Resilience of primary healthcare system across low- and middle-income countries during COVID-19 pandemic: a scoping review

A majority of the LMICs adopted resilience strategies related to service delivery and health workforce domains.Nigeria was the only country that showed evidence of resilience measures across all six WHO building blocks.Only a few countries reported healthcare financing measures.Most of the LMICs have developed national guidelines on SRMNCAH to ensure the continuation of healthcare services.Interruption in facility-based services shifted the burden to community-based healthcare services and most of the PHC-level services were offered at doorstep or at community sites.For essential service delivery, most of the countries had demonstrated transformative capacity that included use of digital platforms (teleconsultation/telemedicine establishing hotline number, WhatsApp messaging), for appointment system, extended timings, etc.Health workforce strategies varied from task shifting of health workforce, developing contractual agreements, and extending working hours to redeployment of retired staff in a majority of the countries.