Opinion: How Renewed Lockdowns Might Affect Women’s Health Services In Rural India And Further Tire Already Weak Systems | Blogs

April 28, 2021 0 Comments



According to experts, COVID-19 has impacted women’s access to high quality uninterrupted services

With over 312,000 cases registered on April 21st India’s daily caseload is now the highest of any country since the pandemic began over a year ago. With an overall caseload over 15 million, the second highest after the United States, the country’s fragile health infrastructure is being pushed to a breaking point. Reports from state after state suggest that patients and their families are scrambling to secure hospital beds and governments are struggling to provide oxygen and critical life-saving medicines for serious patients.

Also Read: Discrimination And Barriers Make Access To Quality Healthcare A Challenge For Many Transgenders

Several health facilities, including AIIMS in Delhi, which have been treating large numbers of non-COVID patients through the pandemic have suspended routine OPD services. Doctors, nurses and other healthcare professionals are being diverted to COVID-only duty as states convert non-COVID hospitals into COVID treatment centres. As we had witnessed during the lockdown last year, it is likely that health care services will be affected due to local restrictions already in place in a number of states and union territories, and health facilities either shut down or converted for delivering pandemic related services. Furthermore, restrictions on mobility and fear of health centres also reduce access to health care services, including family planning and reproductive health services. With ASHAs, ANMs and Anganwadi Workers diverted to COVID care and limited outreach services such as Village Health, Sanitation and Nutrition Days (VHSND), the effect in rural areas is magnified.

Population Foundation of India’s own analysis of the first lockdown shows that there have been severe drops in access to contraception, ante-natal care services and institutional deliveries. In Bihar, Rajasthan and Uttar Pradesh, adolescents reported an unmet need for reproductive health services, especially menstrual hygiene products. While it is commendable that the Ministry of Health and Family Welfare (MOHFW) included reproductive health services in the list of essential services, women’s access to high quality uninterrupted services have been impacted.

A recent UNICEF report, Direct and Indirect Effects of COVID-19 Pandemic and Response in South Asia, estimates that disruptions due to the pandemic will result in significantly higher numbers of maternal and child deaths, unwanted pregnancies and disease related mortality in women and adolescents than in previous years. India alone is likely to record an additional 154,000 child deaths. Maternal deaths are estimated to rise by 18% and stillbirths by 10%. Of the 3.5 million additional unintended pregnancies estimated due to disruptions in access to reproductive healthcare, 3 million are likely to be in India.

Also Read: ‘Indian Strain’ Of Coronavirus Spreads Faster, But Little Evidence Of It Being More Lethal: Experts

The unmet need for family planning services is already high and disruptions to health services will have far-reaching consequences for the health of women. Research suggests that as a result of the pandemic, 26 million couples in India will have no access to contraceptives. The inability to access contraceptives is likely to result in an additional 2.4 million unintended pregnancies and close to 2 million Indian women will be unable to access abortion services due to COVID 19.

Emergency situations, such as this pandemic, require even the strongest health systems to reorganise and prioritize the needs of vulnerable populations. India’s fragile healthcare sector is not equipped for the unprecedented rise in COVID-19 cases in this second wave. With only 5 hospital beds per 10,000 population and 8.6 physicians for every 10,000 people the country does not have the infrastructure for a crisis of this enormity. Moreover, inefficiency and acute shortages have not kept pace with the growing needs of the population. Under these prevailing circumstances there will also be severe implications for not only routine health services but also the COVID-19 vaccine roll-out. Challenges remain for the states as existing nursing personnel are expected to undertake both COVID-19 vaccination as well as provide routine health care services, including reproductive health services and immunisation. The differential pricing that has been proposed as the vaccine is opened to people below 45 will further underscore health inequity and inadequate supplies. It is likely that those who are most vulnerable or living in remote areas that are distant from health facilities will not have access to vaccination.

The disruption to essential health services due to the high burden of COVID-19 cases demonstrates the need to build health systems that have the capacity to not only cater to the ever-increasing demand for health services but also withstand crises such as this one. Shifting government priority to focus on health management and disease prevention is critical. So is ensuring greater equity in accessing healthcare – improving public health infrastructure is vital to ensuring quality health care for all.

Also Read: Second Wave Of Coronavirus: Countries Promise Medical Support To India Amid Rising COVID-19 Cases

Frontline health workers have been the face of India’s fight against COVID over the last 12 months. Greater investments in their capacity building during and beyond the pandemic is necessary, given that they represent the first and often only point of contract with the public health system for rural women.

