Technical Cooperation: COVID-19 measurements under the Indo-German Programme on Universal Health Coverage
The COVID-19 pandemic is straining health systems worldwide. The rapidly increasing demand on health facilities and health care workers threatens to leave some health systems overstretched and unable to operate effectively. The Government of India has set-up a national task force for a coordinated effort to ensure that people are well prepared to face the challenge and threat posed by the growing pandemic of COVID-19. The most important factor in preventing the spread of the virus locally is to empower the citizens with the right information and taking precautions as per the advisories being issued by the Ministry of Health & Family Welfare. The Government of India has also aggressively stepped up the response measures – find, isolate, test, treat and trace, social distancing, travel restrictions and lockdown measures.
The lockdown is likely to be gradually withdrawn in the coming days, and it is expected that regular movements and businesses will continue. Worker’s movement for livelihood and the return of migrant labourers from high risk States are expected at this point, increasing the risk of transmitting infection.
The Indian public health infrastructure tends to vary across States. Those with a weak public health infrastructure and limited capacities were already struggling, even before the onset of the coronavirus pandemic. Even though the Government of India has enabled COVID-19 testing in private laboratories, for the poor and vulnerable population affordability of testing in private laboratories will be a challenge.
The Indo-German Programme on Universal Health Coverage (IGUHC) works with the Ministry of Health & Family Welfare (MoHFW), the National Health Authority (NHA) and with selected State Governments to provide policy advice and implementation support in the areas of Universal Health Coverage (UHC) and convergence of social security programmes.
With regards to the pandemic IGUHC additionally provides Technical Cooperation (TC) support for activities related to COVID-19 testing, awareness raising and preparedness for future pandemics.
On a national level the Ministry of Health & Family Welfare (MoHFW) and the National Health Authority (NHA) are supported in their efforts regarding the coordination and triage of potential COVID-19 patients. This includes general awareness raising but also the support of the national call centres who are first in line as people seek help.
On a state level the Indo-German Programme on Universal Health Coverage (IGUHC) focusses especially on states that additionally deal with stretched health resources and capacities due to the huge numbers of migrant workers returning to their home states. It is estimated that 29% of the population in India’s big cities migrated from other areas within the country and lives on daily wages*. This is the number of people which might be logically wanting to move back to their states during the current crisis. There are no exact numbers on the number of people actually returning but the States need to be prepared. Thus both public and private laboratories in some of the most challenged northern and north-eastern States are backed in their efforts to react quickly and efficiently to mitigate the effects of the crisis.
The purpose of this support is to subsidize the testing cost for poor and vulnerable people who are not covered under any Government sponsored programme. Increasing the number of testing centres by equipping private and public laboratories with the necessary equipment as per the ICMR (Indian Council of Medical Research) guidelines for COVID-19 testing. And additionally, the treating facilities in private and public hospitals will be strengthened with the necessary lifesaving equipment. The engagement will equip the state to be prepared in case of a surge in the number of COVID-19 patient.
The following activities will be carried out as part of this initiative
- A gap analysis in terms of preparedness for COVID 19 testing and treating in selected public / private facilities by the State.
- The support of selected private / public laboratories with necessary equipment to be ready for COVID 19 testing.
- The support of selected private hospitals to be ready for COVID 19 treatment. If required some public hospitals will also be supported.
- A pilot study to partner with private/public laboratories accredited by the National Accreditation Board for Testing & Calibration Laboratories (NABL) and approved by ICMR COVID-19 testing in select districts focussing on their capacity on sample collection, logistics, testing and reporting.
- Capacity development of personnel in these private/public testing laboratories / hospitals
- Information, Education & Communication: Making relevant information available to the wider population through an appropriate medium
- Supporting the State to setup a Project Management Unit (PMU) at the State level to implement the project, engaging domain experts and a team at some selected districts
Based on the success of the pilot, the project would be expanded to other districts. The outcome of this initiative would be to improve the capacity of weaker States to increase COVID 19 testing and treatment; Thus the pilot will be showcased as a sustainable model for cooperation in cutting down the cost of healthcare delivery through collective bargain that may be followed by other States.
* study by the Centre for the Study of Developing Societies (CSDS) and Azim Premji University in 2019