Since February 2020, Manipur had started Covid-19 control activity in the form of screening at the ports of entry. By March 2020, Manipur had encountered its first patient of Covid-19. Since then, the State has carried out various activities to control the pandemic with palpable results and hiccups. The single overarching objective of the control activities of the present pandemic is to limit the number of deaths – both from Covid-19 as well as other health conditions. However, the vision of the control activities seems to be tubular in nature. It sees only the deaths from Covid-19, which needs rethinking.
The state has witnessed a major disruption in providing the other essential health care services, especially in the public hospitals for the past few months. The Government Guidance document defines essential services to include, for all areas, reproductive, maternal, new-born and child health, prevention and management of communicable diseases, treatment for chronic diseases to avoid complications, and addressing emergencies. The PULSE Survey conducted by WHO has reported a disruption to other health care services by 5-50% in majority of the countries surveyed, mostly in low income countries. Though majority of the countries have identified packages of essential health care services during the pandemic times, there were problems in provision or receiving care all over the world. From the supply side, there was cancellation of services (66%) as per the survey. Interestingly, the private players are doing better in this front.
The consequences of disruptions in providing Non-Covid essential health care services during this pandemic could be disastrous and can be seen even after the pandemic is subdued and stabilized. Just to cite as an example, there were allegedly 4 deaths from malaria and 2 deaths from scrub typhus during the pandemic in the State. We may see excess deaths over and above the Covid-19 pandemic deaths, outbreak of vaccine preventable diseases, increased deaths from non-communicable diseases, etc. in the coming days. WHO and Ministry of Health and Family Welfare, Government of India have issued guidelines for continuing delivery of health care services during the pandemic. Even the State has also released a framework for the health care set-up to ensure provision of other essential health care services. Now is the time for the State to give a little more interest and push ahead with a clear actionable plan to ensure essential health care services are provided all over the state apart from the e-consultations. This endeavor will give good dividends later and will help in realizing the overarching goal of pandemic control in general.
The writer is Professor of Community Medicine and Dean of Academics, Regional Institute of Medical Sciences