ABSTRACT
Background: Achieving universal health coverage (UHC) is critical for ensuring equity, improving health, and protecting households from financial catastrophe. The COVID-19 pandemic derailed the progress made across primary health targets. This article aims to review the policy challenges to achieve UHC in a post-pandemic world. Methods: A narrative review of 118 peer reviewed and grey literature was conducted. A total of 77 published articles were identified using an electronic search in PubMed and Scopus and a bibliographic search of relevant literature. Another 41 Reports, websites, blogs, news articles, and data were manually sourced from international agencies (WHO, World Bank, IMF, FAO, etc.), government agencies, and non-government organizations. Findings: The challenges were identified and discussed under five broad findings: i) weak public health care systems ii) challenges to building resilient health systems, iii) health care financing and financial risk protection, iv) epidemiological and demographic challenges, and v) governance and leadership. Conclusion: LMICs in Africa and South Asia face significant challenges to achieving UHC by 2030. As countries recover from the pandemic's aftermath, significant investments and innovations are needed to ensure progress toward UHC. Efficient resource mobilization through internal accruals, international cooperation, and resource sharing is needed.
ABSTRACT
Purpose: Reports suggest that females experience more adverse events post-coronavirus disease 2019 (COVID-19) vaccination compared to males. However, no gender-specific data on the impact of vaccines on the Indian population are available. The present study was intended to understand the impact of COVID-19 vaccines on the health status of young Indian female adults and to identify the factors associated with experiencing adverse events post-vaccination. Methods: A web-based survey was conducted among 433 young female adults who have taken at least one dose of the COVID-19 vaccine. The prevalence and duration of systemic and generalized symptoms were analyzed using descriptive statistics. The factors associated with symptoms post-vaccination were analyzed using binary logistic regression. Adjusted odds ratios and 95% confidence intervals were computed. A P value of ≤ 0.05 was considered to be statistically significant. Results: Of the 404 surveys returned (93.3%), 371 respondents have received both vaccine doses. COVISHIELD™ was the vaccine of choice among 73% of respondents and nearly 91% of the respondents reported a re-infection post-vaccination. At least one form of the symptom as a side effect of vaccination was experienced by 88.4% (n = 357) of the participants. This included generalized symptoms (77.5%) followed by musculoskeletal (53.2%), localized (38.9%), psychological (35.1%), gastrointestinal (25.5%), gynecological (24%), and endocrine symptoms (22.5%). Presence of chronic ailments was significantly associated with experiencing localized symptoms (OR 2.21, 95% CI 1.25-3.91), psychological symptoms (OR 2.41, 95% CI 1.34-4.34), neurological symptoms (OR 2.98, 95% CI 1.38-6.46), gastrointestinal symptoms (OR 4.76, 95% CI 2.59-8.75), respiratory symptoms (OR 2.45, 95% CI 1.29-4.67), endocrine symptoms (OR 2.92, 95% CI 1.58-5.38), and gynecological symptoms (OR 4.05, 95% CI 2.21-7.44). Older than 21 years was significantly associated with the experience of gynecologic symptoms (OR 2.12, 95% CI 1.24-3.64). Not being re-infected post-vaccination has lower odds of experiencing psychological, gastrointestinal, and respiratory symptoms. Conclusion: Our result suggests serious planning and counseling are warranted while disseminating COVID-19 vaccination among young female adults especially those with comorbidities to foster trust and coverage.
ABSTRACT
The mHealth app Arogya Setu can substantially contribute to the containment and management of COVID-19. This study explores the experiences and expectations of Arogya Setu app users by conducting a combined content analysis of their reviews. Five hundred and three most relevant reviews were analyzed using the descriptive statistics and thematic analysis. The reviews are primarily posted in the areas of user acceptance (80%), app usefulness (72.8%), and app features (62.2%). The thematic analysis resulted in four themes: user acceptance, app usefulness, promptness of the Indian Government in bringing the app on time, and concerns and cautions raised by the users. These help in strengthening the app features enabling the real-time data capture and analytics and providing timely information to authorities for better decision-making.