Table 1.
Programme areas and examples of essential routine services per delivery platform to be unconditionally protected during the COVID-19 pandemic
| Programme | Interventions | Delivery platform* |
| Sexual and reproductive health | ||
| Provision of condoms and hormonal contraceptives | Health centre | |
| Modern contraceptives of client choice, long lasting | First-level hospital | |
| Medical abortion | Health centre | |
| Surgical abortion | First-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 care | Health centre | |
| Early detection and management of syphilis, hypertension, pre-eclampsia, diabetes and other pregnancy complications | Health centre | |
| Detection and treatment of bacteriuria | Health centre | |
| Tetanus immunisation | Health centre | |
| Basic emergency obstetric care | Health centre | |
| Assisted vaginal delivery (including vacuum extraction) | Health centre | |
| Administering antibiotics, uterotonic drugs oxytocin and anticonvulsants (magnesium sulphate) | Health centre | |
| Manual removal of the placenta | Health centre | |
| Removal of retained products following miscarriage or abortion | Health centre | |
| Comprehensive emergency obstetric care | First-level hospital | |
| Surgery (eg, caesarean sections, hysterectomy) | First-level hospital | |
| Safe blood transfusion | First-level hospital | |
| Forceps extraction, if properly trained | First-level hospital | |
| Antenatal corticosteroid for preterm labour, including early detection and referral at health centres | First-level hospital | |
| Induction of labour (beyond 41 weeks) | First-level hospital | |
| Management of pregnancy induced hypertension, including pre-eclampsia/eclampsia | First-level hospital | |
| Ectopic pregnancy case management | First-level hospital | |
| Management of maternal sepsis | First-level hospital | |
| Basic neonatal care | Health centre | |
| Basic neonatal resuscitation care (with bag and mask) | Health centre | |
| Thermal protection for all babies, especially preterms | Health centre | |
| Hygienic cord care | Health centre | |
| Kangaroo mother care and additonal feeding support (eg, with nasogastric tube/cup feeding) for small preterm babies | Health centre | |
| Comprehensive neonatal care | First-level hospital | |
| Management of newborn complications, neonatal meningitis and other very serious infections | First-level hospital | |
| Neonatal acute respiratory infection detection and treatment (intravenous antibiotics, oxygen therapy and respiratory support) | First-level hospital | |
| Newborn sepsis-injectable antibiotics | First-level hospital | |
| Management of jaundice | First-level hospital | |
| Child health | ||
| Routine childhood vaccines (diptheria, pertussis, tetanus, polio, Bacillus Calmette-guerin (BCG), measles, hepatitis B, Hib, rubella) | Community | |
| Pneumococcus vaccination | Community | |
| Rotavirus vaccination | Community | |
| Tetanus toxoid immunisation among schoolchildren | Community | |
| Integrated community case management of childhood illness | Community | |
| Integrated management of childhood illness | Health centre | |
| Full supportive care for severe childhood infections | First-level hospital | |
| HIV and sexually transmitted infections (STIs) | ||
| Community-based HIV education and testing services | Community | |
| Provision of condoms to at risk populations | Community | |
| Cotrimoxazole prophylaxis | Community | |
| HIV treatment | Health centre | |
| Provider HIV, STI, Hepatitits testing and linkage to care | Health centre | |
| Prevention of mother to child HIV transmission (option B+) and syphilis | Health centre | |
| Antiretrovirals for tuberculosis (TB)/HIV co-infection | Health centre | |
| Syndromic management of sexually transmitted infections | Health centre | |
| Malaria | ||
| Indoor residual spraying in high endemic settings | Community | |
| Insecticide-treated bednets for pregnant women and children | Community | |
| Malaria treatment with artemisinin-based combination therapy preceded by rapid diagnostic tests if feasible | Community | |
| Malaria chemoprophylaxis in high endemic season (p. falciparum dominant) | Community | |
| Intermittent malaria prevention in infancy | Community | |
| Intermittent malaria prevention during pregnancy | Community | |
| Comprehensive management of severe malaria | First-level hospital | |
| TB | ||
| Active case finding followed by treatment when needed in HIV +individuals and other high-risk groups | Population based | |
| TB, contact tracing | Community | |
| 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 fever | Population based | |
| Mass drug administration for lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases and trachoma, and foodborne trematode infections | Community | |
