COVID-19 and the burden of ill-health: a double crisis of disruptions and inequalities

Bisht, Ramila; Saharia, R.P.; Sarma, Jyotishmita

doi:10.1007/s40847-020-00117-x

Cited by 13 publications

(10 citation statements)

References 19 publications

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“…With the call for lockdown, our health authorities started making amendments in the healthcare policies to prioritize services only for COVID-19 over other important health issues. Hence, major facilities like the medical colleges and the district hospitals were transformed into COVID-19 facilities, which led to the diversion of non-COVID patients to the Community Health Centres (CHCs) and Primary Health Centres (PHCs) as alternative arrangements, worsening the fate of the associated conditions [18]. In addition, most of the TB testing facilities were converted into COVID testing centres causing an overall reduction in capacity for TB testing, diagnosis of newer cases, diagnosis of DR-TB and follow-up of existing cases.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on tuberculosis services: an experience from a tertiary care hospital

Jamwal

Mohanty

Swami

et al. 2022

Journal of Medical Microbiology

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Introduction. India is home to the most significant number of tuberculosis (TB) cases around the globe. The COVID-19 crisis has massively affected TB healthcare services in the country. Hypothesis/Gap Statement. Are we sufficiently equipped to fight against TB during emergencies? Aim. Our study aims to provide a true insight into the disruption of TB care during the pandemic period at a tertiary care hospital in India. Methods. A retrospective observational cohort analysis was conducted on 6491 patients who accessed the TB diagnostics at the tertiary care hospital during the study period, i.e. the COVID-19 pandemic period (March 2020 to March 2021) compared with 14 665 in the control period (March 2019 to Feb 2020). Results. Out of the total tested, 3136 patients were notified as new TB cases in the study period than 4370 in the control period (P-value=0.0000001), i.e. 28.23 % decline in notifications. A drastic decline of 69 % in notifications was observed during the lock down months in the pandemic period, i.e. March to June 2020 (P-value=0.00001). A reduction of 44 % in treatment accession by 3690 TB patients in the control period compared with 2062 in the study period (P-value=0.0000001) was noted. Lost to follow-up patients increased by 65 % from 460 in the control period to 760 in the study period (P-value=0.0000001). Also, an increased death rate by 43 % from control to study period (P-value=0.0000001) was reported. Conclusion. There is an urgent need to maintain the continuity of essential TB services to reduce the rising burden in vulnerable populations. The need of the hour is to undertake novel strategies for tuberculosis control to combat such emergencies in the coming future.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on tuberculosis services: an experience from a tertiary care hospital

Jamwal

Mohanty

Swami

et al. 2022

Journal of Medical Microbiology

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“…In Mumbai, access to health care inequalities based on privatisation of care surfaced during the pandemic as the poor lacked access to COVID-19 care. 79 In Karachi, accessing vaccination centres that are located far away from informal settlements has been cumbersome, particularly for workers who cannot afford to take time off from work. The opportunity cost of going to the vaccination centre and coming back is relatively higher (for a daily wage earner) in the form of loss of a day's income and intra-city transportation cost.…”

Section: Longer-term Considerations For Public Health Measures Includ...mentioning

confidence: 99%

Evidence Review: COVID-19 Recovery in South Asian Urban Informal Settlements

Aslam¹,

Schmidt‐Sane²

2022

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The global pandemic has brought renewed attention toward the everyday challenges in informal settlements. COVID-19 reminds us that southern urban life is rooted in ‘collective’ experiences where toilets and kitchens are shared by multiple families; where the categories of work and home, private and public space overlap; and where the majority live in vulnerable conditions. Despite these challenges, some of the most innovative and collective responses to COVID-19 have emerged from these areas. While informal settlements did face a host of risks and vulnerabilities during the pandemic, local responses have highlighted the resilience of informal settlement communities. However, few informal settlements are actually ‘resilient’ and any local responses must be robustly supported by system-wide change including support from local and national governments, improvements to built infrastructure, and improved access to health care services, among other priorities. The category of ‘informal settlements’ also captures a wide range of settlement types, from a legal slum to an informal settlement with no legal status, with many other types in between. This underscores the need to address fundamental issues that ‘perpetuate conditions of inequity, exclusion and vulnerability’ while also recognising the needs and contexts of different kinds of informal settlements. Whether COVID-19 helps governments recognise conditions of insecurity and vulnerability to address safe and secure housing and infrastructures remains to be seen. This is an update to the previous SSHAP brief on ‘COVID-19 in Informal Urban Settlements’ (March 2020). This evidence review highlights local responses, grassroots efforts, and challenges around COVID-19 recovery within urban informal settlements in South Asia. It focuses on specific examples from Karachi, Pakistan and Mumbai, India to inform policy responses for COVID-19 recovery and future epidemic preparedness and response. We show how local level responses are shaped in these cities where national and international responses have not reached communities at municipal and sub-municipal levels. This brief was written by Saba Aslam (IDS Alumni) and Megan Schmidt-Sane (IDS), with reviews from Professor Amita Bhide (Tata Institute of Social Sciences, India), Dr Asad Sayeed (Collective for Social Science Research, Pakistan), Annie Wilkinson (IDS), and contributions from Swati Mishra (LSHTM), Prerana Somani (LSHTM), Saleemullah Odho (Deputy Commissioner, Korangi district Karachi), Dr Noman Ahmed (NED University, Karachi), Tahera Hasan (Imkaan Foundation, Karachi), Atif Khan (District Health Officer, Korangi district Karachi), Dr Harris (District Focal person, Korangi), Aneeta Pasha (Interactive for Research and Development, Karachi), Yasmeen Shah (Pakistan Fisherfolk Forum), Ghulam Mustafa (HANDS Pakistan), and Dr Shehrin Shaila Mahmood (icddr,b). This brief is the responsibility of SSHAP.

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“…Despite the visible signs of a growing crisis in the healthcare sector during the lockdown, the entire healthcare system was diverted to COVID-19 care. Most routine healthcare services were suffering from neglect, including a decrease in TB-related diagnosis, treatment and prevention services (Bisht et al, 2020). The stories from major city hospitals and the shortages they faced in the second wave and the tales from un-attended villages need no repetition.…”

Section: Institutional Augmentation Of Public Sector Healthcarementioning

confidence: 99%

COVID’s Effect on India’s Health Services: A Commentary

Qadeer

2021

Social Change

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Using a comprehensive framework (the state’s will to deliver, its institutional strength and its legitimacy), this article assesses the impact of the COVID-19 pandemic on public sector healthcare services in India. The power to deliver was explicit when the interventions were harsh, increasing the burden of death and disease on health services. But when it came to healthcare by the public sector we find a worsening of achievements of non-COVID ailments during the pandemic and an inability to tackle the second wave due to gaps in the nation's infrastructure, a centralised control undermining state authority; and visible results of a flawed policy that pushed further the agenda of making healthcare a profitable business.

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COVID-19 and the burden of ill-health: a double crisis of disruptions and inequalities

Cited by 13 publications

References 19 publications

Impact of COVID-19 on tuberculosis services: an experience from a tertiary care hospital

Impact of COVID-19 on tuberculosis services: an experience from a tertiary care hospital

Evidence Review: COVID-19 Recovery in South Asian Urban Informal Settlements

COVID’s Effect on India’s Health Services: A Commentary

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