Environmental Disease

SHORT COMMUNICATION
Year
: 2022  |  Volume : 7  |  Issue : 2  |  Page : 57--60

Sustaining essential health services for maternal, newborn, child, adolescent, and elderly people amid the ongoing coronavirus disease-2019 pandemic


Saurabh RamBihariLal Shrivastava1, Prateek Saurabh Shrivastava2,  
1 Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India

Abstract

The ongoing coronavirus disease-2019 (COVID-19) pandemic continues to disrupt the health-care services, including the essential ones, even after the detection of the novel viral infection 2 years back. The population group comprising mothers, antenatal women, newborns, children, adolescents, and elderly people is a vulnerable one. The COVID-19 pandemic has significantly accounted for the disruption of services targeting the above population groups, especially in low- and middle-income nations. COVID-19 pandemic has resulted in a wide range of problems targeting the above population groups, which has indirectly impacted the delivery of care and services. There arises the need to take specific measures to reduce the impact of the potential problems that have emerged. To conclude, the COVID-19 pandemic has resulted in significant interruptions in the health-care services aimed for the welfare of mothers, antenatal women, newborns, children, adolescents, and elderly people. However, as these are vital population groups, we have to adopt a multisectoral approach involving different stakeholders and move forward toward improving the reach of health-care services.



How to cite this article:
Shrivastava SR, Shrivastava PS. Sustaining essential health services for maternal, newborn, child, adolescent, and elderly people amid the ongoing coronavirus disease-2019 pandemic.Environ Dis 2022;7:57-60


How to cite this URL:
Shrivastava SR, Shrivastava PS. Sustaining essential health services for maternal, newborn, child, adolescent, and elderly people amid the ongoing coronavirus disease-2019 pandemic. Environ Dis [serial online] 2022 [cited 2022 Aug 12 ];7:57-60
Available from: http://www.environmentmed.org/text.asp?2022/7/2/57/349542


Full Text



 Introduction



The ongoing coronavirus disease-2019 (COVID-19) pandemic continues to disrupt the health-care services, including the essential ones, even after the detection of the novel viral infection 2 years back.[1] This is predominantly because of the rising caseload, the ability of the disease to overwhelm the infection, and the emergence of new variants of the causative virus making it extremely difficult and challenging for the public health authorities.[2] In fact, the available global estimates depict that as of March 15, 2022, a cumulative total of 455 million cases and more than 6 million deaths have been attributed to the infection.[2] These are alarming estimates for any disease, especially considering that effective vaccines have been launched for more than a year now.

 Coronavirus Disease-2019 and The Vulnerable Population Groups



The population group comprising mothers, antenatal women, newborns, children, adolescents, and elderly people is a vulnerable one.[1],[3],[4],[5] With reference to antenatal women, there has been a significant cause of concern pertaining to the risk of vertical transmission of the COVID-19 infection to the newborn, and that has emerged as an important reason to cause fear and anxiety.[6],[7] The newborns are found to be extremely susceptible to acquire the infection once the parents acquire the infection, as they are pretty much dependent on them for their survival.[8],[9] In most of the nations, the available vaccines have not been recommended for use among children and adolescents, and thus these population groups remain extremely susceptible to acquire the infection, especially now as the decisions have been taken to initiate offline schooling.[10],[11] The adolescent population groups have also been subjected to impairment of their mental health and multiple psychological disturbances owing to the ongoing pandemic.[12],[13] The vulnerability of the elderly population group has been known since the early stages of the emergence of the infection owing to the simultaneous presence of coexisting morbidities, which have been found to have a direct impact on the prognosis and survival.[14],[15]

 Coronavirus Disease-2019 and The Problems in Maternal and Child Health



The COVID-19 pandemic has significantly accounted for the disruption of services targeting the above population groups, especially in low-and middle-income nations, which simultaneously have to deal with many competing priorities.[16] COVID-19 pandemic has resulted in a wide range of problems targeting the above population groups, which has indirectly impacted the delivery of care and services.[1],[3] The first and foremost problem has been a decrease in the care provided to the beneficiaries, which has in turn resulted because of a temporary interruption in services, leaves availed by the health care staff, interruption in the supply chain, and because of the sense of fear among the health workers about acquiring the infection and developing complications, including a fatal outcome.[5],[16],[17]