The COVID-19 pandemic poses one of the biggest health and humanitarian crises India and the world has ever witnessed. It has exacerbated existing challenges to public health, particularly for the most vulnerable and marginalised. As the government fire-fights to realign and redirect resources to where they are needed most, we must recognise that this pandemic has underscored the importance of investing in public health and prioritizing universal health coverage to ensure uninterrupted essential health services for India’s most vulnerable.

(The article was co-authored by Poonam Muttreja, Executive Director of the Population Foundation of India and Mandira Kalra Kalaan, Communication Expert, Population Foundation of India.)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

14,87,14,865Cases

5,93,34,719Active

8,62,45,217Recovered

31,34,929Deaths

Coronavirus has spread to 192 countries. The total confirmed cases worldwide are 14,87,14,865 and 31,34,929 have died; 5,93,34,719 are active cases and 8,62,45,217 have recovered as on April 28, 2021 at 4:35 am.

India

1,79,97,267 360960Cases

29,78,709 96505Active

1,48,17,371 261162Recovered

2,01,187 3293Deaths

In India, there are 1,79,97,267 confirmed cases including 2,01,187 deaths. The number of active cases is 29,78,709 and 1,48,17,371 have recovered as on April 28, 2021 at 2:30 am.

State & District Details

State Cases Active Recovered Deaths

DistrictCases

Mumbai45,478

Thane13,660

Pune9,920

Mumbai Suburban5,363

Aurangabad1,974

Nashik1,575

Raigad1,462

Palghar1,421

Solapur1,291

Jalgaon1,039

Akola757

Nagpur692

Kolhapur646

Satara629

Ratnagiri350

Amravati291

Dhule228

Hingoli208

Jalna201

Ahmednagar190

Nanded176

Yavatmal150

Sangli145

Latur139

Osmanabad125

Sindhudurg114

Buldhana88

Parbhani78

gondia69

Beed54

Nandurbar42

Gadchiroli42

Bhandara41

Chandrapur32

Washim13

Wardha11

44,10,085 66,358

6,74,358 2,289

36,69,548 67,752

66,179 895

DistrictCases

Kannur357

Kasaragod333

Palakkad224

Malappuram119

Kollam118

Thrissur106

Thiruvananthapuram104

Pathanamthitta98

Kozhikode90

Alappuzha76

Kottayam73

Ernakulam60

Idukki40

Wayanad36

14,60,364 32,819

2,47,514 14,374

12,07,680 18,413

5,170 32

DistrictCases

Udupi1,176

Kalaburagi669

Yadgir538

Bengaluru Urban529

Raichur369

Mandya346

Belagavi337

Bidar219

Hassan205

Davangere204

Vijayapura201

Dakshina Kannada179

Chikkaballapura149

Mysuru107

Bagalkote103

Uttara Kannada95

Shivamogga67

Dharwad61

Ballari60

Gadag45

Bengaluru Rural40

Tumakuru36

Kolar29

Haveri24

Chikkamagaluru19

Chitradurga14

Koppal5

Kodagu4

Ramanagara3

Chamarajanagara0

14,00,775 31,830

3,01,918 20,857

10,84,050 10,793

14,807 180

DistrictCases

Gautam Buddha Nagar1,119

Agra933

Ghaziabad794

Meerut504

Lucknow386

Saharanpur298

Kanpur Nagar286

Moradabad252

Varanasi243

Hapur225

Aligarh215

Basti214

Amethi206

Rampur203

Jaunpur194

Firozabad190

Barabanki168

Gorakhpur166

Bulandshahr166

Siddharth Nagar159

Ghazipur159

Bijnor157

Deoria143

Azamgarh138

Sant Kabeer Nagar132

Mathura129

Ayodhya120

Muzaffarnagar117

Sambhal116

Sultanpur97

Ambedkar Nagar92

Maharajganj85

Amroha80

Rae Bareli78

Bahraich73

Kheri72

Kannauj69

Baghpat68

Kushi Nagar67

Bhadohi60

Ballia60

Gonda59

Etah52

Hardoi49

Balrampur49

Mau48

