Primary Health Care Adaptations for COVID-19
Primary health care workflow and training adaptations for COVID-19
Primary Health Care (PHC) workflows using the CHT are easily adaptable to help communities and facilities strengthen continuity of routine primary care services during COVID-19. Adapting PHC workflows is designed to:
- Address disruptions to PHC delivery within communities while keeping CHWs and patients safe
- Offer remote patient and CHW support through call and text-first protocols
- Limit physical contact between patients, CHW’s, and facility providers by modifying existing health assessments
- Contain transmission via embedded COVID-19 symptom screening and referral protocols
Problem Being Addressed
Most primary health care programs are not designed to address the specific health needs of pandemics, such as COVID-19. For CHWs and the communities they support, the impact of the pandemic has resulted in disruptions to much needed primary health care services, such as antenatal and postnatal care. This is particularly devastating for already vulnerable populations, such as patients who live in places that lack robust health care infrastructure or have co-morbidities, who face increased challenges when CHWs and care facilities are unable to provide adequate services.
In response, health program administrators are rapidly adapting digitally supported PHC programs to help respond to immediate patient and community health needs. Relying on CHWs and Supervisors to quickly learn and adhere to new care workflows on their own is a major challenge to successfully modifying PHC health programs to impact patients quickly and maintain the safety of health workers.
Solution Overview
Maintaining primary health care is critical both in slowing the spread of COVID-19 and managing the care of patients at home with moderate cases, as well as ensuring that disruptions to PHC are addressed and that routine care is supported during the pandemic. Building on the success of existing digitally-supported health programs and CHW patient relationships enables more effective responses to the specific health needs of their communities.
Through adaptations to PHC workflows, health program administrators are able to:
- Support COVID-19 prevention, detection, and containment efforts within communities
- Create a coordinated approach that safely serves health workers, facilities, and communities
- Support home-based care for non-emergent COVID-19 cases to reduce overburdening on hospital systems
- Capture program learnings to create more robust and resilient health systems beyond supporting the immediate COVID-19 response
Users and Hierarchy Example
| User | Location | Devices | Role |
|---|---|---|---|
| Program Staff | Central, district or local offices | Desktop, laptop and smartphones | Oversee delivery of routine PHC services. Continually monitor care delivery for disruptions. Ensure compliance with program-specific, national and global care protocols. |
| CHW Supervisor | Community level, based at facilities | Smartphone and personal phone | Oversee CHWs and track completion of their remote training modules. Follow up with CHWs needing extra support. |
| CHW | Community level | Feature phone or smartphone | Provide care to community using adapted PHC workflows. Complete remote training for new workflows. Enable home-based care and offer remote support through call and text-first protocols. |
| Patient | Community level | Seek care for non-emergent conditions. Examples: maternal and child health, other infectious diseases, non-communicable diseases. |
Workflow Example
This demo illustrates how a CHT workflow that currently supports PHC can be easily adapted to reflect a COVID-19 health program response. Remote support allows for the integration of new care protocols that follow “no touch” or “visual only” reviews, transition to call/text-first protocols, and embedding COVID-19 symptom screening within PHC workflows.
More background information can be found in this summary deck.