At the same time, a significant reduction in the demand for health-care services has also been reported. This has resulted because people are not willing to avail care due to a lack of trust or the fear that if they visit the health facilities, they might acquire the infection.[16] As a matter of fact, in some of the settings even contrasting trends in terms of rising need for health care has also been reported and this is because of the presence of multiple other infectious and noncommunicable diseases have also kept the health care systems engaged.[18] Furthermore, the issues of mental disorders, insecurity, gender-based violence, population displacement, malnutrition, etc., have also continued as public health priorities, thereby impacting the quality of care required for mothers, antenatal women, newborns, children, adolescents, and elderly people.[17],[18],[19],[20],[21],[22] Moreover, the concerns pertaining to the similar clinical presentation of other illnesses (such as malaria and Ebola virus disease) also make it difficult for the health sector.

 Strategies to Minimize the Impact of Problems



We must realize that most of the above-identified problems have resulted because of the public health and social measures that are planned and implemented to reduce the transmission of the infection.[3] Further, the reduction in the coverage of essential maternal and child health services will account for the additional number of maternal and child deaths.[3] There arises the need to take specific measures to reduce the impact of the potential problems that have emerged.[6],[7],[8] The first and foremost intervention is to improve access to health-care services or explore substitutes, to ensure that health-care services are closer to the general population.[5],[16] This can be accomplished by providing mental health care (through schools or psychological first aid), abortion care through referral centers, general health through mobile clinics, nutrition services to newborns through breastfeeding tents, transportation services through a network of ambulance systems, and minimizing financial load by providing cash transfer, through the removal of user fees, or through copayment.[5],[6],[7],[8],[10],[12],[13],[16],[17],[19]

The next intervention is to maintain and strengthen the available health workforce to meet the potential health-care needs.[6],[7] This can be attained by organizing regular training for all levels of health care workers (such as doctors, nurses, midwives, general practitioners, and specialists). In addition, measures to improve access of health professionals for mental health counseling, periodic group briefings to keep them informed, motivating health professionals, ensuring their safety, and providing incentives and adequate personal protective equipment to them, are also expected to improve the existing scenario.[6],[7],[16],[17],[18],[19],[20] The next area is to ensure collaboration between different health-care services, institutions, and health professionals, and this can be attained by designing an appropriate protocol for the same or by establishing liaison with the local partners.[3],[20]

We must understand that all the planned approach will not fit universally, and they have to be customized as per the local settings. This means that we have to implement strategies in a gender-sensitive and age-sensitive manner and also design culturally-acceptable messages for the benefit of the community.[16] Another approach will be to employ social sciences to enhance understanding about the local context and thus enable better planning and implementation of the services.[16] The general rule to ensure sustainability for any kind of interventions is that we have to rope in the stakeholders and the local community. This essentially means that we should involve schools and community health workers for the necessary push to the health actions. In addition, traditional healers can also be employed for supporting the prevention, screening, and referral services.[16],[20],[21],[22]

In the era of information technology and considering the fact that the COVID-19 pandemic spreads by close contact, the ideal approach to remove the existing barriers will be through the employment of digital health interventions. This can be translated into clinical practice through the adoption of telemedicine services (such as teleradiology and web-based mental health counseling), portable ultrasound, use of mobile-based applications, and initiation of online programs for the management of different psychiatric illnesses.[6],[11] Finally, we have to ensure access to essential supplies and products (such as drugs and vaccines), and this will essentially require optimal allocation of resources and mass media campaigns to continue the practice of blood donation. In addition, we have to ensure the availability of cold boxes for the transportation of vaccines, vaccine vial monitor to check for the potency of vaccines, and distribute contraceptives to all those who are in need of the same.[3],[4],[5]

