A new framework for performance analysis
Here is a list of technical resources developed by WHO in collaboration with many partners on the issue of health systems and COVID19. While in no way exhaustive, the list include the most relevant technical documents recently developed by the WHO, many of them produced in collaboration with other partners.
We particularly want to highlight the recently completed WHO guidance put out under Pillar 9 of the SPRP on Maintaining Essential Health Services and Systems. It covers key programmatic actions as well as detailed clinical adjustments to be made service area by service area and represents weeks of work by over 25 departments and over 220 technical staff here in HQ and across all WHO regions. The guidance is here. We also want to highlight the various documents prepared jointly with UHC2030 over the past four months, involving different agencies and the UHC2030 civil society engagement mechanism, with a focus on strengthening health systems for health security.
Horizontal cross-cutting health system implications
UHC2030 discussion paper with key messages linking health system needs (delivery, financing, governance) to the COVID19 responses.
Frontline health workers – linkage to Pillar 6 on Infection Prevention and Control
- Collected work on health workers including rights and responsibilities, IPC, Rational use of PPE
- Q&A on protecting health workers
- Guidance on protecting health workers and delivering services safely when health workers need to head out into the community to do treatment or outreach
- Psychosocial skills for first line responders for COVID (relevant here and for other pillars)
- Guidance on advice on the use of masks in communities, during home care, and in health care settings in areas that have reported cases of COVID-19
This links both Pillar 7 on Case Management and Pillar 9 on Essential Health Services and Systems
- Flagship (and recently updated) clinical management for COVID patients
- Use of chest imaging in acute care of COVID patients
- Polio services in COVID
- Immunization services in the context of COVID
- Maintaining safe blood supply during COVID
- Operational considerations for case management of COVID (should be used in the EHSS guidance above)
- Q&A for Tuberculosis and COVID
This links to Pillar 7 on Case Management and especially Pillar 9 (Operational support and logistics).
- Tool for disease commodities for operations and supplies
- Guidance on oxygen sources and distribution for COVID-19 treatment
- Technical specifications for invasive and non-invasive ventilators for COVID
The purposes driving this area are to: (a) increase resource adequacy to access COVID-19 products, fund Common Goods for Health at country and global level and strengthen core public health functions; and (b) facilitate the inclusion and prioritization of preparedness and maintenance of essential health services in public finance allocations. Key elements of the Health-Finance budget dialogue are to support needed actions in Public Financial Management, such as budget formulation and execution, ensuring funds reach frontline service providers who in turn have the authority to manage and the responsibility to account, and to remove financial barriers to access essential services, including COVID-19 vaccines and diagnostics. In relation to this, WHO, the World Bank the IMF and others have already produced relevant guidance and analysis, including for example:
- Re-tooling PFM in the COVID19 era
- Guidance on how to budget for a COVID-19 response
- Expanding budgetary space for health in the wake of COVID-19
- Preparing government financial management systems ready for COVID-19
- Financing Common Goods for Health
Essential Health Services
- Maintaining essential health services: operational guidance for the COVID-19 context interim guidance,
- Related publications
- Preventing and managing COVID-19 across long-term care services: Web annex
- Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report, 27 August 2020
- Considerations for the provision of essential oral health services in the context of COVID-19
- Considerations for implementing mass treatment, active case‐finding and population-based surveys for neglected tropical diseases in the context of the COVID-19 pandemic
- Preventing and managing COVID-19 across long-term care services: Policy brief, 24 July 2020
- Maintaining a safe and adequate blood supply during the pandemic outbreak of coronavirus disease (COVID-19)
- Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic
Harmonized suite of health service capacity assessment modules in the context of the COVID-19 pandemic
Under development, below documents have already been published:
- Rapid hospital readiness checklist: Interim Guidance
- Biomedical equipment for COVID-19 case management - inventory tool: Interim guidance
Guidance on how governments can more effectively engage with population, communities, and civil society for health policy-making at country level in the COVID19 era.
