Access to Care in this Pandemic Part 2
Our last feature, published on June 9, 2021, was ‘Access to Care in this Pandemic Part 1’. We promised that in our next feature, which is the second part of our previous feature, we will discuss some strategies that could help the region in supporting NCD patients in this pandemic and thereby not further contribute to the rising rates of NCDs. Let us see how innovation and robustness in our healthcare strategies can make things better.
Owopetu et al. (2021, p. 2) emphasizes on the provision of modular healthcare which has the capacity to withstand short-term/long-term blows like COVID 19 and does not overwhelm the healthcare service delivery system (WHO, 2020). In modular healthcare the focus continues to remain on patients, and vulnerable populations such as NCD patients continues to receive the healthcare service that they routinely require (Owopetu et al. 2021, p. 2). Proper restructuring in strategies is required to ensure high-quality essential health services for all (WHO, 2020). When we say essential services, we are talking about everything essential starting from critical inpatient therapies to management of emergency health conditions to auxiliary services like basic diagnostic imaging, laboratory services, and blood bank services to routine vaccination to reproductive health services (pregnancy and childbirth) to care of young infants and older adults to diagnosis of mental health conditions as well as NCDs and infectious diseases (WHO, 2020). In our case, we are most importantly talking about essential healthcare services of NCD patients.
To ensure the essential healthcare services that are required for NCD patients to maintain a continuous support in this pandemic is to ensure the provision of technology (Owopetu et al. 2021, p. 2, 3). Technology that is cheap and accessible by all and using that technology tele-consultation, telemonitoring and tele-pharmacy can be harnessed (Owopetu et al. 2021, p. 2, 3). In this pandemic, telemedicine is indeed the best option as it reduces the human-to-human physical contact. The pandemic has restricted our mobility but has not reduced or eliminated our stress and diseases like NCDs and mental disorder that require continuous medical support. Telemedicine is what could continue the constant support that is required by NCD patients as these diseases also does not always require a physical visit to the doctor. Telemedicine in this pandemic is not only saving the NCD patients but is also helping people to reduce human-to-human contact which is necessary in this pandemic. Telemedicine can reduce burden over the already stressed-out healthcare system and at the same time improving access to care for all NCD patients and others who can benefit from these remote medical services (Chauhan et al, 2020, p. 20, 21). Also, another benefit of telemedicine is that it provides direct consultation to the patients utilising the medium of both audio and video. This is easy to reach patients and it also reduces consultation avoidance and dropout rates (Kamel, 2020, p. 124).
Another aspect to be considered is to adopt the supply infrastructure of products such as bottled water and soda. Areas where these products are already reaching vulnerable and hard-to-reach populations of Sub-Saharan African countries, that infrastructure can be harnessed and adapted to utilise that supply chain to supply services such as mobile clinics, essential medications, and home testing kits (Owopetu et al. 2021, p. 3). The strategic positioning of Coca-Cola in their global marketing operation and how they supply their products in the hard-to-reach areas can be studied and adapted to be utilised in case of developing a supply chain to supply medical services in hard-to-reach areas of Sub-Saharan countries, especially in this pandemic (Vrontis & Sharp, 2003).
Another innovative approach that can be utilised is shifting of tasks from expert healthcare workers to not so expert healthcare workers. In this way, the burden on the system would be less as expertise to high level is not required in areas such as essential services and also in services such as risk communication, health education, and non-complex procedures. This is beneficial for countries and regions like Sub-Saharan African countries where there is shortage of high-skilled healthcare workers (Owopetu et al. 2021, p. 3). Task shifting improves access to healthcare for NCDs and it is both an effective and affordable strategy for areas where there is lack of resources or during an emergency or where healthcare delivery system is overburdened and access to care is limited. This strategy requires restructuring of healthcare system where task shifting occurs when non-physician healthcare workers (NPHWs) are trained to perform medical services which are generally provided by physicians (Joshi et al. 2014). This would reduce the burden from the already stressed-out healthcare system and would also bridge the gap of shortage of expert healthcare workers.
Therefore, the innovation and robustness required in restructuring the healthcare system suggested by experts for countries like Sub-Saharan African countries is a must especially when the world has been now hit by a pandemic. The necessity of this strategical leap is further recommended for NCDs as NCDs (cardiovascular disease, chronic respiratory disease, cancer, diabetes, and mental health) globally will lead to economic losses of about US$ 47 trillion over the next two decades. It is also known that middle income countries are to bear the brunt of these economic losses more than the developed countries. If these economic losses can be reversed than middle income countries and low-income countries like Sub-Saharan African countries could use that money in eradicating poverty (Bloom et al. 2011, p. 6). So, why not bring in a little bit of restructuring in the healthcare system with being a little bit more innovative and robust and so what is also required is political will in bringing in these changes (Owopetu et al. 2021, p. 3).
Bloom, D. et al. (2011). The Global Economic Burden of Non-communicable Diseases. World Economic Forum & Harvard School of Public Health. http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf
Chauhan et al. (2020). Novel Coronavirus (COVID-19): leveraging telemedicine to optimize care while minimizing exposures and viral transmission. J Emerg Trauma Shock, 1(13), 20–24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161346/
Joshi, R. et al. (2014). Task shifting for non-communicable disease management in low and middle-income countries–a systematic review. PLoS One, 9 (8).
Kamel, M. (2020). A view of the health services after COVID-19: an Egyptian perspective. Alexandria Journal of Medicine, 56(1), 118-129. https://doi.org/10.1080/20905068.2020.1789391
Owopetu et al. (2021). COVID-19: implications for NCDs and the continuity of care in Sub-Saharan Africa. Global Health Promotion, 1-4. https://doi.org/10.1177/1757975921992693
Vrontis, D., & Sharp, I. (2003). The strategic positioning of Coca-Cola in their global marketing operation. The Marketing Review, 3, 289-309.
World Health Organization. (2020). WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic. https://www.who.int/news/item/30-03-2020-who-releases-guidelines-to-help-countries-maintain-essential-health-services-during-the-covid-19-pandemic
Photo by National Cancer Institute on Unsplash
Photo by Hush Naidoo on Unsplash
About Nusrat Shafiquddin:
After completing her bachelor’s in business administration, Nusrat worked with International Finance Corporation, a sister organization of the World Bank and member of the World Bank Group, which provides investments and advisory services to promote sustainable growth and private sector development in developing countries. Due to her passion to contribute in the society and the interest to work with international development agencies, she pursued master’s in development studies. Afterwards, Nusrat worked with a Washington D.C. based international NGO called International Foundation for Electoral Systems, which works in developing nations promoting better governance and strengthening electoral systems. Nusrat also worked in the Emergency Response and Preparedness unit of United Nation’s humanitarian organization, World Food Programme. Currently, she is pursuing MA in Development Studies with York University, Canada.