Combating the COVID-19 pandemic in a resource-constrained setting: insights from initial response in India

Abstract

The low-and-middle-income country (LMIC) context is volatile, uncertain and resource-constrained. India, an LMIC, has put up a complex response to the COVID-19 pandemic. Using an analytic approach, we have described India’s response to combat the pandemic during the initial months (from 17 January to 20 April 2020). India issued travel advisories and implemented graded international border controls between January and March 2020. By early March, cases started to surge. States scaled up movement restrictions. On 25 March, India went into a nationwide lockdown to ramp up preparedness. The lockdown uncovered contextual vulnerabilities and stimulated countermeasures. India leveraged existing legal frameworks, institutional mechanisms and administrative provisions to respond to the pandemic. Nevertheless, the cross-sectoral impact of the initial combat was intense and is potentially long-lasting. The country could have further benefited from evidence-based policy and planning attuned to local needs and vulnerabilities. Experience from India offers insights to nations, especially LMICs, on the need to have contextualised pandemic response plans.

Small and sick newborn care during the COVID-19 pandemic: global survey and thematic analysis of healthcare providers’ voices and experiences

“…These results underline the additional stressors of a pandemic overlaid on already overstretched health systems, especially in Africa and South Asia. 16 Even 9 months into the pandemic, with the world facing a second wave, testing of pregnant women was reported to be unavailable by more than one in five African respondents. Even when testing was available, the lag between testing and results delayed or impacted safe clinical management.…”

“…Delays in seeking or reaching care may be caused by fear of acquiring infection in hospitals and/or logistical effects of lockdown policies, such as curfews and transport restrictions. 16 Pre-existing societal barriers also compound care-seeking for small and sick newborns and women with complications. Fatalism regarding newborns, BMJ Global Health especially those who are born preterm, is common in many cultures.…”

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