Covid-19 in Rural Areas: A Policy Brief

The pandemic affects rural areas as much as it does urban areas, though the spread in rural areas began later than in urban area. However, because of greater health inequities and poor access to health care in rural areas, the consequences of the pandemic could be worse in rural areas. We draw on existing data from various sources including print media in order to examine and contextualise urban-rural differentials and the State's response to the Covid-19 pandemic. In the short run, protecting rural areas from further suffering caused by the pandemic requires a combination of a robust disease surveillance programme, an effective health communication strategy, and a public outreach programme that ensures universal vaccination. In the long run, health systems preparedness and resilience require greater public health expenditure, strengthening public health services, and ensuring that these services have adequate surge capacity and support from effective public health informatics.

COVID-19 in rural areas: a policy brief

The pandemic affects rural areas as much as it does urban areas, though the spread in rural areas began later than in urban area. However, because of greater health inequities and poor access to health care in rural areas, the consequences of the pandemic could be worse in rural areas. We draw on existing data from various sources including print media in order to examine and contextualise urban-rural differentials and the State's response to the Covid-19 pandemic. In the short run, protecting rural areas from further suffering caused by the pandemic requires a combination of a robust disease surveillance programme, an effective health communication strategy, and a public outreach programme that ensures universal vaccination. In the long run, health systems preparedness and resilience require greater public health expenditure, strengthening public health services, and ensuring that these services have adequate surge capacity and support from effective public health informatics.

Discourses around Stigma and Denial in the COVID-19 Pandemic : A Case Study from Tamil Nadu

A widespread but underexplored aspect of the Covid-19 pandemic in India has been the prevalence of stigma and denial at different levels in the community mediated by state policy and actions. Based on a fi eld study in three districts of Tamil Nadu between the two waves of the pandemic, this article explores the nature of stigma and denial and their consequence for health-seeking behaviour and access to healthcare. © 2022 Economic and Political Weekly. All rights reserved.

Pandemic resilience and health systems preparedness: lessons from COVID-19 for the twenty-first century.

The pandemic of COVID-19 disease has acted like a stress test on every aspect of life, but particularly exposed weaknesses of health systems design and capacity. There have been similar pandemics in the past, and the threat of more frequent future pandemics in the twenty-first century is real. It is therefore important to learn the right lessons with regard to health systems preparedness and resilience. The five design features that this paper discusses are related to the organization of primary care services, planned surge capacity in secondary and tertiary care, a robust disease surveillance system that is integrated with the health management information system, adequate domestic capacity in being able to innovate and scale up production and logistics of much needed medical products and a governance approach that recognizes the importance of the health systems being able to continuously learn and adapt to meet changing needs. In addition to this, the organizational capacity of the system to deliver required services would need more investment in financial resources, and a suitable health human resource policy.

Good public health logistics for resilient health systems during the pandemic: Lessons from Tamil Nadu.

The article highlights the importance of strengthening of public systems and the need for rapid scaling up of access to testing and to appropriate therapeutics in the context of the Covid-19 pandemic, to have in place robust public procurement systems for drugs and diagnostics. The paper draws lessons from the Tamil Nadu experience and validates the understanding that investing in public institutions is essential for rapid responsiveness to pandemics and other public health emergencies from both the ethical and health systems points of view.

Challenges to India's rural healthcare system in the context of COVID-19. (Special Issue: The impact of the covid-19 pandemic.)

This article explores the likely spread of Covid-19 to rural areas in India and the preparedness of Indian rural healthcare systems to meet the demands created by the pandemic. Less well recognized are the lockdown's adverse impacts on the social determinants of health and on access to essential health services. If the impact of this disease is similar to that of earlier contagious diseases like TB, it will have a greater adverse impact on socio-economically disadvantaged populations. For example, although both infection and case fatality are higher in males, 70 per cent of health and social service staff, globally, are women, putting them at a higher risk of contracting Covid-19. Also, there are other gendered effects that flow from the lockdown, rather than the virus. For instance, domestic violence increased globally during the 2014-16 Ebola and 2015-16 Zika epidemics, and is increasing during the Covid-19 pandemic as well. Although India's Covid-19 death rates may be lower than elsewhere because of India's younger population, this demographic advantage may be offset by the threat of malnutrition. One recent post-lockdown study by PRADHAN conducted in 12 States showed that 50 per cent of rural households are eating less than usual, and 68 per cent have reduced the number of food items from their meals. The workforce in health must have regular employment. It is difficult, if not impossible, to provide universal access to quality public services using only contractual or contracted-in employment. If public policy supports a meaningful expansion of public sector employment, it could be an effective way to address burgeoning poverty and unemployment as well as the lack of social security across rural India.

Health systems preparedness for COVID-19 pandemic.

Some nations in the world and some states in India have had more success in containing this pandemic. Recent efforts in strengthening the health sector have focused largely on reforms in modes of financing, but as the pandemic brings home to us, the main challenge in India remains the challenge of the organization of public services using a health systems understanding. A close to community comprehensive primary health care, quality assurance, and planned excess capacity in public health systems, a more robust disease surveillance systems that can integrate data on new outbreaks and the indigenous technological capacity to scale up innovation and manufacture of essential health commodities are some of our most important requirements for both epidemic preparedness and response.