Opinion: How Renewed Lockdowns Might Affect Women’s Health Services In Rural India And Further Tire Already Weak Systems

Opinion: How Renewed Lockdowns Might Affect Women’s Health Services In Rural India And Further Tire Already Weak Systems

The unmet need for family planning services is already high and disruptions to health services will have far-reaching consequences for the health of women, write Poonam Muttreja and Mandira Kalra Kalaan of Population Foundation of India
Blogs, Coronavirus Outbreak, News, Swasth India
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Opinion: How Renewed Lockdowns Might Affect Women's Health Services In Rural India And Further Tire Already Weak SystemsAccording to experts, COVID-19 has impacted women’s access to high quality uninterrupted services

With over 312,000 cases registered on April 21st India’s daily caseload is now the highest of any country since the pandemic began over a year ago. With an overall caseload over 15 million, the second highest after the United States, the country’s fragile health infrastructure is being pushed to a breaking point. Reports from state after state suggest that patients and their families are scrambling to secure hospital beds and governments are struggling to provide oxygen and critical life-saving medicines for serious patients.

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Several health facilities, including AIIMS in Delhi, which have been treating large numbers of non-COVID patients through the pandemic have suspended routine OPD services. Doctors, nurses and other healthcare professionals are being diverted to COVID-only duty as states convert non-COVID hospitals into COVID treatment centres. As we had witnessed during the lockdown last year, it is likely that health care services will be affected due to local restrictions already in place in a number of states and union territories, and health facilities either shut down or converted for delivering pandemic related services. Furthermore, restrictions on mobility and fear of health centres also reduce access to health care services, including family planning and reproductive health services. With ASHAs, ANMs and Anganwadi Workers diverted to COVID care and limited outreach services such as Village Health, Sanitation and Nutrition Days (VHSND), the effect in rural areas is magnified.

Population Foundation of India’s own analysis of the first lockdown shows that there have been severe drops in access to contraception, ante-natal care services and institutional deliveries. In Bihar, Rajasthan and Uttar Pradesh, adolescents reported an unmet need for reproductive health services, especially menstrual hygiene products. While it is commendable that the Ministry of Health and Family Welfare (MOHFW) included reproductive health services in the list of essential services, women’s access to high quality uninterrupted services have been impacted.

A recent UNICEF report, Direct and Indirect Effects of COVID-19 Pandemic and Response in South Asia, estimates that disruptions due to the pandemic will result in significantly higher numbers of maternal and child deaths, unwanted pregnancies and disease related mortality in women and adolescents than in previous years. India alone is likely to record an additional 154,000 child deaths. Maternal deaths are estimated to rise by 18% and stillbirths by 10%. Of the 3.5 million additional unintended pregnancies estimated due to disruptions in access to reproductive healthcare, 3 million are likely to be in India.

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The unmet need for family planning services is already high and disruptions to health services will have far-reaching consequences for the health of women. Research suggests that as a result of the pandemic, 26 million couples in India will have no access to contraceptives. The inability to access contraceptives is likely to result in an additional 2.4 million unintended pregnancies and close to 2 million Indian women will be unable to access abortion services due to COVID 19.

Emergency situations, such as this pandemic, require even the strongest health systems to reorganise and prioritize the needs of vulnerable populations. India’s fragile healthcare sector is not equipped for the unprecedented rise in COVID-19 cases in this second wave. With only 5 hospital beds per 10,000 population and 8.6 physicians for every 10,000 people the country does not have the infrastructure for a crisis of this enormity. Moreover, inefficiency and acute shortages have not kept pace with the growing needs of the population. Under these prevailing circumstances there will also be severe implications for not only routine health services but also the COVID-19 vaccine roll-out. Challenges remain for the states as existing nursing personnel are expected to undertake both COVID-19 vaccination as well as provide routine health care services, including reproductive health services and immunisation. The differential pricing that has been proposed as the vaccine is opened to people below 45 will further underscore health inequity and inadequate supplies. It is likely that those who are most vulnerable or living in remote areas that are distant from health facilities will not have access to vaccination.

The disruption to essential health services due to the high burden of COVID-19 cases demonstrates the need to build health systems that have the capacity to not only cater to the ever-increasing demand for health services but also withstand crises such as this one. Shifting government priority to focus on health management and disease prevention is critical. So is ensuring greater equity in accessing healthcare – improving public health infrastructure is vital to ensuring quality health care for all.

