THE VOICE OF PRIVATE SECTOR

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COVID19

Suggested Guidelines for Employers

  • Encourage those that are sick or not feeling well (especially with a respiratory issue) to stay home and not go to the workplace.
  • Make handwashing / sanitizing facilities, complete with running water and soap, available at the workplace and ensure all persons entering use them prior to entry. Liquid soap may be better than a bar of soap because multiple hands come into contact with the bar of soap.   
  • Encourage employees to wash their hands for a minimum of 20 seconds with soap and warm water upon arrival at the workplace as well as frequently throughout the day. Provide paper towels or a clean dedicated towel for each worker that only the worker should use.  If using cloth towels, wash them daily to prevent the spread of germs and possible illness.
  • Provide hand sanitizer so that if soap and water are not available, people have access to hand sanitizer that contains at least 60% alcohol.
  • Routinely clean and disinfect surfaces that people frequently touch.
  • Make sure that common areas such as toilets, kitchens and vestibules are well ventilated and open.
  • Require everyone who enters the workplace to wear a mask and that it covers both their mouth and nose. Provide extra clean masks for those that do not have a mask.  Make sure to have everyone track their own mask so no cross contamination occurs.
  • Limit large gatherings.
  • Maintain social distancing of a minimum of one meter. Ensure that employees sit and/or stand at least one meter apart.  If necessary, rearrange the work stations.  If the space is small, then consider rotating employees every other day (or other intervals) as long as the workplace is deeply cleaned and sanitized every evening or early morning in order to avoid sharing of germs.
  • Delay anything that cause employees to gather in one place where they would be located close to each other until the outbreak is over. If that is not possible, then try to hold the activity outdoors and have it last for a short period of time.
  • Rooms and offices should be well ventilated and, if possible, the distance between employees should be at least one meter.
  • Provide a waiting area for clients in the open air and try to be one meter away from each other. Avoid accepting a large number of clients at one time and in one place and try to divide the clients into different branches and keep them apart.
  • Ask your employees to report if they have a sick family member at home with COVID-19 or the flu. Maintain a log.
  • Ensure you have a master log of all workers’ names, addresses, phone numbers, and/or email addresses so that you can contact them in the event you need to notify them if one of your workers has been infected with COVID-19 within the last 14 days.
  • Given flu season is approaching, encourage workers to get the flu shot.
  • Avoid business travel as much as possible, especially to provinces where COVID-19 disease has been found.
  • Those employees who have been in contact with a COVID-19 positive patient and do not have signs and symptoms, the business must allow such staff to be in home quarantine for 14 days and must not report to office. 
    1. The person should be in a separate room as much as possible and if this is not possible, consider a minimum distance of 1-3 meters in all situations with all people at the workplace.
    2. Avoid touching objects that others come in contact with as much as possible and do not share personal items such as sheets, soap, plates, and towels.
    3. Wash your hands with soap and warm water every half-hour for at least 20 seconds.
    4. Cover your mouth and nose with a handkerchief or tissue while coughing and sneezing.
    5. Avoid going to public places such as mosques, bazaars, hospitals, etc. If you have COVID-19 symptoms (see table below), call 166 and follow the instructions.
  • Follow the advice and guidance put forward by the Ministry of Public Health and the officials of Ministry of Public Health. For updates, refer to the website of the Ministry of Public Health (MoPH.gov.af).  Guidance (e.g. wash your hands, do not touch your eyes and mouth, etc.) provided by the Ministry of Health should be posted in visible areas for staff to read.

Disrupted health services during COVID-19

Health systems around the world—regardless of income level—are struggling to curb the rapid spread of COVID-19 (coronavirus). Low- and middle-income countries are particularly vulnerable. In countries where health systems already struggle to meet their population’s needs, the stress of COVID-19 is likely to disrupt essential health services —from ensuring women can safely deliver babies, access family planning services, and immunize their children; to maintaining lifesaving treatments for malaria, HIV, tuberculosis, non-communicable diseases, and childhood pneumonia.

