ABSTRACT
BackgroundThe remarkable progress seen in maternal and child health (MCH) in India over the past two decades has been impacted by setbacks from the COVID-19 pandemic. We aimed to undertake a rapid assessment to identify key priorities for public health research in MCH in India within the context and aftermath of the COVID-19 pandemic. MethodsA web-based survey was developed to identify top research priorities in MCH. It consisted of 26 questions on six broad domains: vaccine preventable diseases, outbreak preparedness, primary healthcare integration, maternal health, neonatal health, and infectious diseases. Key stakeholders were invited to participate between September and November 2020. Participants assigned importance on a 5-point Likert scale, and assigned overall ranks to each sub-domain research priority. Descriptive statistics were used to examine Likert scale responses, and a ranking analysis was done to obtain an "average ranking score" and identify the top research priority under each domain. ResultsAmongst the 84 respondents, 37% were public-health researchers, 25% healthcare providers, 20% academic faculty and 13% were policy makers. Across the six domains, most respondents considered conducting research on systems strengthening as extremely important. The highest ranked research priorities were strengthening the public sector workforce (vaccine preventable diseases), enhancing public-health surveillance networks (outbreak preparedness), nutrition support through community workers (primary care integration), encouraging at least 4-8 antenatal visits (maternal health), neonatal resuscitation to reduce birth asphyxia (neonatal health) and pediatric and maternal screening and treatment of tuberculosis (infectious diseases). Common themes identified through open-ended questions were also systems strengthening priorities across domains. ConclusionsThe overall focus for research priorities in MCH in India during the COVID-19 pandemic is on strengthening existing services and service delivery, rather than novel research. Our results highlight pivotal steps within the roadmap for advancing and sustaining maternal and child health gains during the ongoing COVID-19 pandemic and beyond.
ABSTRACT
Background and ObjectiveThe COVID-19 pandemic has led to disruptions to routine immunization programs in India and around the world, setting the stage for potentially serious outbreaks of vaccine-preventable diseases. MethodsWe surveyed pediatric healthcare providers in India in 2 rounds in April-June and September 2020 to understand how COVID-19 control measures may have impacted routine vaccination. ResultsRespondents were predominantly pediatricians working in primary, secondary or tertiary healthcare centers, across 21 Indian states and two union territories. Among the 424 (survey 1) and 141 (survey 2) respondents, 33.4% and 7.8%, respectively, reported near complete suspension of vaccination services due to COVID-19. A 50% or greater drop in vaccination services was reported by 83.1% of respondents in June, followed by 32.6% four months later, indicating slow recovery of services. By September 2020, 83.6% were aware of updated guidelines on safe provision of immunization services, although awareness of specific catch-up vaccination plans was low, and 76.6% expressed concern about a vaccine coverage gap that could potentially lead to increased non-COVID-19 illnesses and deaths. ConclusionsPandemic-related disruptions to vaccination services were reported by pediatricians across India. Concerted efforts are needed from governing and academic groups to ensure that routine immunization and catch-up programs are implemented during this pandemic, which can sustain gains in vaccination coverage and provide a robust blueprint for the national roll-out of the COVID-19 vaccine.
