The rural health centres along with grassroot level workers are going to play a crucial role in curbing the second wave of Covid-19 in the Indian villages (Pic: Courtesy oxfamindia.org)
India has stepped up its drive to defeat the second Covid wave in the villages, by issuing detailed health protocols and earmarking personnel who will implement the plan.
The focus of the initiative will be containment of the Covid-19 in the semi-urban, rural and tribal areas. The rising incidents of Black Fungus which is specially targeting diabetics will also be addressed.
Detailing the steps during a video conference on Sunday with States and Union Territories, Health Secretary Rajesh Bhushan along with Member (Health), NITI Aayog Dr. Vinod K. Paul, and several top doctors, the States were asked to sensitise the ground workers, particularly the Medical Officers and the block level nodal officers on containment, surveillance and Rapid Antigen Test for screening. The use of RT-PCR, teleconsultation and important elements of the SOPs issued by the Union Health Ministry were also detailed.
The states were explained the importance of the RAT and the necessity of large-scale screening and quick identification of the Covid infection among the communities. The states were also advised to screen people for diabetes and other comorbidities.
State Health Secretaries were told to hold daily regular review meetings with the Medical Officers and the block levels nodal officers to ensure that the SOPs and the advisories have reached the grassroots level.
To make the personnel on the ground level aware of the Covid-19 and its protocols, States were asked to organise a series of meetings for sensitisation of the ASHAs, ANMs, Panchayati Raj institutions along with the Community Health Officers (CHO). The need to train to identify the early signs of SARI/ILI and COVID symptoms as also advised.
Dr Randeep Guleria, head of AIIMS who was also present highlighted the importance and need for infection control protocols. He cautioned that with the spread of Covid in the rural hinterland, donning and doffing protocols were not being strictly followed which could infect the healthcare workers deployed. Stressing the adherence to protocol for donning and doffing areas for PPE kits, he advised the State health administrators for triaging of critical cases to reduce mortality.
While throwing light on the Covid complications being reported from many States, he advised States to curb the excessive use of steroids. Steroids are to be administered only to those hypoxic; in low doses; not beyond 10 days at a stretch.
On the issue of treatment of Black Fungus or Mucor-mycosis which involves ophthalmologists, neuro-surgeons and other specialized branches of medicine, he advised that prevention is more important than treatment when it comes to such complex infections.
It was suggested that in coordination with Ministries like Rural Development and Panchayati Raj meetings should be organised with women Self Help Groups (SHGs). This was with the aim to utilise their services for dissemination of Covid appropriate behaviours and for behaviour change communication to enhance awareness about Covid symptoms and prevention measures.
The services of both the village health and sanitation committee are to be used as first responders.
The meeting highlighted the importance of ensuring community-based services and PHC services to manage the situation. At length the mechanism for surveillance, screening, isolation and referral of cases from such areas, monitoring of home Isolation cases and providing them with information pamphlets, ramping up of facilities in all the three subsequent levels of COVID-19 Healthcare; CCCs, DCHCs and DCHs was discussed.
Training of volunteers using IGOT Diksha portal module and risk communication using IEC campaigns was also stressed. The States were exhorted to share their best practices, and leverage their existing capacity in tele-consultation. Mental health support was also highlighted.
The changes in the CoWIN platform were notified to the States/UTs. States were urged to break the myth that the CoWIN platform is biased to those abled by technology and requested them to make good use of facilitated cohort registration.
It was also suggested using ASHA workers and ANMs to mobilise eligible population groups on pre-publicised date and time to enable them to facilitate the vaccination of such groups by proactively bringing them to the vaccination centres, registering them as on-site registration and then ensuring their vaccination.
Similarly, it was advised that the other means of facilitating vaccination of eligible population groups in rural areas is through block Medical Officers and through the Common Service Centres where such groups can be helped to get registered and to book appointments.
The States were informed that the SoPs had been uploaded on the website of the Union Health Ministry on the Containment and Management of Spread in Peri-urban, Rural and Tribal Areas.