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Frontline health workers have been the face of India’s fight against COVID over the last 12 months. Greater investments in their capacity building during and beyond the pandemic is necessary, given that they represent the first and often only point of contract with the public health system for rural women.

The COVID-19 pandemic poses one of the biggest health and humanitarian crises India and the world has ever witnessed. It has exacerbated existing challenges to public health, particularly for the most vulnerable and marginalised. As the government fire-fights to realign and redirect resources to where they are needed most, we must recognise that this pandemic has underscored the importance of investing in public health and prioritizing universal health coverage to ensure uninterrupted essential health services for India’s most vulnerable.

(The article was co-authored by Poonam Muttreja, Executive Director of the Population Foundation of India and Mandira Kalra Kalaan, Associate Director, Communication, Population Foundation of India.)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

19,78,31,904Cases
6,39,24,968Active
12,96,89,916Recovered
42,17,020Deaths
Coronavirus has spread to 194 countries. The total confirmed cases worldwide are 19,78,31,904 and 42,17,020 have died; 6,39,24,968 are active cases and 12,96,89,916 have recovered as on August 1, 2021 at 3:55 am.

India

3,16,55,824 41,831Cases
4,10,952 2,032Active
3,08,20,521 39,258Recovered
4,24,351 541Deaths
In India, there are 3,16,55,824 confirmed cases including 4,24,351 deaths. The number of active cases is 4,10,952 and 3,08,20,521 have recovered as on August 1, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

63,03,715 6,959

80,138 733

60,90,786 7,467

1,32,791 225

Kerala

33,90,761 20,624

1,65,011 3,679

32,08,969 16,865

16,781 80

Karnataka

29,05,124 1,987

23,820 318

28,44,742 1,632

36,562 37

Tamil Nadu

25,59,597 1,986

20,716 218

25,04,805 2,178

34,076 26

Andhra Pradesh

19,66,175 2,058

21,180 18

19,31,618 2,053

13,377 23

Uttar Pradesh

17,08,441 31

712 17

16,84,973 48

22,756

West Bengal

15,28,019 769

11,113 58

14,98,770 819

18,136 8

Delhi

14,36,265 58

581 1

14,10,631 56

25,053 1

Chhattisgarh

10,02,008 102

1,863 102

9,86,621 203

13,524 1

Odisha

9,77,268 1,578

14,538 389

9,56,828 1,899

5,902 68

Rajasthan

9,53,667 17

248 6

9,44,465 22

8,954 1

Gujarat

8,24,877 27

252 8

8,14,549 35

10,076

Madhya Pradesh

7,91,828 22

122 1

7,81,193 21

10,513

Haryana

7,69,913 29

712 0

7,59,566 27

9,635 2

Bihar

7,24,835 44

457 1

7,14,735 45

9,643

Telangana

6,44,951 621

9,069 72

6,32,080 691

3,802 2

Punjab

5,99,104 51

534 10

5,82,277 60

16,293 1

Assam

5,66,198 989

13,322 510

5,47,616 1,480

5,260 19

Jharkhand

3,47,173 36

252 8

3,41,793 44

5,128

Uttarakhand

3,42,139 116

632 13

3,34,145 129

7,362

Jammu And Kashmir

3,21,462 118

1,176 5

3,15,908 113

4,378

Himachal Pradesh

2,06,027 153

1,217 80

2,01,289 72

3,521 1

Goa

1,71,146 94

1,058 35

1,66,941 128

3,147 1

Puducherry

1,20,915 100

962 17

1,18,158 115

1,795 2

Manipur

98,499 801

10,540 195

86,403 981

1,556 15

Tripura

78,583 222

3,482 2

74,346 224

755

Meghalaya

65,000 686

5,966 175

57,949 499

1,085 12

Chandigarh

61,953 1

31 5

61,111 5

811 1

Arunachal Pradesh

48,122 266

3,954 188

43,939 451

229 3

Mizoram

38,925 861

12,388 213

26,387 643

150 5

Nagaland

27,872 159

1,329 55

25,977 99

566 5

Sikkim

26,548 237

3,400 98

22,804 137

344 2

Ladakh

20,338 10

56 6

20,075 4

207

Dadra And Nagar Haveli

10,650 6

29 1

10,617 7

4

Lakshadweep

10,189 11

84 7

10,055 4

50

Andaman And Nicobar Islands

7,537 2

8 0

7,400 2

129

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