Challenges to research implementation during public health emergencies: anecdote of insights and lessons learned during the COVID-19 pandemic in Gujarat, India (preprint)

ABSTRACT

Background: Health emergencies, including pandemics, are not entirely new occurrences; some notable ones occurred in the past. However, the scale of the COVID-19 pandemic is unprecedented. The COVID-19 pandemic exposed the unpreparedness of national health systems in effectively managing health emergencies. During the pandemic, controlling the spread of the virus and hopes of exiting into a post-pandemic era were reliant on research to improve patient care and inform government policies. Nonetheless, research implementation during health emergencies can be challenging in low-resourced settings. This paper presents anecdotes of experiences encountered in implementing a research project during the COVID-19 pandemic in Gujarat, India, and offers insights into ways research can be supported during health emergencies. Methods: We implemented a longitudinal study to investigate the impact of the COVID-19 pandemic, including SARS-CoV-2 infection, during pregnancy on birth outcomes, growth, and development in early childhood. The study utilises hospital records and databases to recruit women who were infected with SARS-CoV-2 during pregnancy and those with no known infection. Mother-infant pairs in the infected and uninfected group were then followed longitudinally for over 3 years. Results: Observations of challenges encountered during implementation of the research, including those related to planning, retrieval of hospital records, tracking, recruitment, and follow-up of eligible women were recorded by study staff, and the observations produced as anecdotes. The challenges observed are group into three overarching themes a) individual factors, b) health system challenges, and c) research operational challenges. Some notable observations include misinformation, misconception, mistrust, underdeveloped health record systems, stigma, and hesitance. Conclusion: We believe early planning, effective communication, and community awareness are likely to be helpful in implementing a successful research project. Additionally, efforts at improving collaboration and co-creation between health practitioners, researchers and the public may benefit the implementation of research projects during a health emergency.