Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
Source of Support: None, Conflict of Interest: None
The ongoing coronavirus disease-2019 (COVID-19) pandemic continues to disrupt the health-care services, including the essential ones, even after the detection of the novel viral infection 2 years back. The population group comprising mothers, antenatal women, newborns, children, adolescents, and elderly people is a vulnerable one. The COVID-19 pandemic has significantly accounted for the disruption of services targeting the above population groups, especially in low- and middle-income nations. COVID-19 pandemic has resulted in a wide range of problems targeting the above population groups, which has indirectly impacted the delivery of care and services. There arises the need to take specific measures to reduce the impact of the potential problems that have emerged. To conclude, the COVID-19 pandemic has resulted in significant interruptions in the health-care services aimed for the welfare of mothers, antenatal women, newborns, children, adolescents, and elderly people. However, as these are vital population groups, we have to adopt a multisectoral approach involving different stakeholders and move forward toward improving the reach of health-care services.
The population group comprising mothers, antenatal women, newborns, children, adolescents, and elderly people is a vulnerable one.,,, With reference to antenatal women, there has been a significant cause of concern pertaining to the risk of vertical transmission of the COVID-19 infection to the newborn, and that has emerged as an important reason to cause fear and anxiety., The newborns are found to be extremely susceptible to acquire the infection once the parents acquire the infection, as they are pretty much dependent on them for their survival., In most of the nations, the available vaccines have not been recommended for use among children and adolescents, and thus these population groups remain extremely susceptible to acquire the infection, especially now as the decisions have been taken to initiate offline schooling., The adolescent population groups have also been subjected to impairment of their mental health and multiple psychological disturbances owing to the ongoing pandemic., The vulnerability of the elderly population group has been known since the early stages of the emergence of the infection owing to the simultaneous presence of coexisting morbidities, which have been found to have a direct impact on the prognosis and survival.,
The COVID-19 pandemic has significantly accounted for the disruption of services targeting the above population groups, especially in low-and middle-income nations, which simultaneously have to deal with many competing priorities. COVID-19 pandemic has resulted in a wide range of problems targeting the above population groups, which has indirectly impacted the delivery of care and services., The first and foremost problem has been a decrease in the care provided to the beneficiaries, which has in turn resulted because of a temporary interruption in services, leaves availed by the health care staff, interruption in the supply chain, and because of the sense of fear among the health workers about acquiring the infection and developing complications, including a fatal outcome.,,
At the same time, a significant reduction in the demand for health-care services has also been reported. This has resulted because people are not willing to avail care due to a lack of trust or the fear that if they visit the health facilities, they might acquire the infection. As a matter of fact, in some of the settings even contrasting trends in terms of rising need for health care has also been reported and this is because of the presence of multiple other infectious and noncommunicable diseases have also kept the health care systems engaged. Furthermore, the issues of mental disorders, insecurity, gender-based violence, population displacement, malnutrition, etc., have also continued as public health priorities, thereby impacting the quality of care required for mothers, antenatal women, newborns, children, adolescents, and elderly people.,,,,, Moreover, the concerns pertaining to the similar clinical presentation of other illnesses (such as malaria and Ebola virus disease) also make it difficult for the health sector.
| Strategies to Minimize the Impact of Problems|| |
We must realize that most of the above-identified problems have resulted because of the public health and social measures that are planned and implemented to reduce the transmission of the infection. Further, the reduction in the coverage of essential maternal and child health services will account for the additional number of maternal and child deaths. There arises the need to take specific measures to reduce the impact of the potential problems that have emerged.,, The first and foremost intervention is to improve access to health-care services or explore substitutes, to ensure that health-care services are closer to the general population., This can be accomplished by providing mental health care (through schools or psychological first aid), abortion care through referral centers, general health through mobile clinics, nutrition services to newborns through breastfeeding tents, transportation services through a network of ambulance systems, and minimizing financial load by providing cash transfer, through the removal of user fees, or through copayment.,,,,,,,,,
The next intervention is to maintain and strengthen the available health workforce to meet the potential health-care needs., This can be attained by organizing regular training for all levels of health care workers (such as doctors, nurses, midwives, general practitioners, and specialists). In addition, measures to improve access of health professionals for mental health counseling, periodic group briefings to keep them informed, motivating health professionals, ensuring their safety, and providing incentives and adequate personal protective equipment to them, are also expected to improve the existing scenario.,,,,,, The next area is to ensure collaboration between different health-care services, institutions, and health professionals, and this can be attained by designing an appropriate protocol for the same or by establishing liaison with the local partners.,
In the era of information technology and considering the fact that the COVID-19 pandemic spreads by close contact, the ideal approach to remove the existing barriers will be through the employment of digital health interventions. This can be translated into clinical practice through the adoption of telemedicine services (such as teleradiology and web-based mental health counseling), portable ultrasound, use of mobile-based applications, and initiation of online programs for the management of different psychiatric illnesses., Finally, we have to ensure access to essential supplies and products (such as drugs and vaccines), and this will essentially require optimal allocation of resources and mass media campaigns to continue the practice of blood donation. In addition, we have to ensure the availability of cold boxes for the transportation of vaccines, vaccine vial monitor to check for the potency of vaccines, and distribute contraceptives to all those who are in need of the same.,,
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