Many Lessons from Covid-19

Context: Covid-19 pandemic has exposed the fragility of the global health system and its gendered impact on women. India can do better in many aspects.

Impact of Pandemic

• Gendered Impact:

• Disruption of Medical Services: family planning and other immunisation services (up to 70%) were impacted, leading to a rise in maternal death (by 60% or more.)

• Surge in domestic violence: A third of women experienced domestic violence, but less than 1% sought help from the police. 

• Rising Incidence of poverty: In India, the number of women and girls living in extreme poverty is expected to increase from 87 million to 100 million. 

• Increased rate of wasting in children (10% to 50%): due to a reduction in coverage of essential services.

• Reduced access to nutritious food: As a huge number of children depend on school meals.

Way Forward

• Ensure gender analysis and gender-responsive public health policies: 

• World Health Organization (WHO) member states must collect data, report and analyse it, disaggregated by sex and include responses to violence against women as an essential service.

• Ensure financial protection and effective coverage of health services: by reducing out-of-pocket payments For, E.g. through schemes like Ayushman Bharat

• Out-of-pocket payments cause about 100 million to fall into extreme poverty every year, and 800 million globally spend more than 10% of their household budget on healthcare. 

• Ensure effective health coverage index: to measure the quality of health services which looks at the provision and efficacy of services in terms of health outcomes.

• Employ digital technology-based healthcare platforms: 

• Telemedicine: For, E.g. Platforms like ECHO have been used in many States to train health care workers and the government’s e-Sanjeevani platform is enabling telemedicine appointments. 

• Electronic and portable health records: as a new way of collecting, using and sharing data, enabling local, contextualised decision-making. 

• Private collaboration in the medical sector: to improve health outcomes, productivity, apart from reducing costs and saving a lot of time for doctors. 

• Integrate social protection systems, food systems and health systems: to expand nutrition services.

• Ensure efficient infodemic management: through setting up of behavioural insights group to provide advice on behaviour change.

• False or misleading information leads to harmful behaviours and mistrust in governments and the public health response. 

• Reduce other factors impacting health: including various social and environmental determinants of health, such as quality of water and air.
• Empower frontline health workers: by investing in them in terms of the tools they need, training, mentoring, and salary.
• Invest in strong institutional mechanisms and capacities: in regulatory bodies, research centres and public health institutions. 
• Promote health literacy to counter health-related fear: stigma and discrimination circulated on social media
• Promote investment in human resources and engage and empower communities: for achieving the goal of Universal Health Coverage. 

Conclusion: Health system must involve people it is trying to serve and have them involved in developing the services that we are bringing to them.