Rural Areas & Second Wave

HEALTH/ GOVERNANCE

Topic:

• GS-2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation. 

Rural Areas & Second Wave

Context: The big cities battered by Covid-19 are now showing early signs of recovery from the second wave. There is growing concern now about smaller towns and rural areas where the virus has made inroads.

During the first wave, the virus did not have easy passage into rural areas. This was because

• Travel restrictions, prescribed or voluntary, prevailed even after the lockdown was lifted. 
• Large gatherings were mostly avoided. 
• Even where the virus entered, it had slow transmission as villages have lower population density than urban areas — people live in relatively ventilated houses and work in open fields. 
• Because co-morbidities like hypertension, diabetes and cardiovascular disease are lower in rural populations, risk of severe illness and death was also less

However, during the second wave, complacency about the seriousness of COVID-19 and emergence of new strains created havoc in rural areas.

India suffered during second wave due to frail health systems in rural areas

• Inadequate health infrastructure
• Lack of trained health workforce
• Poor availability of drugs and other medical supplies, 
• Poor connectivity to higher levels of care are deficient in many districts.

What measures is needed to tackle second wave in rural areas?

• Household visits by frontline health workers for symptom surveillance and case detection.
• Engagement of the local community is vital. Where available, NSS and NCC resources can be drawn upon. Community-based organisations, which have grassroots presence, can assist in the delivery of health and social services.
• Home care support and monitoring.
• Emergency transport systems that can transfer seriously ill patients to pre-determined points of advanced care and mobile laboratories must be organised with assurance of availability, affordability and equity.
• Other than for essential needs, commuting between urban and rural areas must be restricted to reduce the risk of transmission. 
• Large gatherings must be prohibited for at least six months.
• Decentralised, data-driven decision making 
  • Essential data must be readily available locally at the block level for real-time alerts and rapid response. 
  • Expanded data sets can be analysed at the district level for monitoring and supportive supervision. 
  • More elaborate (optimal) data sets can flow to the state capital level for course corrections and resource allocation.
  • At the local level, qualitative information from key informant interviews must supplement quantitative data to help in identifying roadblocks and solutions.