Mainpuri46

Etawah46

Hathras43

Unnao42

Jalaun41

Jhansi41

Shamli40

Chandauli38

Auraiya37

Farrukhabad36

Sitapur32

Prayagraj30

Banda27

Shahjahanpur25

Shravasti23

Budaun23

Mirzapur22

Bareilly17

Kasganj16

Pratapgarh15

Pilibhit15

Sonbhadra10

Kaushambi6

Kanpur Dehat4

Chitrakoot4

Lalitpur3

Hamirpur3

Mahoba3

Fatehpur3

11,53,097 32,921

3,06,458 2,259

8,34,961 30,398

11,678 264

DistrictCases

Chennai23,324

Chengalpattu1,314

Thiruvallur774

Villupuram509

Kanchipuram503

Tiruvannamalai496

Cuddalore477

Ariyalur444

Tirunelveli433

Tuticorin333

Kallakurichi324

Madurai322

Salem258

Coimbatore188

Virudhunagar185

Dindigul175

Perambalur133

Ranipet133

Thanjavur130

Theni129

Tiruchirappalli119

Ramanathapuram119

Tiruppur116

Kanniyakumari110

Tenkasi103

Nagapattinam99

Karur88

Namakkal83

Erode75

Vellore71

Thiruvarur67

Pudukkottai53

Sivaganga46

Tirupathur45

Krishnagiri43

The Nilgiris17

Dharmapuri15

11,13,502 15,830

1,08,855 1,710

9,90,919 14,043

13,728 77

DistrictCases

North West5,463

Central4,817

West4,768

New Delhi3,405

North3,059

East2,472

South East2,446

South West2,391

South2,329

North East1,914

Shahdara1,580

10,72,065 24,149

98,264 5,906

9,58,792 17,862

15,009 381

DistrictCases

Kurnool795

Krishna557

Guntur511

Anantapur428

East Godavari356

Chittoor319

Sri Potti Sriramulu Nell*296

Y.S.R.205

West Godavari199

Srikakulam183

Prakasam104

Visakhapatnam103

Vizianagaram23

10,54,875 11,434

99,446 4,315

9,47,629 7,055

7,800 64

DistrictCases

Kolkata2,777

Howrah1,435

24 Paraganas North1,031

Hooghly604

24 Paraganas South281

Maldah235

Dinajpur Uttar216

Coochbehar210

Birbhum206

Medinipur West159

Medinipur East153

Nadia139

Purba Bardhaman130

Murshidabad125

Bankura116

Darjeeling97

Jalpaiguri88

Paschim Bardhaman70

Purulia66

Dinajpur Dakshin50

Alipurduar39

Kalimpong18

Jhargram9

7,76,345 16,403

1,00,615 5,666

6,64,648 10,664

11,082 73

DistrictCases

Bilaspur100

Korba100

Mungeli87

Baloda Bazar85

Jashpur77

Janjgir-Champa56

Mahasamund54

Rajnandgaon52

Kabirdham52

Raigarh47

Raipur46

Balod41

Korea39

Durg31

Bemetara21

Kanker19

Balrampur17

Surguja14

Gariyaband10

Surajpur9

Dhamtari6

Bijapur2

Bastar2

Dantewada0

Kondagaon0

Narayanpur0

Sukma0

6,82,339 14,893

1,19,068 2,284

5,55,489 16,931

7,782 246

DistrictCases

Jaipur2,177

Jodhpur1,748

Udaipur724

Bharatpur563

Kota503

Nagaur500

Ajmer379

Dungarpur374

Pali352

Jhalawar329

Bhilwara250

Sikar231

Chittorgarh188

Tonk171

Jalore164

Rajsamand140

Sirohi130

Bikaner112

Banswara91

Alwar90

Churu81

Jhunjhunu64

Dausa61

Dholpur60

Baran59

Jaisalmer53

Barmer34

Hanumangarh31

SawaiMadhopur26

Karauli17

Pratapgarh14

Ganganagar8

Bundi5

5,46,964 16,089

1,55,182 8,542

3,87,976 7,426

3,806 121

DistrictCases

Indore3,839

Bhopal1,880

Ujjain799

Burhanpur351

Neemuch319

Jabalpur276

East Nimar266

Sagar228

Gwalior211

Khargone196

Dewas140

Dhar132

Mandsaur112

Morena109

Bhind87

Raisen71

Barwani60

Ratlam51

Rewa39

Shajapur39

Hoshangabad37

Vidisha37

Chhatarpur35

Betul35

Rajgarh31

Dindori29

Sheopur26

Damoh26

Satna24

Anuppur22

Panna20

Tikamgarh18

Sidhi17

Narsinghpur17

Chhindwara16

Agar Malwa15

Mandla15

Shivpuri15

Jhabua14

Shandol14

Singrauli13

Ashoknagar13

Datia12

Sehore12

