Table 1

Programme areas and examples of essential routine services per delivery platform to be unconditionally protected during the COVID-19 pandemic

ProgrammeInterventionsDelivery platform*
Sexual and reproductive health
Provision of condoms and hormonal contraceptivesHealth centre
Modern contraceptives of client choice, long lastingFirst-level hospital
Medical abortionHealth centre
Surgical abortionFirst-level hospital
Postgender-based violence care, including counselling, provision of emergency contraception, and rape-response referral (medical and judicial)Health centre
Maternal and newborn health
Antenatal careHealth centre
Early detection and management of syphilis, hypertension, pre-eclampsia, diabetes and other pregnancy complicationsHealth centre
Detection and treatment of bacteriuriaHealth centre
Tetanus immunisationHealth centre
Basic emergency obstetric careHealth centre
Assisted vaginal delivery (including vacuum extraction)Health centre
Administering antibiotics, uterotonic drugs oxytocin and anticonvulsants (magnesium sulphate)Health centre
Manual removal of the placentaHealth centre
Removal of retained products following miscarriage or abortionHealth centre
Comprehensive emergency obstetric careFirst-level hospital
Surgery (eg, caesarean sections, hysterectomy)First-level hospital
Safe blood transfusionFirst-level hospital
Forceps extraction, if properly trainedFirst-level hospital
Antenatal corticosteroid for preterm labour, including early detection and referral at health centresFirst-level hospital
Induction of labour (beyond 41 weeks)First-level hospital
Management of pregnancy induced hypertension, including pre-eclampsia/eclampsiaFirst-level hospital
Ectopic pregnancy case managementFirst-level hospital
Management of maternal sepsisFirst-level hospital
Basic neonatal careHealth centre
Basic neonatal resuscitation care (with bag and mask)Health centre
Thermal protection for all babies, especially pretermsHealth centre
Hygienic cord careHealth centre
Kangaroo mother care and additonal feeding support (eg, with nasogastric tube/cup feeding) for small preterm babiesHealth centre
Comprehensive neonatal careFirst-level hospital
Management of newborn complications, neonatal meningitis and other very serious infectionsFirst-level hospital
Neonatal acute respiratory infection detection and treatment (intravenous antibiotics, oxygen therapy and respiratory support)First-level hospital
Newborn sepsis-injectable antibioticsFirst-level hospital
Management of jaundiceFirst-level hospital
Child health
Routine childhood vaccines (diptheria, pertussis, tetanus, polio, Bacillus Calmette-guerin (BCG), measles, hepatitis B, Hib, rubella)Community
Pneumococcus vaccinationCommunity
Rotavirus vaccinationCommunity
Tetanus toxoid immunisation among schoolchildrenCommunity
Integrated community case management of childhood illnessCommunity
Integrated management of childhood illnessHealth centre
Full supportive care for severe childhood infectionsFirst-level hospital
HIV and sexually transmitted infections (STIs)
Community-based HIV education and testing servicesCommunity
Provision of condoms to at risk populationsCommunity
Cotrimoxazole prophylaxisCommunity
HIV treatmentHealth centre
Provider HIV, STI, Hepatitits testing and linkage to careHealth centre
Prevention of mother to child HIV transmission (option B+) and syphilisHealth centre
Antiretrovirals for tuberculosis (TB)/HIV co-infectionHealth centre
Syndromic management of sexually transmitted infectionsHealth centre
Malaria
Indoor residual spraying in high endemic settingsCommunity
Insecticide-treated bednets for pregnant women and childrenCommunity
Malaria treatment with artemisinin-based combination therapy preceded by rapid diagnostic tests if feasibleCommunity
Malaria chemoprophylaxis in high endemic season (p. falciparum dominant)Community
Intermittent malaria prevention in infancyCommunity
Intermittent malaria prevention during pregnancyCommunity
Comprehensive management of severe malariaFirst-level hospital
TB
Active case finding followed by treatment when needed in HIV +individuals and other high-risk groupsPopulation based
TB, contact tracingCommunity
TB diagnosis and treatment (including extrapulmonary)Health centre
Referral of cases of treatment failure for drug susceptibility testing; enrollment of those with multidrug resistant TB for treatment per WHO guidelines (either short or long regimen)First-level hospital
Neglected tropical diseases
Sustained vector management for chagas disease, visceral leishmaniasis, dengue, and other nationally important causes of nonmalarial feverPopulation based
Mass drug administration for lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases and trachoma, and foodborne trematode infectionsCommunity
Early detection and treatment of Chagas disease, human African trypanosomiasis, leprosy, and leishmaniasesFirst-level hospital
Infections in general
Pharyngitis treatmentHealth centre
Fever evaluation and basic management, clinically stable, WHO Integrated Management of Adolescent and Adult Illness/Integrated Management of Childhood Illness (IMAI) guidelines, with referral of unstable individualsHealth centre
