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Though demand- and supply-side factors have been causing persistent disruptions, countries show notable signs of recovery after three years of the COVID-19 pandemic.
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WHO Interim Survey: Health Systems Recover From Pandemic Aftereffects

Number of countries with national supply chain system disruptions reduced from nearly half to about a quarter in just the last year

World Health Organization
Published:May 02, 2023
|3 min read
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After three years of the COVID-19 pandemic, health systems in countries have started showing the first major signs of recovery, according to the WHO interim report on the “Fourth round of the global pulse survey on continuity of essential health services during the COVID-19 pandemic: November 2022–January 2023.” By early 2023, countries reported experiencing reduced disruptions in the delivery of routine health services but highlighted the need to invest in recovery and resilience for the future.

Among the 139 countries that responded to the fourth round of WHO’s pulse survey, countries reported continued disruptions in almost one-quarter of services on average. In 84 countries where trend analysis is possible, the percentage of disrupted services declined on average from 56 percent in July–September 2020 to 23 percent in November 2022–January 2023. 

Persisting disruptions are due to both demand- and supply-side factors, including low levels of health care-seeking in communities as well as limited availability of health workers and other health care resources, such as open clinics or available stocks of medicines and products. 

“It is welcome news that health systems in the majority of countries are starting to restore essential health services for millions of people who missed them during the pandemic,” said Rudi Eggers, MMed, MBBS, WHO director for Integrated Health Services. “But we need to ensure that all countries continue to close this gap to recover health services, and apply lessons learned to build more prepared and resilient health systems for the future”.

First notable signs of recovery

In this new survey, fewer countries reported intentionally scaling back access across all service delivery platforms and essential public health functions since 2020–2021 reporting, showing an important step to return to prepandemic levels of service delivery and broader system functioning. 

By the end of 2022, most countries reported partial signs of service recovery, including in services for sexual, reproductive, maternal, newborn, child, and adolescent health; nutrition; immunization; communicable diseases (including malaria, HIV, TB, and other sexually transmitted infections); neglected tropical diseases; noncommunicable diseases; management of mental, neurological and substance use disorders; care for older people; and traditional and/or complementary care. 

The number of countries reporting disruption to their national supply chain system reduced from nearly half (29 of 59 responding countries) to about a quarter (18 of 66 responding countries) within the last year. 

Despite signs of recovery, service disruptions persist across countries in all regions and income levels, and across most service delivery settings and tracer service areas. Countries are also dealing with increasing service backlogs—most frequently in services for screening, diagnosis, and treatment of noncommunicable diseases—which can lead to negative consequences as people are delayed access to timely care.

Recovering essential health service delivery is critical because disruptions in services—like health promotion, disease prevention, diagnosis, treatment, rehabilitation, and palliation—may have even greater adverse health effects at population and individual levels than the pandemic itself, especially among vulnerable populations. 

Integrating COVID-19 services into essential health services 

In another important step towards system recovery and transition, most countries have made progress in integrating COVID-19 services into routine health service delivery. About 80–90 percent of countries have fully integrated COVID-19 vaccination, diagnostic, and case management services as well as services for post-COVID-19 condition into routine service delivery. 

Still, most countries (80 percent of 83 responding countries) reported at least one bottleneck to scaling up access to essential COVID-19 tools (e.g., COVID-19 diagnostics, therapeutics, vaccines, and PPE), with health workforce issues and lack of funding being the most common barriers. 

Extensive support for recovery, resilience, and preparedness 

Most countries have started to apply what they have learnt during the COVID-19 pandemic by institutionalizing a number of innovative service disruption mitigation strategies into routine health service delivery. These include the deployment of telemedicine approaches, promotion of home-based care or self-care interventions, approaches for strengthening health care workers' availability, capacities, and support mechanisms, innovations in procuring and delivering medicines and supplies, more routine community communications, and partnerships with private sector providers. 

Around three-quarters of countries reported additional funding allocation toward longer-term system recovery, resilience, and pandemic preparedness. 

Countries expressed the need for WHO’s support to address remaining challenges in the COVID-19 context and beyond—mostly related to health workforce strengthening, building the monitoring capacities of health services, designing primary models of care, governance, policy and planning, and financial planning and funding.

- This press release was originally published on the World Health Organization website