Umaria10

Balaghat9

Guna8

Harda4

Alirajpur3

Katni3

Seoni2

Niwari0

5,25,407 13,417

94,276 1,742

4,25,812 11,577

5,319 98

DistrictCases

Ahmadabad17,125

Surat2,311

Vadodara1,555

Gandhinagar410

Mahesana159

Banas Kantha147

Bhavnagar146

Rajkot135

Arvalli134

Mahisagar125

Anand107

PanchMahals107

Patan105

SabarKantha101

Kachchh99

Kheda98

Jamnagar63

Bharuch56

Botad55

Surendranagar55

Valsad47

GirSomnath45

Dohad43

Chhotaudepur37

Naysari35

Junagadh31

Narmada25

DevbhumiDwarka22

Amreli16

Porbandar11

Tapi6

Dang5

Morbi4

5,24,725 14,352

1,27,840 6,379

3,90,229 7,803

6,656 170

DistrictCases

Gurugram2,950

Faridabad867

Sonipat404

Rohtak145

Palwal120

Jhajjar114

Karnal104

Hisar98

Ambala93

Panipat78

Nuh68

Bhiwani60

Rewari56

Kurukshetra55

Sirsa50

Kaithal48

Mahendragarh47

CharkiDadri43

Panchkula39

Fatehabad38

Jind38

Yamunanagar19

4,47,754 11,931

84,129 4,663

3,59,699 7,184

3,926 84

DistrictCases

Patna279

Bhagalpur266

Rohtas256

Khagaria253

Begusarai243

Madhubani199

Munger188

Jehanabad178

Katihar175

Darbhanga143

Samastipur139

Siwan139

PurbiChamparan138

Purnia135

Banka134

Buxar134

Nalanda123

Gopalganj123

Nawada122

Sheikhpura118

Gaya115

Kaimur (bhabua)105

Bhojpur103

Saran101

Muzaffarpur96

Saharsa88

Supaul87

Vaishali87

Madhepura82

Kishanganj75

Aurangabad75

Sitamarhi73

Lakhisarai72

Araria68

Pashchim Champaran57

Arwal52

Jamui47

Sheohar20

4,28,001 12,604

94,276 4,615

3,31,418 7,904

2,307 85

DistrictCases

Ganjam581

Jajapur322

Khordha238

Baleshwar190

Kendrapara164

Cuttack155

Bhadrak137

Balangir129

Puri103

Sundargarh102

Jagatsinghapur91

Nayagarh86

Mayurbhanj73

Nuapada69

Gajapati61

Dhenkanal36

Boudh34

Kendujhar34

Deogarh33

Kalahandi33

Sonepur29

Kandhamal28

Anugul26

Malkangiri20

Bargarh16

Koraput16

Sambalpur16

Jharsuguda8

Nabarangpur2

Rayagada2

4,20,129 6,073

46,922 1,974

3,71,200 4,089

2,007 10

DistrictCases

Hyderabad2,475

Ranga Reddy183

Suryapet87

Jagitial77

Nizamabad76

MedchalMalkajgiri75

Mancherial43

YadadriBhuvanagiri40

Jogulamba Gadwal40

Vikarabad40

Nalgonda33

Warangal Urban32

Mahabubnagar30

Sangareddy26

Khammam26

Adilabad22

Nirmal21

Karimnagar17

RajannaSircilla16

Medak11

Kamareddy11

Mahabubabad10

Jayashankar Bhupalapally9

Nagarkurnool8

Kumuram Bheem Asifabad8

Jangoan8

Siddipet7

Peddapalli5

Bhadradri Kothagudem5

Warangal Rural4

Mulugu3

Narayanpet3

Wanaparthy1

4,19,966 8,061

72,133 2,912

3,45,683 5,093

2,150 56

DistrictCases

Amritsar485

Jalandhar297

Ludhiana293

Tarn Taran163

Gurdaspur154

Hoshiarpur140

S.A.S Nagar137

Patiala132

Sangrur107

Shahid Bhagat Singh Nagar (Nawanshahr)99

Pathankot86

Rupnagar (Ropar)74

Faridkot74

Sri Muktsar Sahib71

Moga65

Bathinda60

Fatehgarh Sahib57

Fazilka53

Firozepur50

Kapurthala44

Mansa31

Barnala25

3,51,282 5,916

51,936 2,042

2,90,716 3,774

8,630 100

DistrictCases

Kamrup Metro276

Golaghat203

Nagaon143

Hojai89

Dima Hasao86

Karimganj85

Tinsukia84

Cachar80

Dibrugarh61

Hailakandi57

Lakhimpur57

Marigaon50

Dhemaji47

Kamrup42

Kokrajhar37

Dhubri30

Charaideo29

Barpeta28

Udalguri28

Sonitpur27

Jorhat24

Nalbari23

Darrang20

Sivasagar20

Goalpara19

Biswanath16

Baksa14

KarbiAnglong13

Bongaigaon12

Chirang6

West KarbiAnglong5

