A recent survey by the Centre for Economic Performance at the London School of Economics shows that half of the urban workers earned nothing in April-May 2020 during the nationwide lockdown. Many public services, including routine health services, were also disrupted due to the immediate fear of spreading coronavirus. The Health Management Information System (HMIS) of the Indian government also presents enough data to suffice the claims of massive disruption to health services. But an interesting pattern can be seen in the uneven distribution of this irregularity between states. This means that even though the collapse of health services across the country was inevitable, it only happened to an extent the state government allowed it to happen.
Understanding the HMIS Data
The HMIS data is collected monthly from healthcare centres across the country. There are many indicators included like outpatient attendance, deliveries, immunization, antenatal care, surgeries, TB treatment and other health services. An in-house study of the report by The Wire noted this huge disparity in the records of different states. They chose eight basic healthcare services as indicators:
- Number of pregnant women registered for antenatal care (ANC)
- Institutional deliveries
- Child immunisation (BCG)
- Number of patients registered for DOTS
- Treatment of outpatient diabetics
- Out-patient attendance
- In-patient headcount at midnight
- Major operations
How are The Trends for Different States?
For each basic service, they considered two indicators of resilience during the lockdown, and all the parameters showed a drastic decline in the health services, ranging from 20% to 60% in cases of in-patient headcount and major operations. Out-patient attendance also decreased by 50% during the lockdown. After a detailed study of all parameters by the team of The Wire, they found that the top five states in terms of health service resilience include three states that are known to have good social and health services like, Kerala, Tamil Nadu and Himachal Pradesh.
With consistent efforts to provide for health and nutrition, Odisha and Telangana are in the top-five, while the latter is the topper too. The bottom three states are Bihar, Jharkhand, and Uttar Pradesh, which are already known for their disrupted public services. The healthcare services have completely collapsed in these states, with a 70% decline in UP and a 50% decline in the other two.
A Sharp Distinction in the Healthcare Services of the Country
The sole reason behind this sharp contrast is the usual “leaders and laggards” of the social policy highlights. The states with a better commitment to welfare and capacity of handling responsibility have handled the coronavirus pandemic better than the states that are known for their bad management. The irresponsible states made little effort to sustain the basic healthcare infrastructure. Bihar, UP, and Jharkhand are also some of the poorest states of India, which further contributed to the disruption of these services. But even Odisha and Chattisgarh are among the poor states, still, they managed and contained the system perfectly and even came in the top charts of health management. Another instance of comparison is between Kerala, which had institutional deliveries close to a normal level even in the lockdown, but in Bihar, the number crashed by 47% in comparison to the January-February 2020 data.
The Policy Times Suggestions
- We can only hope that there was a rapid recovery in the routine health services after the lockdown has been removed in most states.
- People are waiting for the HMIS data for recent months to have a clearer picture of the recent scenario.
- Even if the disruption was for a short time, we should remember that it resulted in lasting damage for a lot of people who needed urgent care, especially in the cases of terminal diseases.