New mother Sophia Turkson brought her baby for the tenth-day review at the Greater Accra Regional Hospital. “Honestly in the beginning, (with) the fear of the whole pandemic I missed about two of my antenatal appointments,” she says. Health authorities in many countries are striving to restore routine health services: refocusing overstretched workforce and reinforcing COVID-19 preventive measures to reassure patients.
People avoiding clinics and hospitals as the pandemic gained ground in many African countries has been a common tale. So has the intense focus by governments on curbing COVID-19 infections that drew resources and health personnel away from other essential services. But out of precaution, non-essential medical care and services such as mass immunizations were suspended. Lockdowns, curfews and other movement restrictions also caused disruptions.
In several health centres across Ghana, outpatient attendance fell sharply “and you could see that in two ways,” says Dr Neema Rusibamayila Kimambo, World Health Organization (WHO) Acting Representative for Ghana. “People were afraid to (seek) health services thinking that it is a place where they may actually get into contact with people with COVID-19. So, because of that fear, even people who needed to access health services were too afraid to go.”
“And then on the other side health workers were also worried, as they interact with different patients,” Dr Kimambo explains.
With the pandemic’s growing impact on essential health services, countries have been taking steps to avert a deeper fallout. For Ghana this has meant having dedicated COVID-19 response teams in every region so that “not everybody (is) directed to doing COVID-19,” says Dr Patrick Kuma-Aboagye, Ghana Health Service director-general.
Collaborating with WHO and other partner organizations, countries in Africa are working to ensure that the provision of essential services is a priority in the COVID-19 response, which means identifying health services most affected by the pandemic and giving them priority attention.
Dr Kimambo points out that in Ghana WHO has supported the efforts to maintain various essential health services, particularly the reproductive, maternal, newborn and child health services where guidelines have been issued to ensure safe and quality service delivery with minimal COVID-19 transmission risk.
At the Greater Accra Regional Hospital, staff have taken extra precautions to encourage people to seek services. Patients are given strict time slots so they arrive in smaller numbers to allow physical distancing. Both staff and patients must wear masks, and each patient takes a temperature check and must sanitize their hands on arrival.
Dr Emmanuel Srofenyoh, the hospital’s medical director, says the measures have made a huge difference to service delivery. “At the beginning, especially during the lockdown, most of the routine essential services came to a halt. We were no longer doing elective surgeries. Outpatient services also came to a halt.”
“Antenatal care services and children’s services programmes were still running, but in a very skeletal manner. As we are here now, antenatal services are running at maximum stream, paediatric clinics, children’s clinics, child welfare clinics are also running maximally, general (outpatient) services are back to full stream. Elective surgical operations and labour ward services are also running, caesarean sections, all these routine health system services are going on as expected.”
Along with reassuring people that hospitals are safe, strict infection prevention and control measures and separating COVID-19 treatment from other services mean that Ghana’s health workers can safely help the many others who depend on them.
In addition, educating patients on how to protect themselves from COVID-19 has also helped. Turkson, the new mother, says the information provided by the hospital staff on the COVID-19 preventive measures reassured her to continue her antenatal visits.
Ten days after she had her baby, she is back for the first postnatal check-up, trusting that the hospital has all in place to protect them both. “I feel safe to come to the hospital,” she says, her baby cocooned in cosseting shawl.Distributed by APO Group on behalf of WHO Regional Office for Africa.