South SalmaraMancachar4

Majuli2

2,43,802 3,132

21,270 2,159

2,21,299 955

1,233 18

DistrictCases

East Singhbum170

Ranchi148

Hazaribagh110

Garhwa80

Ramgarh75

Koderma58

Simdega48

Dhanbad32

Gumla28

Palamu27

West Singhbhum21

SaraikelaKharsawan20

Giridih19

Bokaro16

Latehar14

Khunti10

Lohardaga8

Deoghar5

Dumka5

Pakur4

Jamtara2

Godda2

Chatra1

Sahebganj0

2,13,414 6,126

51,252 1,748

1,59,916 4,247

2,246 131

DistrictCases

Anantnag395

Srinagar300

Kulgam295

Baramulla271

Shopian255

Kupwara231

Bandipora175

Udhampur155

Ramban151

Jammu138

Budgam110

Pulwama108

Kathua53

Rajouri39

Ganderbal37

Poonch35

Doda27

Reasi26

Samba25

Kishtwar10

Mirpur0

Muzaffarabad0

1,66,054 3,164

22,283 1,682

1,41,574 1,457

2,197 25

DistrictCases

Dehradun370

Nainital323

Tehri Garhwal110

Haridwar94

Udam Singh Nagar83

Almora71

Champawat45

Pithoragarh43

Chamoli36

PauriGarhwal36

Bageshwar31

Rudraprayag30

Uttar Kashi24

1,62,562 5,703

43,032 4,001

1,17,221 1,606

2,309 96

DistrictCases

Hamirpur117

Kangra105

Una41

Solan32

Chamba29

Bilaspur21

Mandi21

Sirmaur11

Shimla10

Kullu4

Kinnaur2

Lahaul And Spiti0

91,350 2,157

15,151 825

74,812 1,308

1,387 24

DistrictCases

South Goa69

North Goa57

81,908 2,110

16,591 1,331

64,231 748

1,086 31

DistrictCases

Pondicherry111

Mahe4

Karaikal2

Yanam0

55,047 1,021

7,828 318

46,448 690

771 13

DistrictCases

Chandigarh313

40,350 837

5,980 405

33,924 426

446 6

DistrictCases

Dhalai196

Sepahijala174

Gomati74

South Tripura53

Unakoti49

West Tripura45

Khowai24

North Tripura14

34,862 124

917 87

33,549 35

396 2

DistrictCases

Churachandpur32

Kangpokpi26

Imphal West21

Thoubal18

Imphal East10

Tengnoupal9

Bishnupur7

Senapati6

Chandel5

Kamjong5

Ukhrul4

Jiribam3

Pherzawl3

Kakching2

Tamenglong2

Noney1

30,742 175

1,032 122

29,317 50

393 3

DistrictCases

Changlang31

Papum Pare8

Lohit3

Namsai2

West Siang1

East Siang1

Upper Siang1

Tawang1

PakkeKessang1

West Kameng0

Upper Subansiri0

Tirap0

Siang0

Shi Yomi0

Anjaw0

Lower Subansiri0

Lower Dibang Valley0

Longding0

Leparada0

KurungKumey0

KraDaadi0

Kamle0

East Kameng0

Dibang Valley0

Lower Siang0

17,898 123

819 95

17,021 28

58

DistrictCases

East Khasi Hills22

West Garo Hills5

South West Garo Hills4

North Garo Hills1

West Jaintia Hills1

West Khasi Hills1

East Garo Hills0

East Jaintia Hills0

Ribhoi0

South Garo Hills0

South West Khasi Hills0

16,271 147

1,456 53

14,650 90

165 4

DistrictCases

Kargil77

LehLadakh43

13,642 140

1,703 154

11,800 293

139 1

DistrictCases

Dimapur20

Mon8

Kohima7

Kiphire3

Tuensang3

Peren2

Phek1

Longleng0

Mokokchung0

Wokha0

Zunheboto0

13,445 207

874 147

12,472 59

99 1

DistrictCases

East District3

South District3

North District0

West District0

7,426 97

982 54

6,302 41

142 2

DistrictCases

Dadra And Nagar Haveli20

6,912 186

2,025 3

4,883 183

4

DistrictCases

South Andamans33

Nicobars1

North And Middle Andaman1

5,764 48

136 6

5,562 42

66

DistrictCases

Kolasib11

Aizawl10

Mamit8

Lawngtlai2

Lunglei2

Saitual1

Champhai0

Hnahthial0

Khawzawl0

Saiha0

Serchhip0

5,742 229

986 217

4,743 12

13

DistrictCases

Lakshadweep District0

2,401 154

1,202 23

1,198 131

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