key: cord-0068286-jp0cybr3
authors: Kharya, Pradip; Rath, Rama S.; Joshi, Hari S.; Dixit, Anand M.; Koparkar, Anil R.
title: Investment on primary health care: Need of the hour
date: 2021-08-27
journal: J Family Med Prim Care
DOI: 10.4103/jfmpc.jfmpc_758_21
sha: 72deeb2973c19a6867bb0629636de4f8d787cfb0
doc_id: 68286
cord_uid: jp0cybr3

nan

The first case of COVID-19 (20-year-old female having a history of travel to Wuhan) in India was diagnosed in January 30, 2020, [3] and after that, India has reported 14,526,609 cases and 175,649 deaths from the novel coronavirus as of April 15, 2021. [2] The coronavirus disease is an unprecedented pandemic, and so far, it has been transmitted to every county, precisely saying every corner of the world, which has led to millions of lives being affected and thousands of people dying every day across the world. Decisions made in the current time on health policy and resource allocation in response to the novel COVID-19 outbreak will shape our world for years to come. As countries enact emergency measures to meet the immediate needs of communities and health workers, it is also critical to diagnose and fix broader gaps in health systems as well.

We know that the new variant of Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) in various countries including India causes a surge of COVID-19. After various modeling exercises, it was estimated that the new variant is 70% more transmissible than the previously circulating form of the virus. [4] Various states of India have started the night and weekly lockdowns and other restrictions to stop the wave of virus, especially in the Maharashtra state due to the high number of emerging cases. [5] The Government of India has already started COVID vaccine administration, [6] but still, our preventive strategies should focus on stopping the transmission of the new strain. So, this is the best opportunity to utilize the primary health care system to stop one more wave in India.

In India, for the detection of coronavirus, people either come to tertiary health facilities like medical colleges or they visit district hospitals, where, after a detailed history of symptoms or travel history and examination, samples are collected and transported to the designated laboratory. In both cases, the person has to travel large distances as most of the population is living in rural areas, and if infected, there is a high chance of the risk of transmission among the public and health care providers. Since the identification, isolation, and treatment of COVID-19-infected people in any country has so far been mainly dependent on the services of tertiary or secondary care health services, therefore, here, primary health care plays an important role to minimize these risks.

Primary health care can play a particularly crucial role to overcome the problem of COVID-19 and other infectious diseases in low-and middle-income countries especially in sub-Saharan African countries and Southeast Asian countries where residents may have limited availability of health care resources and inadequate access to health facility and specialized care. Primary health care, which can meet more than two-thirds of the people's health needs at every age and time, must be central to these efforts. Now, strengthening the primary health care services will not only reduce the impact of COVID-19 on the health and well-being of millions of people and the financial system, but also limit susceptibility to the next pandemic attack, and one day, we can ensure the world fulfill the promise of health for all. Overall, strong primary health care systems are paramount to our future global health security, well-being, protecting people from impending waves of COVID-19, and other communicable disease threats.

Strong and systematic primary health care services in response to the COVID-19 outbreak will shape our world for years to come and will make sure service provision and quality of health care workers. Primary care can play a significant role in the COVID-19 screening by differentiating patients with respiratory symptoms or other flu-like symptoms from those with COVID-19, making an early diagnosis, and reducing the demand for hospital services. Therefore, effective and safe supportive management of patients with suspected and confirmed COVID-19 at the primary care level and delivery of essential health services at the primary care level during the COVID-19 outbreak will be the most important pillar to mitigate COVID-19 problems.

They need to provide people affordable, accessible, and high-quality services as depicted in Figure 1 , and therefore, by committing to prioritizing primary health care globally, countries and global stakeholders can shape a future where every person has access to the care they need, in any circumstance, anytime, and without any financial burden.

Appropriate primary health care is essential to break the chain of transmission of the novel corona disease. It will contribute Letter to Editor to the attainment of other goals like a decrease in morbidity and mortality. Addressing increasing health needs calls for a multi-sectoral approach that integrates rapid testing, better contact tracing, provision of treatment and referral, and strict adherence to isolation and home quarantine. Overall, this process requires long-term behavior change in communication. Mental health redressal can be done at the earliest level and social stigma can be minimized with timely intervention and raising awareness in the community. Development of human resources for contact tracing, testing, and patient care through capacity building will be the most important activity.

In India, approximately 66% of the population is living in rural area. The health system of rural India consists of a subcenter as well as primary, and community health centers. We should always try to start our activities from the rural centers to overcome the outbreak/epidemic situation then the impact of preventive strategies will be more and also faster.

Overall, the appropriate level of primary care will make the communities aware of social distancing, covering of the nose and mouth, and proper hand hygiene through Information, Education and Communication (IEC). It will mobilize the community for testing, better contact tracing, importance of home quarantine and isolation, etc.

Nil.

The novel coronavirus outbreak in Wuhan

First confirmed case of COVID-19 infection in India: A case report

New variant of SARS-CoV-2 in UK causes surge of COVID-19

The Hindu. 2021. Available from