| Early detection and treatment of Chagas disease, human African trypanosomiasis, leprosy, and leishmaniases | First-level hospital | |
| Infections in general | ||
| Pharyngitis treatment | Health 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 individuals | Health centre | |
| Fever evaluation and comprehensive management, clinically unstable, WHO IMAI guidelines | First-level hospital | |
| Refractory febrile illness including etiologic diagnosis | Referral hospital | |
| Cancer | ||
| Human Papilloma virus vaccine | Community | |
| Early detection of cancer symptoms | Health centre | |
| Early detection and treatment of early-stage cervical cancer | Referral hospital | |
| Treatment of early stage breast cancer, multimodal approaches (including generic chemotherapy), curative intent | Referral hospital | |
| Treatment of early-stage colorectal cancer, multimodal approaches (including generic chemotherapy), curative intent | Referral hospital | |
| Treatment of early-stage childhood cancers (Burkitt and Hodgkin lymphoma, acute lymphoblastic leukaemia, retinoblastoma, Wilms tumour), curative intent | Referral 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, penicillin | Health 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 failure | First-level hospital | |
| Aspirin for all cases of suspected acute myocardial infarction | First-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 anxiety | Health centre | |
| Management of PTSD | Health centre | |
| Management of bipolar disorder | Health centre | |
| Management of psychosis (schizophrenia) | Health centre | |
| Management for attention deficit hyperactivity disorder | Health centre | |
| Basic psychosocial follow-up for suicide and self harm | Health centre | |
| Substance use disorders | ||
| Opioid agonist treatment and safe needles | Health centre | |
| Neurological disorders | ||
| Epilepsy treatment | Health 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 abscess | Health centre | |
| Drainage of dental abscess | Health centre | |
| Management of bowel obstruction | First-level hospital | |
| Appendectomy | First-level hospital | |
| Colostomy | First-level hospital | |
| Hernia repair | First-level hospital | |
| Management of osteomyelitis | First-level hospital | |
| Repair of peptic ulcer perforations | First-level hospital | |
| Urinary catheterisation/suprapubic cystostomy | First-level hospital | |
| Emergency care | ||
| First aid | Community | |
| Basic life support and first aid for burns, bleeding and wounds and choking | Community | |
| Basic emergency care | Health centre | |
| Management of non-displaced fractures | Health centre | |
| Resuscitation with basic life support measures | Health centre | |
| Identify and refer patients with high risk including pregnant women, young children, and those with underlying medical conditions | Health centre | |
| Advanced emergency care | ||
| Suturing laceration | Health centre | |
| Traction for fractures | First-level hospital | |
| Irrigation and debridement of open fractures | First-level hospital | |
| Resuscitation with advanced life support measures | First-level hospital | |
| Trauma laparotomy | First-level hospital | |
| Trauma-related amputations | First-level hospital | |
| Tube thoracostomy | First-level hospital | |
| Management of septic arthritis | First-level hospital | |
| Urgent orthopaedic management of injuries | Referral hospital | |
| Palliative care and pain control | ||
| Palliative care and pain control | Health centre | |
| Prevention/relief of refractory suffering and of acute pain | First-level hospital | |
| Nutrition | ||
| Detection and referral of severe acute malnutrition | Community | |
| Vit. A and Zinc to children and food for women | Community | |
| Iron and folic acid supplementation, pregnant women, adolescent girls. Provision of food or caloric supplementation to pregnant women in food insecure households | Health centre | |
| Promotion of early and exclusive breastfeeding or complementary feeding | Health 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 facilities | Population based | |
| WASH: targeted WASH subsidies to poor and vulnerable groups | Population based | |
| WASH: enact national standards for safe drinking water and sanitation within and outside households and institutions | Population based | |
| Media messages on handwashing and air pollution | Community | |
| WASH behavioural change interventions, such as community-led total sanitation | Community | |
| Health education and behavioural change communication | ||
| Education on handwashing and safe disposal of children’s stools | ||
| Health system services | ||
| Laboratory services | All facilities | |
*The delivery platform will vary by country. We suggest here the recommended lowest delivery platform.