Impact on Public Health Nutrition Services Due to COVID-19 Pandemic in India: A Scoping Review of Primary Studies on Health and Social Security Determinants Affecting the First 1000 Days of Life.

CONTEXT: COVID-19 was declared 'a global pandemic' by the World Health Organization in March 2020. India's lockdown, one of the harshest in the world, came with additional challenges for women. This paper aims to assess the impact of COVID-19 pandemic-related pathways on the first thousand days of life in the Integrated Child Development Scheme and the public distribution ecosystem in India. DATA SOURCES: Using Cochrane guidelines, electronic databases, namely Google Scholar and PubMed-NCBI, were searched for evidence between 1 March 2020 and 1 May 2022. A total of 73 studies were identified in initial search; 20 met the inclusion criteria and, thus, were included in the research analysis. Primary studies were conducted throughout pan-India in rural, urban, and semi-urban areas to study the impact of COVID-19 pandemic-related pathways on the first 1000 days of life. The impact of social security, food insecurity, service delivery, nutrition of pregnant and nursing mothers (P&NMs), and infant and young child feeding (IYCF) varied between geographies and within geographies. Most of the primary studies were conducted at small scale, while only three studies were pan-Indian. The majority of studies were conducted on the mental health of P&NMs and pre-natal and post-natal service delivery disruption. The paucity of the available literature highlights the need to undertake research on the impact of the COVID-19 pandemic-related pathways on 1000 days of life in India and worldwide. The best implementation practices were observed where cross-sectional programs were carried out in relation to health services and social security for P&NMs and children.

Disruptions, restorations and adaptations to health and nutrition service delivery in multiple states across India over the course of the COVID-19 pandemic in 2020: An observational study.

BACKGROUND: Modeling studies estimated severe impacts of potential service delivery disruptions due to COVID-19 pandemic on maternal and child nutrition outcomes. Although anecdotal evidence exists on disruptions, little is known about the actual state of service delivery at scale. We studied disruptions and restorations, challenges and adaptations in health and nutrition service delivery by frontline workers (FLWs) in India during COVID-19 in 2020. METHODS: We conducted phone surveys with 5500 FLWs (among them 3118 Anganwadi Workers) in seven states between August-October 2020, asking about service delivery during April 2020 (T1) and in August-October (T2), and analyzed changes between T1 and T2. We also analyzed health systems administrative data from 704 districts on disruptions and restoration of services between pre-pandemic (December 2019, T0), T1 and T2. RESULTS: In April 2020 (T1), village centers, fixed day events, child growth monitoring, and immunization were provided by <50% of FLWs in several states. Food supplementation was least disrupted. In T2, center-based services were restored by over a third in most states. Administrative data highlights geographic variability in both disruptions and restorations. Most districts had restored service delivery for pregnant women and children by T2 but had not yet reached T0 levels. Adaptations included home delivery (60 to 96%), coordinating with other FLWs (7 to 49%), and use of phones for counseling (~2 to 65%). Personal fears, long distances, limited personal protective equipment, and antagonistic behavior of beneficiaries were reported challenges. CONCLUSIONS: Services to mothers and children were disrupted during stringent lockdown but restored thereafter, albeit not to pre-pandemic levels. Rapid policy guidance and adaptations by FLWs enabled restoration but little remains known about uptake by client populations. As COVID-19 continues to surge in India, focused attention to ensuring essential services is critical to mitigate these major indirect impacts of the pandemic.

Digital Storytelling and Community Engagement to Find Missing TB Cases in Rural Nuh, India.

Nuh, Haryana, is one of India's least developed districts. To improve TB case notifications, ZMQ carried out an active case-finding (ACF) intervention conducted by community health workers (MIRAs) using a digital TB storytelling platform to create TB awareness in the community. The combined storytelling and ACF intervention were conducted house-to-house or in community group settings. Steps included (A) the development of digital TB awareness-raising stories using a participatory approach called Story Labs; (B) the implementation of the intervention; and (C) process, outcome, and impact evaluation of these activities. Six digital stories were created and used during ACF in which 19,345 people were screened and 255 people were diagnosed with TB. Of 731 participants surveyed, the stories were well received and resulted in an increase in TB knowledge. ACF activities resulted in a 56% increase in bacteriologically confirmed TB and an 8% decrease in all forms of TB compared to baseline. All form notifications may have been impacted by COVID-19 lockdowns. Digital TB storytelling can improve TB awareness and knowledge, particularly for low-literacy populations. The use of these tools may benefit ACF campaigns and improve TB case finding.

Review of Thoracic Imaging Manifestations of COVID-19 and Other Pathologic Coronaviruses.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an easily transmissible coronavirus that emerged in late 2019 and has caused a global pandemic characterized by acute respiratory disease named coronavirus disease 2019 (COVID-19). Diagnostic imaging can be helpful as a complementary tool in supporting the diagnosis of COVID-19 and identifying alternative pathology. This article presents an overview of acute and postacute imaging findings in COVID-19.