of other essential health services which can lead to greater harm in terms of morbidity and mortality.  As a recent modelling study has shown, a 45% reduction in MCH services coverage over a period of 6 months, is estimated to lead to an additional over 1 million under-5 child deaths and more than 55,000 maternal deaths across 118 LMICs[i].

Today we had an exciting webinar on Maintaining Essential Services at the Primary Care Level during the Pandemic where through the sharing of countries, academics, global health institutions and front liners, what came across were that all despite the different contexts, countries have similar barriers and the diversity was in the approaches to overcome these challenges in maintaining essential non-COVID-19 services.  Kenya presented data on the decrease in utilisation of non-COVID essential services, they formed a technical working group at the national level to focus on identifying barriers and devising innovative approaches.  Malaysia shared the opportunities of harnessing technology, business process re-engineering and bringing in the private sector, to overcome the challenges they faced.  What was common was in the importance of communication and ensuring safe utilisation of essential services at primary care level.  Participants posed many good questions about the experiences of Kenya and Malaysia, which we’ll further discuss in this online forum.

The ensuing discussion in the breakout groups identified important questions, such as:

• How to finance additional need for HRH given the existing shortage? Can we look at task shifting, utilising workers from outside the traditional health sector to address capacity and capability of HRH? How do we involve the community health workers to address the disparities in rural areas and across geographical regions?  How do we ensure adequate training and professional competence when rapidly recruiting a cadre of health workers?
• How do we address the professional tension PHC providers face in responding to all in need while at the same time putting themselves at personal risk for COVID? How can we protect our providers when PPE are so limited? How do we provide mental health support for healthcare workers?
• How do we leverage technology to support digitasation/telehealth, self-care, access to drugs to increase access to PHC?
• How can we prepare to integrate COVID-19 services e.g. vaccine, into existing primary care activities?

Over the next two weeks we will be addressing many of these questions and important topics.  We invite you to keep the discussion going here.  What additional questions, reflections, and resources would you like to share? 

[i] Roberton T, Carter ED, Chou VB, et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet Glob Health 2020; published online May 12. https://doi.org/10.1016/ S2214-109X(20)30229-1.

Best,

Emma

Emma Stewart

Senior Program Officer, Results for Development

1111 19th St. NW Suite 700, Washington, DC 20036

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