Fever evaluation and comprehensive management, clinically unstable, WHO IMAI guidelinesFirst-level hospital
Refractory febrile illness including etiologic diagnosisReferral hospital
Cancer
Human Papilloma virus vaccineCommunity
Early detection of cancer symptomsHealth centre
Early detection and treatment of early-stage cervical cancerReferral hospital
Treatment of early stage breast cancer, multimodal approaches (including generic chemotherapy), curative intentReferral hospital
Treatment of early-stage colorectal cancer, multimodal approaches (including generic chemotherapy), curative intentReferral hospital
Treatment of early-stage childhood cancers (Burkitt and Hodgkin lymphoma, acute lymphoblastic leukaemia, retinoblastoma, Wilms tumour), curative intentReferral hospital
Cardiovascular and related disorders (metabolic disorders, kidney failure, etc)
Cardiovascular disease (CVD), primary prevention with absolute risk approach (antihypertensives, statins)Health centre
CVD, secondary prevention (aspirin, beta blockers, ACE inhibitors, statins)Health centre
Secondary prophylaxis for rheumatic fever or established rheumatic heart disease, penicillinHealth centre
Active case finding and management of diabetes (glycaemic control, antihypertensives, statins, and consistent foot care)Health centre
Management of heart failure (diuretics, beta-blockers, ACE inhibitors, and mineralocorticoid antagonists)Health centre
Management of acute heart failureFirst-level hospital
Aspirin for all cases of suspected acute myocardial infarctionFirst-level/referral hospital
Mental health disorders
Active case finding of psychosis, depression, anxiety, bipolar disorder and post-traumatic stress disorder (PTSD)Health centre
Management of depression and anxietyHealth centre
Management of PTSDHealth centre
Management of bipolar disorderHealth centre
Management of psychosis (schizophrenia)Health centre
Management for attention deficit hyperactivity disorderHealth centre
Basic psychosocial follow-up for suicide and self harmHealth centre
Substance use disorders
Opioid agonist treatment and safe needlesHealth centre
Neurological disorders
Epilepsy treatmentHealth centre
Musculoskeletal disorders
Combination therapy for moderate to severe rheumatoid arthritis, low-dose corticosteroids, folic acid supplementation, disease-modifying anti-rheumatic drugs (including methotrexate)First-level hospital
Surgery
Drainage of abscessHealth centre
Drainage of dental abscessHealth centre
Management of bowel obstructionFirst-level hospital
AppendectomyFirst-level hospital
ColostomyFirst-level hospital
Hernia repairFirst-level hospital
Management of osteomyelitisFirst-level hospital
Repair of peptic ulcer perforationsFirst-level hospital
Urinary catheterisation/suprapubic cystostomyFirst-level hospital
Emergency care
First aidCommunity
Basic life support and first aid for burns, bleeding and wounds and chokingCommunity
Basic emergency careHealth centre
Management of non-displaced fracturesHealth centre
Resuscitation with basic life support measuresHealth centre
Identify and refer patients with high risk including pregnant women, young children, and those with underlying medical conditionsHealth centre
Advanced emergency care
Suturing lacerationHealth centre
Traction for fracturesFirst-level hospital
Irrigation and debridement of open fracturesFirst-level hospital
Resuscitation with advanced life support measuresFirst-level hospital
Trauma laparotomyFirst-level hospital
Trauma-related amputationsFirst-level hospital
Tube thoracostomyFirst-level hospital
Management of septic arthritisFirst-level hospital
Urgent orthopaedic management of injuriesReferral hospital
Palliative care and pain control
Palliative care and pain controlHealth centre
Prevention/relief of refractory suffering and of acute painFirst-level hospital
Nutrition
Detection and referral of severe acute malnutritionCommunity
Vit. A and Zinc to children and food for womenCommunity
Iron and folic acid supplementation, pregnant women, adolescent girls. Provision of food or caloric supplementation to pregnant women in food insecure householdsHealth centre
Promotion of early and exclusive breastfeeding or complementary feedingHealth centre
Treatment of severe acute malnutrition for cases presenting with or without associated medical complications (eg, Infections)Health centre and first-level hospital
Water supply, sanitation and hygiene
WASH: establish quality WASH facilities in schools, workplaces, public spaces, and healthcare facilitiesPopulation based
WASH: targeted WASH subsidies to poor and vulnerable groupsPopulation based
WASH: enact national standards for safe drinking water and sanitation within and outside households and institutionsPopulation based
Media messages on handwashing and air pollutionCommunity
WASH behavioural change interventions, such as community-led total sanitationCommunity
Health education and behavioural change communication
Education on handwashing and safe disposal of children’s stools
Health system services
Laboratory servicesAll facilities
  • *The delivery platform will vary by country. We suggest here the recommended lowest delivery platform.