- Documented experience in country processes Representation in participation Necessary capacities for government-population/community/civil society engagement
- Legal frameworks for participation
- Policy uptake of participatory process outputs
- Sustaining participation over time
Risk communication and community engagement (RCCE) guidance
- All risk communication and community engagement guidance
- RCCE Guidance
- RCCE Action Plan Guidance
- Advice for general public – please scroll down to view and download all materials
- Advice on masks
- Myth busters
- Advice per audience
- Advice for individuals and communities
Private sector engagement and COVID-19
This means supporting governments to adopt a whole of government, whole of society approach to the COVID-19 response, mobilizing all available resources to keep health systems functioning, and focusing on efforts to work with the private sector to help meet the double surge in demand for COVID treatment and other essential health services.
- A call to action together with the UHC2030 partners
- An action plan for member states to use
- Documentation of the policy challenges facing countries during the containment stage of the pandemic
- Private sector engagement in the COVID-19 response - Kenya country experience
- Private sector engagement in the COVID-19 response - Rwanda country experience
- Private sector discussion note - COVID-19 testing
- Private sector discussion note - COVID-19 supplies
- Private sector discussion note - COVID-19 treatment
- Options - how to engage the private health sector to tackle COVID-19?
- Additional information (blogs, webinars, key resources) on private sector engagement & COVID-19
- COVID-19: Promoting accountability and transparency during the pandemic
- Integrating a focus on anti-corruption, transparency and accountability in health systems assessments
- Reinforcing the focus on anti-corruption, transparency and accountability in national health policies, strategies and plans
- Findings from a rapid review of literature on ghost workers in the health sector: towards improving detection and prevention
- Potential corruption risks in health financing arrangements: report of a rapid review of the literature
- A special edition in Global Health Action on Anti-Corruption, Transparency and Accountability (ACTA)
Integrated Health Systems Performance monitoring
Data, analytical and monitoring needs are outlined in the EHSS guidance. A mapping exercise of data collection efforts is ongoing to maximise alignment across the partners and avoid duplication and burden on countries.
Rapid national pulse surveys on impact of COVID on essential health services
There are several existing rapid pulse surveys developed to assess impact of COVID on essential health services. There is room for much further alignment/convergence across these different survey tools.
- Rapid assessment on impact on essential health services (25 health services), including data for SPRP KPI 9.3; WHO, May-June 2020 (to be published)
- NCD rapid assessment of service delivery for NCDs during the COVID-19 pandemic
- Immunization pulse poll, Covid-19 2020. WHO, UNICEF, Sabin’s Boost community, GAVI
- Rapid situation tracking for COVID-19 socioeconomic impacts (UNICEF survey to regional and country offices)
- Covid-19 MNCH/FP/RH situation rapid country survey, April 2002
- Global Fund COVID-19 Country Monitoring Tool, Survey to inform and trigger GF business continuity planning processes.
Suite of service capacity and community needs assessment tools
There are a number of rapid service capacity and community assessment tools that are under development, leveraging/adapting existing guidance and tools for the current context as a quick win.
- Rapid hospital readiness checklist, WHO, June 2020. (forthcoming), adapted from Hospital preparedness for epidemics. Geneva: World Health Organization; 2014
- Case management for COVID-19. WHO, June 2020 (forthcoming), adapted from WHO service availability and readiness assessment, 2015 ,
- Biomedical equipment for COVID-10 case management June 2020 (forthcoming)
- Infection prevention and control response capacity for COVID-19 (forthcoming) – adapted from IPC assessment framework at the facility level, 2019.
- Continuity of essential services WHO, June 2020 (forthcoming). Tailored for monitoring of EHS (ref EHSS guidance), and draws from and adapts existing tools (e.g SARA, HERAMs)
- Community needs and demand (WHO, UNICEF, GAVI, TGF in progress) Tailored for monitoring community needs and demand. Other resources include PREMISE and UNICEF U-Report to survey community needs.
Analysis and dashboards
Lots of existing dashboards and analytical guidance at both national and global level can be tailored quickly to meet the demands of the current context. This section will be updated with more content soon.
- Analytical guidance WHO, 2019
- Primary health care dashboards, PHCPI
- Legal information and support, COVID19 Law Lab
- COVID-19 Essential Supplies Forecasting Tool - Overview of the structure, methodology and assumptions used: Interim guidance, 25 August 2020
- COVID-19 Essential Supplies Forecasting Tool: Frequently Asked Questions (FAQ), 25 August 2020
- WHO COVID-19 Essential Supplies Forecasting Tool (COVID-ESFT) v3, 25 August 2020
Photo: WHO / Tom Pietrasik