This vulnerability is neither new nor unique to the current pandemic. During the 2014-2016 West African Ebola outbreak, use of routine health services decreased by an estimated 18%. Researchers estimate that service disruptions resulted in as many as 10,000 additional deaths due to malaria, HIV/AIDS, and tuberculosis as well as measles and other health conditions that would have otherwise been preventable.

COVID-19’s secondary health crisis

Millions of women and children may die or endure lifelong health impacts because of disruptions to essential health services and the reluctance by patients to seek care for fear of Covid-19 infection.  A recent analysis by The Lancet examined the effects of service disruptions on mortality because of the COVID-19 pandemic. The results, although expected, are overwhelming.

The study modeled three scenarios in which coverage of basic life-saving interventions was reduced to different extents (from 10% to 50%) and for different durations (3, 6, and 12 months), with assumptions based on emerging reports of the supply-side and demand-side effects of the pandemic.  

Reductions in coverage of around 15% for 6 months would result in 253,500 additional child deaths and 12,190 additional maternal deaths, while reductions of around 45% for 6 months would result in 1,157,000 additional child deaths and 56,700 additional maternal deaths. This would represent a 9.8% to 44.7% increase in under-five child deaths per month, and an 8.3% to 38.6% increase in maternal deaths per month, across 118 countries.

A rapid assessment of 25 essential services carried out by the WHO in May 2020 uncovered serious disruptions to essential health services across the world. “Routine immunization and supplementary measles and rubella campaigns were significantly disrupted. Services for non-communicable diseases such as diabetes, high blood pressure, heart diseases, and cancer, have been significantly affected.”

New data from Somalia, Mali, and Liberia shows up to a 40 per cent reduction in essential health services such as childhood immunization, antenatal care and safe childbirth.The Global Financing Facility (GFF) also estimates that as many as 26 million women could lose access to contraception across 36 countries, leading to nearly 8 million unintended pregnancies.

Mental health—a challenge to address in regular times—has been most affected.

Repurposing of health workers, cancellation of elective care, closure of outpatient services, insufficient personal protective equipment, and changes in treatment policy have significantly impacted delivery of essential services. Additionally, changes in health-seeking behavior, constrained physical access, and financial hardship have limited service uptake.

How do we address this?

Strengthening health system resilience with a focus on primary health care is key to maintaining and strengthening essential health services in this new reality.  The World Bank is fully cognizant of the need to fight the pandemic while also helping countries maintain other essential services. This was evident in the majority of  our first 100 projects launched during the first 100 days of the pandemic. Our ongoing programs are reinforcing healthcare systems while also helping to procure vital life-saving medical equipment and supplies.

In parallel, the GFF is helping ensure that safe and equitable delivery of essential health and nutrition services for women and children is a central part of COVID-19 response and recovery efforts. Through flexible financing and technical assistance, the GFF is working with 36 countries to prioritize investments in essential services for women and children, strengthen frontline service delivery, and address constraints in demand for sexual and reproductive health and other services. 

Policy makers at the country level may benefit from some of the following policy options:

1. Governmental COVID-19 taskforces should designate an “Essential Health Services” pillar that is tasked with ensuring response strategies (particularly social distancing) are adhered to. It should also take steps to protect the delivery of routine health services including vaccinations, antenatal care, skilled births, and critical medications.

2. COVID-19 taskforces should design public messaging on the importance of continuity of essential health services and include this in their progress updates.

3. International development agencies should continue to provide programmatic and operational advice to countries in the form of context-specific guidelines and policy briefs at the national or subnational level.

While the coronavirus pandemic is responsible for increasing overall mortality, the indirect effects of the pandemic need not increase mortality from other preventable diseases.  We need to pay special attention to weakened health systems with reduced availability and utilization of routine services during the pandemic.

Nearly a third of Afghanistan's population — around 10 million people — has been infected by the novel coronavirus since February, according to a report published by the country's Health Ministry.

The World Health Organization-backed survey revealed that around 31.5% of Afghanistan's population contracted the virus since the country imported its first cases from neighboring Iran.

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