 Conclusion



The COVID-19 pandemic has resulted in significant interruptions in the health-care services aimed for the welfare of mothers, antenatal women, newborns, children, adolescents, and elderly people. However, as these are vital population groups, we have to adopt a multisectoral approach involving different stakeholders and move forward toward improving the reach of health-care services.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Legro RS. The COVID-19 pandemic and reproductive health. Fertil Steril 2021;115:811-2.
2World Health Organization. Weekly Epidemiological Update on COVID-19 – 15 March, 2022; 2022. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---15-march-2022. [Last accessed on 2022 Mar 22].
3Sharma P, Sharma S, Singh N. COVID-19: Endangering women's mental and reproductive health. Indian J Public Health 2020;64:S251-2.
4Ferreira-Filho ES, de Melo NR, Sorpreso IC, Bahamondes L, Simões RD, Soares-Júnior JM, et al. Contraception and reproductive planning during the COVID-19 pandemic. Expert Rev Clin Pharmacol 2020;13:615-22.
5Di Toro F, Gjoka M, Di Lorenzo G, De Santo D, De Seta F, Maso G, et al. Impact of COVID-19 on maternal and neonatal outcomes: A systematic review and meta-analysis. Clin Microbiol Infect 2021;27:36-46.
6Karimi-Zarchi M, Neamatzadeh H, Dastgheib SA, Abbasi H, Mirjalili SR, Behforouz A, et al. Vertical transmission of coronavirus disease 19 (COVID-19) from infected pregnant mothers to neonates: A review. Fetal Pediatr Pathol 2020;39:246-50.
7Bartick MC, Valdés V, Giusti A, Chapin EM, Bhana NB, Hernández-Aguilar MT, et al. Maternal and infant outcomes associated with maternity practices related to COVID-19: The COVID mothers study. Breastfeed Med 2021;16:189-99.
8DiLorenzo MA, O'Connor SK, Ezekwesili C, Sampath S, Zhao M, Yarrington C, et al. COVID-19 guidelines for pregnant women and new mothers: A systematic evidence review. Int J Gynaecol Obstet 2021;153:373-82.
9Tomori C, Gribble K, Palmquist AE, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr 2020;16:e13033.
10Waters AR, Kepka D, Ramsay JM, Mann K, Vaca Lopez PL, Anderson JS, et al. COVID-19 vaccine hesitancy among adolescent and young adult cancer survivors. JNCI Cancer Spectr 2021;5:Pkab049.
11Olusanya OA, Bednarczyk RA, Davis RL, Shaban-Nejad A. Addressing parental vaccine hesitancy and other barriers to childhood/adolescent vaccination uptake during the coronavirus (COVID-19) pandemic. Front Immunol 2021;12:663074.
12Magson NR, Freeman JY, Rapee RM, Richardson CE, Oar EL, Fardouly J. Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic. J Youth Adolesc 2021;50:44-57.
13Guessoum SB, Lachal J, Radjack R, Carretier E, Minassian S, Benoit L, et al. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry Res 2020;291:113264.
14Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect 2020;80:e14-8.
15Li T, Zhang Y, Gong C, Wang J, Liu B, Shi L, et al. Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China. Eur J Clin Nutr 2020;74:871-5.
16World Health Organization. Scoping Review of Interventions to Maintain Essential Services for Maternal, Newborn, Child and Adolescent Health and Older People during Disruptive Events. Geneva: WHO Press; 2021. p. 1-28.
17Lindberg LD, Bell DL, Kantor LM. The sexual and reproductive health of adolescents and young adults during the COVID-19 pandemic. Perspect Sex Reprod Health 2020;52:75-9.
18Palmer K, Monaco A, Kivipelto M, Onder G, Maggi S, Michel JP, et al. The potential long-term impact of the COVID-19 outbreak on patients with non-communicable diseases in Europe: Consequences for healthy ageing. Aging Clin Exp Res 2020;32:1189-94.
19Salem D, Katranji F, Bakdash T. COVID-19 infection in pregnant women: Review of maternal and fetal outcomes. Int J Gynaecol Obstet 2021;152:291-8.
20Akseer N, Kandru G, Keats EC, Bhutta ZA. COVID-19 pandemic and mitigation strategies: Implications for maternal and child health and nutrition. Am J Clin Nutr 2020;112:251-6.
21Kotlar B, Gerson E, Petrillo S, Langer A, Tiemeier H. The impact of the COVID-19 pandemic on maternal and perinatal health: A scoping review. Reprod Health 2021;18:10.
22Chmielewska B, Barratt I, Townsend R, Kalafat E, van der Meulen J, Gurol-Urganci I, et al. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: A systematic review and meta-analysis. Lancet Glob Health 2021;9:e759-72.