‘Population self-reliance in health’ and COVID-19: The need for a 4th tier in the health system

Abstract

The COVID-19 pandemic is straining health systems globally. The current international biomedical focus for disease control and policies fails to include the resource of a population’s capacity to be self-reliant in its health care practices. The ancient wisdom of Ayurveda (‘the knowledge of life’) and Local Health Traditions (LHTs) in India understand that health is about Svasthya , ‘being rooted within’; a concept that includes the relationship and balance between the individual, their families, communities and the environment in creating their own health. This ‘population self-reliance in health’ is the focus of the 4 th Tier in the health system which honours and respects an individual’s capacity for self-care and their inherent responsibility to the health system and its values. It encourages the inclusion of this knowledge in the creation of health systems and in the policies that direct them. Research and practice into the 4 th Tier will provide health systems and policy information into how communities are managing the COVID-19 epidemic. These insights will help into the creation of future health systems that are better aligned to the ‘self-reliance in health’ of individuals and their communities.

The COVID-19 pandemic and healthcare systems in Africa: a scoping review of preparedness, impact and response

“…While COVID-19 remains a biomedical challenge, an approach focused on disease control alone will be insufficient to contain the pandemic. 70 Lesson from past epidemics and major health challenges in the region remind us of the need to protect, support and empower the frontline healthcare workers, particularly the community health workforce, which remains the backbone of Africa’s health system. 71 …”

“…However, establishing a resilient health system will not be without challenges, partly due to limited resources, including insufficient health financing and shortage of skilled health workforce. While COVID-19 remains a biomedical challenge, an approach focused on disease control alone will be insufficient to contain the pandemic 70. Lesson from past epidemics and major health challenges in the region remind us of the need to protect, support and empower the frontline healthcare workers, particularly the community health workforce, which remains the backbone of Africa’s health system 71…”

A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda

“…These mRNA vaccines appear to offer hope to the international community against COVID-19; however, the growth of skepticism continues to undermine vaccine confidence. In addition, increased reliance of local communities on alternative and complementary medicinal options to control infectious diseases furthermore complicates COVID-19 control [ 11 , 12 ]. For example, Echinacea, Cinchona, Curcuma longa , and Curcuma xanthorrhiza [ 12 ] have been recommended; however there is limited information on clinical assessment of their immunogenicity.…”

Factors associated with preventive practices of COVID-19 among health care workers in Dilla University Hospital, Southern Ethiopia

“…COVID-19 is primarily transmitted through droplets and close contact ( Ssebuufu et al, 2020 ). This virus infects the respiratory, enteric, neurologic, and vascular systems, causing a variety of diseases ( Mathpati et al, 2020 ). It has a broad clinical spectrum, ranging from no symptoms to a severe form of respiratory illness such as acute respiratory distress syndrome ( Deressa et al, 2021 ).…”